As the COVID-era demand for plastic surgery and in-office treatments continues to soar — due to a variety of expert-cited factors, from the so-called 'Zoom Effect' to the WFH lifestyle making downtime less disruptive — lip augmentation procedures have never been more popular. But if you’re fearful of fillers, or want a more long-lasting option (as opposed to the three to six months you’ll get with most HA injectables) it might be time to inquire about surgical lip lifts.
"In the past year of compulsory mask-wearing, there has been a dramatic increase in the popularity of lip lifts," New York-based plastic surgeon Dr. Lara Devgan tells TZR. "In part this is because masks camouflage the healing process, but in addition, I think patients are interested in investing in longer-term and more durable, anatomic-based solutions." In fact, the Plastic Surgery Foundation (PSF), which works alongside the American Society of Plastic Surgeons (ASPS), reported a 71% increase in non-injectable lip augmentation since the year 2000.
So how exactly does it enhance your lips? The lip lift procedure surgically shortens the length of the philtrum (i.e., the space between the nose and the upper lip) which in turn causes the upper lip to advance upwards, leaving you with a fuller, more youthful effect. The change is permanent, and therefore eliminates the need for injectable fillers — which means fewer trips to your surgeon or dermatologist’s office. Still, it might seem a tad drastic to undergo an elective surgical procedure (even if it’s under local anesthesia). Curious to learn more? Here’s everything you need to know before committing to a lip lift.
The Lip Lift: Why Choose a Lip Lift?
As Dr. Devgan explains, the lip lift aims to elevate, reshape, and augment the upper lip by reducing this philtral distance and contouring the vermillion border. "By everting the upper lip and allowing the pink, mucosal tissue to present itself more beautifully, a lip lift surgery can reduce or eliminate the need for lip augmentation," she notes.
When you’re younger, you might not give your philtrum a lot of thought, or considered that shortening that space between your nose and upper lip could help enhance your lips. As Dr. Devgan states, "The philtrum is classically 11 to 14 millimeters in a youthful female face. This distance elongates one to four millimeters per decade of life thereafter, which can create heavy or disproportionate feeling in the lower third of the face." And as U.S. and European board-certified plastic surgeon Dr. Yannis Alexandrides points out, the skin’s natural loss of elasticity over time results in this lengthening of the philtrum.
This natural aging process of the upper lip is why many plastic surgeons recommend lip lifts as a permanent, anti-aging solution in addition to providing permanent lip enhancement for those in search of fuller lips. And while strategic placement of HA fillers and even the Lip Flip procedure — which uses a botulinum toxin, like Botox, to “evert” the lip and make them appear more pouty and full— can provide less-invasive options to enhance your lips, this surgical alternative requires practically zero maintenance (compared to both Botox and fillers which require touchups every few months).
Beverly Hills-based plastic surgeon Dr. Ben Talei considers the lip lift the most high-yield, small procedure to rejuvenate the face, and Dr. Devgan notes that, “About half of my patients are younger and seeking an improvement in vertical lip height or shape of the lips. The other half of patients are more mature. [For instance], I do lip lifts with almost all surgical face lifts because the perioral area [immediately surrounding the mouth] contributes significantly to facial aging.”
As Dr. Talei points out, one of the unique advantages of the lip lift is that it allows for optimal tooth exposure and that of the lateral lip (i.e., the sides of the “under lip”). “The lateral lip is the area of greatest struggle for injectors [attempting to] get exposure,” he says of the procedure’s relative advantage to injectables.
The Lip Lift: The Process and Downtime
The process begins with a consultation appointment to determine if you’re a good candidate — and be forewarned, these can sometimes take months to schedule with in-demand plastic surgeons. During the consultation, your surgeon will discuss their recommendations with you, including whether or not you are a candidate for the lip lift. The procedure itself will vary in terms of individual lip anatomy and how many millimeters of skin is removed, but the process involves raising the center and the sides of the upper lift — via the removal of that philtrum skin — so that there will be an upturn at the corner of the mouth and an elegant curve and exposure of the lateral lip. “The majority of patients are in the median range [requiring] six to eight millimeters of skin removal,” Dr. Talei notes. From the start to the final stitches, the entire thing takes about 30 to 45 minutes under local anesthesia or sedation.
There are a few different options for where the incision happens in a lip lift procedure, including the bullhorn, the double duck, the Italian, and the gullwing techniques. “The most popular [technique] is the bullhorn lip lift in order to achieve a lateral pull, or rolling out, of the lip,” says Dr. Alexandrides. “It does leave a very small scar between the border of the nose and lip but is very well concealed in the groove between those two anatomical units.” Others, like Dr. Talei, swear by the deep plane technique to eliminate the scar altogether (which uses broad incision but a deeper resection). It’s best to speak with your preferred surgeon and discuss which technique is right for your anatomy.
The healing period for a modified upper lip lift with deep plane resection takes approximately three months. “Internally, you keep healing even past the year mark, but externally it takes about three months,” Dr. Talei says. “You will have one week of a gigantic lip [after which] the stitches will be removed, the second week you will have a ‘halfway’ gigantic lip, and the third week, it will be about normal size.”
He explains that the swelling and stiffness is caused by the detached lymph that must grow back in order for the body to resume its innate detoxification pathways in the face. Lymph pathways are located throughout the entire body between the nodes — including in the face — as the body’s natural form of detoxification via lymph fluid. Because deep plane resection operates on the deeper layers of the face’s musculature, it disconnects these lymph pathways along with the tissue and nerve endings, resulting in swelling until they grow back.
After week two, patients are allowed to wear makeup again, but tending to the incision remains of utmost importance. Dr. Yannis points out that you will want to apply ample SPF, as UV-exposure can darken scarring beneath the nose, and he recommends that all patients use the antioxidant-rich serum he developed for his post-op patients to optimize healing, 111 Skin Y Theorem Repair Light Serum NAC Y2. “Generally after a few weeks, the scar will start to fade and you’ll no longer need to cover it with makeup,” Dr. Alexandrides says. Some patients report feeling back to normal and going makeup-free during the second month, and by the third month, patients are able to resume life as normal and enjoy their results.
The Lip Lift: The Cost
The surgical procedure starts at roughly $4,800 but can cost up to $14,000 depending on who you go to, but compared to fillers (which can range from $450 to $2,000 based on the number of vials you receive) it actually proves to be more cost-effective. Filler needs to be replenished regularly — with most options on the market lasting for three to six months on average — to maintain the results, but a lip lift is, well, forever. Again, it’s essential to find a plastic surgeon you trust to advise you on what type of lip augmentation is best for you, your anatomy, and your budget. Like any cosmetic procedure, there are definite pros and cons for for both fillers and lip lifts, all of which should be considered before going under the scalpel (or needle).
Lip Lift: Finding a Plastic Surgeon
Compared to more popular cosmetic procedures, like rhinoplasty or breast augmentation, finding a “lip lift specialist” is a little more difficult since the procedure’s modern applications are still evolving. "It's a specialty that I'm trying to form [because] the understanding of the lip has never been described," says Dr. Talei. "There are so many things to talk about in terms of shape, balance, musculature, dentistry, movement. It’s a dynamic, complex area.” As he points out, the rise in demand for the surgical procedure has also been accompanied by requests for revision surgeries, which speaks to the importance of finding the right doctor for the job.
He emphasizes the importance of finding a plastic surgeon whose results have been consistent, ideally demonstrated via hundreds of procedures. This is no time for cutting corners or costs: Interview them and scrutinize both the before/after photos and the consistency of their work. Ensure that there is great patient-surgeon rapport, and that you trust the surgeon’s skill, technique, and aesthetic savoir-faire. Remember, this procedure is permanent, so don’t be afraid to ask the tough questions in order to get the results you want.