Lip lift and perioral rejuvenation

Upper lip descent and thinning can occur with aging of the face. Lip hyaluronic acid fillers cannot treat this phenomenon. Usually 13-14 mm of upper “white” lip skin and 2-4 front teeth show are considered attractive.

This simple procedure where the upper lip is pulled up to create a more youthful appearance camouflages the “bullhorn” shaped excision into an imperceptible scar under the nose, shortens the lip and everts it (makes it look fuller).

The procedure is usually combined with fat grafting to reduce vertical lip wrinkles, enhance lip volume, and complement other facial procedures such as browlifts, necklifts, or facelifts.

In long lips, adding HA fillers will further obscure teeth show, and should not be used without shortening the lip first.

The excision rarely exceeds 5-6 mm, but will definitely exceed your expectations.

Lip lift with fat grafting
Bullhorn lip lift

Under local anesthesia

  • Excision of excess skin to leave behind 13-14 mm of upper lip skin

  • Suture with fine sutures under nose

  • Minimal pain with medication

  • Moderate swelling and bruising that usually resolve in 1 week.

  • 1st Follow-up: 7 days to remove sutures

  • 2nd Follow-up: 3 months (scar usually fades away in 6 months to 1 year)

Serving patients in Beirut and Dubai. Dr. Serge Zogheib is a board-certified plastic and reconstructive surgeon practicing in Beirut and Dubai, with a special focus on advanced facial surgery.

Frequently asked questions in my practice

  • A lip lift shortens the distance between the base of the nose and the upper lip (the white lip), increasing tooth show and enhancing the natural curvature of the vermilion.

    It does not add volume.
    It adjusts proportion.

  • Fillers increase volume within the lip itself. They do not reduce the vertical height of the upper lip.

    In patients with a long philtrum, filler alone often leads to projection without proportion correction and will often hide the teeth even more. A lip lift addresses the underlying vertical excess.

    Volume and proportion are separate considerations.

  • The incision is typically placed along the base of the nose (subnasal or “bullhorn” pattern), following natural contours.

    With proper technique and careful closure, the scar usually matures well and blends into the nasal base shadow. Scar quality depends on skin type, healing response, and postoperative care.

    It is a trade-off, proportion improvement in exchange for a fine scar placed in a concealed location.

  • Candidates must have:

    • > 45 years old

    • A long upper white lip

    • Minimal tooth show at rest

    • Flattened Cupid’s bow

    • Adequate lip volume but poor vertical proportion

    Assessment focuses on facial balance rather than isolated lip fullness.

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