What the research shows
Why the lip is lifted. The skin between the nose and the lip was about 5 mm longer in older women than in young women, which gives surgeons a guide to how much skin to remove (Sleilati 2024). An early description, in 1986, removed a wavy strip of lip skin and hiding the scar in the shadow under the nose (Austin 1986).
What it does. Pooled studies show the distance from nose to lip shortened by about 3 mm, the red of the lip became taller and more of the upper teeth showed, with high satisfaction (Komisarek 2026). In women around 50, the lip shortened by about a fifth (Marechek 2021).
Risks. The most common problem is an unattractive result or a visible scar, in about 1 patient in 14 across studies (Yamin 2021); revision rates ranged from under 1 in 100 to about 1 in 15 (Komisarek 2026). Patients who wrote unhappy online reviews most often blamed the scar, then changes to the nose and an uneven lip, and many described real distress (Hayat 2025). Even without nose surgery, the lift narrowed the angle between nose and lip and widened the nostrils slightly (Marechek 2021).
How long it lasts. In one surgeon's patients, the improvement declined only slowly, with no significant difference between those under and over five years from surgery (Nagy 2022). 3D imaging told a less steady story: under half of the shortening remained at two years, and the gain in lip fullness faded almost completely (Kong 2026). Reviews report results holding for one to five years (Júnior 2023).
Deeper techniques to protect the scar. Newer lifts hold the lip with the muscle layer beneath the skin so the skin closes with less tension. A deep plane lift with three suspension stitches gave more patients a "very much improved" result than the classic bullhorn excision (Mahmood 2025). In a large SMAS-based series, a few raised scars were treated with laser and no one needed a second operation (Ceran 2026). Tightening the lip muscle trades red lip for tooth show one millimeter for one millimeter, which lets surgeons tune the result (Talei 2026). For patients who will not accept any visible scar, a stitch placed inside the nose shortened the lip in most, with occasional stitch problems (Echo 2011).
Where surgeons disagree
- How much tooth should show. The operation typically raises upper tooth show to several millimeters (Komisarek 2026), yet survey respondents preferred 0 to 1 mm and liked a large show least (Zeng 2025). In simulated photos, observers rated a lifted lip below both the natural lip and a filler-treated lip (Linkov 2019).
- Skin-only or deep plane. Reviews find the classic skin excision safe and effective (Komisarek 2026); surgeons using deep plane and SMAS designs report better scars and satisfaction (Mahmood 2025, Ceran 2026).
- How durable. Measurements from photos suggest a lasting result (Nagy 2022); 3D imaging shows partial relapse by two years (Kong 2026).
What is new
- Deep plane lip lift design, refined over more than two thousand consecutive cases in one practice, aims to avoid an exaggerated or aged look and reduce revisions (Talei 2022).
- Combining a lip lift with rhinoplasty in one operation gave high satisfaction with mostly mild, temporary problems (Alnami 2024).
- 3D tracking now follows the lip over two years instead of a single after photo (Kong 2026).
What is still unknown
- Which technique is best; there are no randomized trials and studies measure the lip in different ways (Júnior 2023, Komisarek 2026).
- Who is the right candidate; data on selection and complications are thin (Yamin 2021).
Key papers
- Austin 1986: an early description of the lip lift under the nose.
- Echo 2011: a lift with no visible scar.
- Yamin 2021: review of upper lip surgery and its complications.
- Marechek 2021: how the lift changes the lip and the nose.
- Nagy 2022: the result held over years.
- Talei 2022: deep plane lip lift design.
- Hayat 2025: why some patients are unhappy.
- Komisarek 2026: pooled results of modern lip lifts.
- Kong 2026: 3D measurement of relapse over two years.