Lip Shortening Surgery | Subnasal Lip Lift to Shorten the Philtrum
Why the Upper Lip Ages and How We Restore It with Dr. Balikian
A youthful, expressive smile depends on more than just lip volume. Over time, the upper lip lengthens, the pink lip rolls inward and the teeth become less visible when you speak or smile. This subtle change shifts balance in the lower face and is one of the earliest signs of aging.
Even when the cheeks, jawline and neck are beautifully lifted with an Artiste Lift™, a long upper lip can make the face appear older than it is. That is why the Subnasal Lip Lift has become an essential part of natural facial rejuvenation.
A properly performed lip lift is not about creating an overly full, artificial lip. It is about restoring proportion, reshaping the Cupid’s bow and allowing the lips to look like they did 15 years ago.
This is the artistic intention behind every subnasal lip lift I perform.
Why the Upper Lip Lengthens With Age
Research confirms that the philtrum gradually lengthens with aging due to soft-tissue descent and weakening of perioral support structures.
This leads to:
- Less visible pink lip
- Loss of tooth show
- Inward rolling of the vermilion
- A heavier, longer appearance to the mid-face
This is why fillers alone cannot correct a long upper lip. In fact, fillers in this area often make the lip look heavier or longer. A philtrum shortening surgery directly corrects the underlying cause.
What Patients See in Lip Shortening Before and After Photos
When you look at lip shortening before and after photos, the transformation is often subtle but striking, revealing how small changes in upper-lip length can brighten the entire face.
Most patients notice:
- A softer, more youthful curl to the upper lip
- A shorter philtrum that restores balance
- More visible pink lip without looking “done”
- Better visibility of the upper teeth while speaking
- A more refined Cupid’s bow
- Reduction of a “long” or “compressed” upper lip
The change is subtle but transformative, often described as “I look brighter and more awake.”
What a Subnasal Lip Lift Does
A Subnasal Lip Lift is a lip shortening surgery that removes a precise strip of skin beneath the nose to:
- Shorten the philtrum (the distance between the nose and the upper lip).
- Shorten the upper lip so more pink lip shows naturally.
- Improve tooth show when talking or smiling.
- Lift and roll the upper lip for a soft, youthful curve.
- Restore balance across the nose, lips, and lower face.
These small adjustments create a big impact. When you look at lip shortening before and after photos, you can see how the entire face brightens when the proportions around the mouth are restored.
Before and After Subnasal Lip Lift
Why I Perform a Deep Plane Subnasal Lip Lift
Traditional lip lifts often remove skin but leave tension on the incision.
This can create:
- A tight, flattened upper lip
- Extended “winged” incisions up the sides of the nose
- Thick, visible “railroad track” scars
- Limited curl or lift of the lip
- Premature scar widening as the lip moves
This is why I do not use the traditional approach. Instead, I perform a deep plane subnasal lip lift, which mirrors the philosophy of my deep plane facelift:
- I place the incision only where it hides naturally. No incision is carried high up the sides of the nose where scars can be obvious.
- I release the skin from the underlying muscle. This is critical. It allows the lip to roll upward naturally, not by force.
- I remove tension from the closure. When tension is removed, scars heal thin and soft, just like the incision lines I create in the Artiste Lift.
- I correct asymmetry at the same time. If one side of the upper lip sits lower than the other, I can adjust this for improved symmetry.
- I add structure when needed. Deep plane support prevents the lip from pulling downward over time.
The result is a lifted, curled, balanced upper lip that looks like the patient’s natural youthful lip, not a surgically altered one.
Who Is a Good Candidate for a Subnasal Lip Lift?
A Subnasal Lip Lift is an ideal choice for patients who want to refine the proportions of the upper lip and restore the balance that naturally softens with age.
You may benefit from a lip shortening surgery if you:
- Have a long upper lip
- Want to shorten the philtrum
- Have lost visible tooth show
- Feel your lips look thin even with filler
- Want a permanent alternative to lip injections
- Are undergoing full facial rejuvenation and want balanced results
Many of my facelift patients choose to combine a lip lift with their Artiste Lift™ because it brings harmony to the entire face.
Combining a Lip Lift With Other Procedures
A Subnasal Lip Lift often creates the most harmonious results when combined with other facial rejuvenation procedures that address aging from multiple angles.
A Subnasal Lip Lift pairs very well with:
- Deep Plane Facelift
- Vertical Neck Lift
- Temporal or 4 Point Brow Lift
- Facial Fat Transfer
- Peri-oral CO₂ Laser
Each procedure addresses a different part of aging. When the upper lip is appropriately shortened, the results of a facelift look even more natural and complete.
Recovery and Results
Recovery after a Subnasal Lip Lift is typically smooth and predictable, with most patients returning to normal activities quickly as the lip settles into its new, natural position.
Most patients experience:
- 7–10 days of swelling
- Sutures removed at one week
- Makeup coverage at 7–10 days
- Continued refinement over the next 3–6 months
Because of our deep plane technique, the incision typically heals exceptionally well and becomes nearly invisible over time.
Discover What’s Possible
Philtrum Shortening FAQs
What is a Subnasal Lip Lift?
A Subnasal Lip Lift is a surgical procedure that removes a strip of skin beneath the nose to shorten the philtrum and lift the upper lip. This increases vermilion show and improves facial balance.
How does lip shortening surgery work?
Lip shortening works by reducing the vertical height of the philtrum and repositioning the upper lip into a more youthful and expressive shape.
What changes do patients typically see in lip shortening before and after results?
Studies show increased vermilion height, improved Cupid’s bow contour, better tooth show, and a shorter upper lip after surgery.
Is Subnasal Lip Lift surgery permanent?
Yes. Research demonstrates long-term stability in shortened philtrum length and upper lip position for multiple years after surgery.
Does the philtrum actually lengthen with age?
Yes. Aging studies confirm progressive elongation of the philtrum due to soft tissue laxity and structural descent.
Who is a good candidate for lip shortening surgery?
Ideal candidates have a long upper lip, reduced tooth show, thin upper lip despite fillers, or desire a permanent change in lip proportion and balance.
How does lip shortening surgery compare with fillers?
Fillers add volume but cannot shorten the philtrum. Studies show that surgical shortening is the only reliable method to restore youthful upper lip length.
Does Subnasal Lip Lift affect lip movement or speech?
Published research shows that lip function, speech, and oral competence remain normal when the surgery is performed correctly with preservation of muscle integrity.
What is the typical recovery for a philtrum shortening surgery?
Most swelling improves within one to two weeks, while refinement of lip shape continues for three to six months. This timeline is consistent across multiple clinical studies.
What are the risks of lip shortening surgery?
Possible risks include scarring beneath the nose, asymmetry, or minor wound healing issues. A systematic review found overall complication rates to be low.
How does shortening the philtrum improve facial aesthetics?
Shortening the philtrum increases vermilion show, improves dental display, enhances lip curvature, and restores youthful facial proportions.
Trust Your Face to a Facial Plastic Surgeon
Dr. Richard Balikian is a highly respected facial plastic surgeon serving the San Diego area.
With over 20 years of experience and double board certification in Facial Plastic and Reconstructive Surgery as well as Head and Neck Surgery, Dr. Balikian offers a unique combination of technical expertise and artistic vision.
He is part of an elite group of surgeons with extensive training focused exclusively on the face and neck.
A Closer Look at Facial Plastic Surgery
Richard V. Balikian, MD, FACS
Double Board-Certified Facial Plastic Surgeon
Balikian Facial Plastic Surgery: Richard V. Balikian, MD, FACS
