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L. Mike Nayak, MD, a double board-certified facial plastic surgeon in St. Louis, recently took to Instagram to caution patients under 40 about getting lip lifts—which surgically shorten the space between the base of the nose and the top lip—explaining that younger skin has a higher chance of healing poorly compared to older skin, which tends to produce less visible scars. (With a lip lift, those scars are smack-dab in the middle of the face.) Dr. Nayak also noted that lip lifts “generally are not indicated” for this age group and have the potential to “make people look very stylized.” He ends somewhat ominously: “I'm telling you right now, there's going to be an epidemic of young women in their 30s that are regretful of lip lift scars.”
After seeing that post, every chance I got, I started asking surgeons how they felt about lip lifts in younger patients. While some dismissed the idea of an age limit, many agreed with Dr. Nayak, saying they generally steer people away from lip lifts in the 20s and 30s, when the rewards tend to be minimal and the scars can be problematic. “Two decades ago, the scenario of a young patient having a lip lift was unheard of,” says Kameron Rezzadeh, MD, a board-certified plastic surgeon in Beverly Hills. “Now it’s happening with alarming frequency.”
Lip lifts were first performed in the ‘80s, typically alongside facelifts, back when facelifts were reserved for older people with clear signs of aging. In those cases, the surgery made sense: The upper cutaneous lip—that’s the flesh-toned skin under the nose—sags and stretches in unison with the rest of the face. As it elongates, the philtrum—the vertical groove above the Cupid’s bow—loses definition and can flatten out. At some point, the upper lip can start to look disproportionate, changing the smile. (At 48, I’m beginning to notice this phenomenon myself, mostly in pictures: When I smile, with teeth or without, my expression looks vaguely unfamiliar.) Since a facelift doesn’t address this area, surgeons may suggest a lip lift: The procedure removes a bullhorn-shaped wedge of tissue from below the nostrils in order to effectively lift the lip, keeping it in sync with its surroundings.
The lip lift flew under the radar until the late 2010s, when it took off on social media, giving us a new feature to fixate on. By promoting the procedure as not just a facelift add-on, but an alternative to lip filler, surgeons broadened its appeal, enticing younger generations who were growing tired of injections—the artificial aesthetic, the migration, the maintenance. Unlike filler, the lip lift doesn’t add volume, per se, but it can give the appearance of plumpness by subtly rolling up the top lip to show off more of the pink vermillion. Elevating the area can also sharpen the contours of the philtrum and reveal a sliver of incisors when the lips are gently parted. Doctors refer to this as “tooth show” and say it contributes to a youthful vibe.
As demand for lip lifts grew, more surgeons dusted off their medical textbooks to refamiliarize themselves with the technique. After “a very cursory review of the lip lift, people started offering it to patients without really understanding the nuances,” says Ben Talei, MD, a double board-certified facial plastic surgeon in Beverly Hills. The lip lift was overprescribed and misused—a common consequence of medical commoditization—and “there were a lot of fuck-ups: patients looking overdone, terrible, imbalanced,” Dr. Talei recalls. In response, lip lift education ramped up across the field, with specialists lecturing on it at meetings and teaching it in courses. But ultimately, “all this knowledge only helps if we have judgment alongside it,” says Dr. Rezzadeh. “And the judgement piece is incredibly challenging to teach.” Even now, he says, surgeons too often do lip lifts without pausing to consider if the procedure is a suitable solution for the issue at hand or if the patient is even a candidate.
The lip lift is the procedure that Dr. Rezzadeh says “no” to most often. “Because I’ve seen the disasters,” he says—not just prominent scars, but overshortened lips, distorted nostrils, and mouths that look odd in motion. Like Dr. Nayak, he is predicting a fallout in the future: “Just walking around Beverly Hills, you can tell a lot of people under 40 have had lip lifts, and frankly, I think we're going to be dealing with the ramifications of that in the coming years.”
Interestingly, Sean Alemi, MD, a double-board certified facial plastic surgeon in New York City, says that what he encounters far more frequently than “lip lifts gone sideways” are patients who’ve been scared away from the procedure by “fear-mongering” doctors, who insist that lip lifts unequivocally cause bad scars or a strange appearance. Conversely, on the West Coast, “there’s an astoundingly low level of fear associated with lip lifts,” according to Dr. Rezzadeh. Another paradox: While some surgeons say the fad-ification of the lip lift has led to an uptick in people requesting the procedure out of hand, without understanding its intent, others find that many patients resist the lip lift—even when it could actually benefit them—because they’ve seen such extreme examples of it online or out in the world.
So what’s the truth about lip lifts? It’s complicated. Here are nine things surgeons want you to know about the powerful procedure.
1. A lip lift does more than just shorten the upper lip. When planned and executed precisely, on the right patient, it can have a rejuvenative and beautifying effect.
Yes, the lip lift is a means of lessening the distance between the nose and the mouth—but to what end? Beyond simply perking up the top lip, the procedure can “restore the right balance to the lower face,” which, in women, tends to square off and look slightly more masculine with age, says Dr. Alemi. “By shortening the [nose-to-lip] distance sometimes just a few millimeters, the lip lift brings a soft femininity back to the mouth.” (When men request a lip lift—which my sources say is happening more frequently—“I specifically tell them that it’s a feminizing procedure,” notes Gary Linkov, MD, a double board-certified facial plastic surgeon in New York City.) In most patients, Dr. Alemi is removing only one-and-a-half to four millimeters of skin. But that tiny adjustment can pay off big, he says, “making the whole face look prettier.”
The lip lift isn’t without limitations, however. For starters, “it’s really only lifting the central region of the upper lip,” says Dr. Linkov. Patients often fail to grasp this point, he says: “They think the lift is going to affect the entire lip, including the corners, and it just doesn’t happen that way.” (Look in the mirror and picture two lines extending down from the outer rims of your nostrils to your top lip. The portion in between those imaginary lines is what gets lifted.)
Surgeons can address the corners of the mouth by performing a separate procedure called a corner lip lift. Depending on the technique used, a corner lift can unfurl the outer edges of the top lip (to expose more red) or pick up the downturned corners of a mouth. Dr. Rezzadeh finds that, in select patients, tweaking the corners during a lip lift can lead to a more natural result: This way, “you’re addressing the full lip, so it doesn’t look like the central part has been brought up, but the corners are untouched and still looking aged,” he says. (In some cases, doing a basic lip lift without addressing the corners can create an overly arched look, where the line of the upper lip sort of resembles a bell curve.) Since the corner lip lift requires making incisions on the vermillion border—where there’s really no place to hide scars—surgeons tend to offer it less frequently. In Dr. Linkov’s office, “the percentage of people who end up truly benefiting [from a corner lip lift] is maybe 5% to less than 10%,” he says. In such cases, he prefers to wait and see how the upper lip lift settles and scars before addressing the corners. Other surgeons may opt to do the two procedures together.
2. The lip lift can be bundled with other procedures or done on its own.
Surgeons commonly perform lip lifts during facelifts to enhance overall harmony—about half of Dr. Alemi’s facelift patients choose to include a lip lift—but the procedure can also be done as a standalone under local anesthesia (meaning you’re numb but awake). This can be a good option for people who’ve already had a facelift, but for whatever reason, chose not to treat the lip at the same time. The solo lip lift might also appeal to those who aren’t ready for a bigger intervention. “I definitely see patients who are a little bit on the younger side, usually in their 40s, and they’re just starting to dip their toe into the aesthetic pond,” Dr. Alemi says. “A lot of them are choosing lip lifts as an entry point.”
The surgery is a relatively straightforward affair: After measuring and marking the upper lip, surgeons remove a bullhorn-shaped strip of skin and fat to reveal the SMAS layer, which is the connective tissue covering the muscle that encircles the mouth. Working along the lower edge of the incision, they separate a few millimeters of SMAS from the underlying muscle to create a small tissue flap, which allows them to move the lip freely and place sutures deep in the SMAS in order to avoid putting tension on the surface incision. (If you’re more of a visual learner—I get it—this is a great step-by-step video of the procedure.) Tension is the enemy, of course, because it leads to widened scars and also risks pulling down and distorting the base of the nose. “If the incision looks tension-free before the final layer of stitches goes in [to the skin], you’re most likely to get an inconspicuous scar,” explains Adam Kolker, MD, a board-certified plastic surgeon in New York City.
While surgeons aim to hide the lip lift incision in the shadow of the nose, they say it’s imperative not to cut into the nostrils. “We don’t want to enter the nasal sill, which is the roll of skin where the nostril meets the upper lip,” says Dr. Alemi. “Violating that area can change the shape of the nostrils, making them look unnaturally round.”
3. With lip lifts, less is always more.
When teaching about lip lifts, Dr. Talei instructs surgeons to “ignore all the old literature that says the lip should be 11 to 14 millimeters long,” he says. There is no prescribed length that can be applied to every patient. Sometimes, though, the lip itself will tell surgeons where to cut. In certain—often older—patients, the upper lip will form a crease when they smile. “They’ll get this horizontal ‘line of declaration’ in the middle of their lip,” says Dr. Rezzadeh. “That tells us exactly where the excess skin is and what needs to be removed in order to restore their lip to its younger anatomy.”
In every case, the key to an undetectable lip lift is knowing how much skin to take, says Dr. Alemi, who calls himself “the most conservative lip lift surgeon on Park Avenue.” He tells me how he recently did a two-millimeter lip lift on a patient: “She was like, ‘Gosh, two millimeters? Is it even worth it?’ And I said, ‘This is a region where a millimeter can be a mile. If [the upper lip] is a millimeter too short, it doesn’t look quite right,” he says. Every surgeon I spoke to stressed the importance of erring on the conservative side. Sometimes patients will push to go shorter, says Dr. Linkov, but “it’s always better to have to go back and remove a little bit more, than to remove too much and then you’re stuck.”
4. The lip lift isn’t for everyone.
Unlike 10 years ago, when the suggestion of a lip lift left patients bewildered, says Dr. Kolker, “now people are coming in requesting a lip lift, but they have no idea what it means and they’re not even remotely candidates for it.” In the age of trending treatments, he adds, “everyone thinks they’re a candidate for everything.”
The success of a lip lift rests heavily on the patient being a good match for the procedure. The best candidates are those whose philtrums are congenitally long or have lengthened with age. (How long? “If I had to put a starting measurement on it, it would be at least 15 to 16 millimeters, at minimum,” says Dr. Linkov—but this isn’t a hard-and-fast rule.) In some cases, the philtrum is so long that the red of the lip has folded under, completely concealing the top teeth when the mouth is neutral or even when smiling. In addition to having a bothersome lack of tooth show, perfect candidates have “the potential to reveal at least a little bit of the upper teeth when the mouth is in repose,” Dr. Linkov explains. This isn’t a given for everyone: “Sometimes the teeth are so high up and hidden that we’d have to remove so much skin in order to see them and it just wouldn’t make sense.”
Beyond the basic anatomical indications for a lip lift, candidacy may also hinge on “how much the patient knows about the procedure and what they hope to achieve,” says Dr. Linkov. “I want patients who understand what they’re getting into. They’ve accepted that, yes, there will be a scar and that they may someday need procedures to improve the appearance of the scar.” In his experience, when patients focus more on the inevitable scar than on the benefits of the procedure, “it’s a setup for dissatisfaction.”
This probably goes without saying, but in the not-a-candidate category are people who already have short philtrums, those who naturally show a lot of teeth or have a gummy smile, and anyone with unrealistic goals or expectations.
5. Some skin types may be more prone to obvious scars.
Responsible surgeons will factor in a patient’s skin tone and age when determining if the lip lift is appropriate. It’s important to note, however, that regardless of color, the skin on the upper lip is universally thicker than that on other parts of the face—and its density influences how it heals. “The reason that blepharoplasty [eyelid lift] incisions heal so beautifully—even in the hands of mediocre surgeons—is because the upper eyelid is privileged skin,” Dr. Rezzadeh says. “It has the ability to heal in an essentially scarless fashion because of how thin it is. But the upper lip skin is the opposite—it’s much less forgiving.”
While “it’s impossible to predict with 100% certainty what the quality of the scar is going to be,” says Dr. Kolker, most surgeons agree that melanated skin is generally thicker than Caucasian skin and more likely to form raised or pigmented scars. But not all surgeons are aligned in thinking that younger skin will have a more exuberant scar response, or in ruling patients out based on age alone. In Dr. Linkov’s office, the majority of lip lift patients are in their 30s and 40s. “I do think that the scar can be a bit more obvious in younger patients,” he says, “but rarely is it truly problematic.” Allure contributor Taryn Brooke got a lip lift in 2023, at age 35, and recounted her experience; we followed up this year and she said that, though she’s “very happy” with the fullness she achieved through the procedure, “the scarring remains around my nose to this day. It's lessened over the years thanks to laser treatments but it's still there, albeit hidden.”
During surgery, if Dr. Linkov feels that a patient’s skin is thick relative to other cases he’s done—or if someone is genetically predisposed to raised scars—he’ll inject steroids at the end of the procedure to try to mitigate the risk of poor scarring. And if someone is under 40 and they have darker skin, “then we really have to ask if the juice is worth the squeeze, because the scar can become an eyesore,” says Dr. Rezzadeh. He can’t stress it enough: “We have to be really discerning when offering this procedure,” he adds. In the wrong patient, “it can be a setup for something that is life-altering and impossible to correct.”
Dr. Talei has designed an app called Cupid Lift, which allows users to upload a photo to “try on” a lip lift and find out if they qualify for one. “Even if you don’t come to us [for surgery], send a photo through the app, and then at least you have my eyes on it, and I can tell you if you’re a candidate.” He says “no” to roughly half of those who inquire about the procedure for a variety of reasons, including the possibility of poor scarring. “Most of the people we turn away are younger and they just don’t need it,” he says. “But that doesn’t mean there aren’t hundreds of people out there in their 30s who would benefit from the procedure.”
6. The lip lift isn’t a cure-all—sometimes filler is actually the answer.
While filler has received its share of bad press in recent years, it clearly still has a place in aesthetics: Nearly 1.5 million lip injections were performed in 2024, according to the American Society of Plastic Surgeons. While lip filler (which volumizes the body of the lip) has a different purpose than a lip lift (which shortens the philtrum), sometimes surgeons will rush to cut when a perceived problem could’ve been better solved with an injection. “If your upper lip is already the perfect length, and what bothers you is your lip shape or size, then maybe filling the lip is the right answer,” says Dr. Rezzadeh.
That said, “the misdiagnosis can go both ways,” he notes. “There are people who’ve become filler dependent—they do have a long upper lip, and they are candidates for lip lifts, yet they’re constantly getting filler to try to improve the look of their lip when, given their anatomy, they should’ve had a lip lift to begin with.”
Sometimes the two treatments can go hand-in-hand. In certain patients, “their natural lip structure is just not amenable to filler,” Dr. Talei explains. “But then we do a lip lift, and the surgery makes them fantastic candidates for filler, because their lip is now more everted, so we can add a little bit of volume and hydration without making them duck out.”
7. Post-op care is critical.
Following a lip lift, swelling and bruising can last two to three weeks and the area may feel firm, tight, tingly, or numb for up to three months. In the first month after surgery, “there's all this fresh collagen that’s contracting, and so patients can feel tight,” Dr. Alemi explains. Then, around four weeks, as the collagen starts to mature, tissues typically feel softer and more pliable. However, the deep sutures that surgeons place can take eight to 12 weeks or more to fully dissolve. “And sometimes patients can feel the knot of a suture or some tightness associated with the sutures,” he says, but those sensations dissipate once stitches dissolve.
During the first two weeks post-op, Dr. Linkov encourages a constant state of “resting bitch face.” “It’s such a critical time when the wound is building up basic strength,” he says. “I really ask people to keep talking, smiling, laughing, and crying to a minimum.” Patients are not robots, he realizes, but staying straight-faced can improve scarring.
As for wound care, every surgeon has their own protocols, but most recommend avoiding sun exposure and keeping the incision coated with an antibiotic ointment or a salve like Aquaphor. Surgeons typically remove skin-level sutures after two to five days. They may then place Steri-Strips over the incision and have patients start applying a silicone-based scar gel once they fall off.
Some doctors routinely laser lip lift scars at three to four weeks to reduce pinkness and head off hyperpigmentation. “I watch these scars like a hawk,” says Dr. Rezzadeh. Not only are they in a highly mobile area that’s constantly under tension, but if something goes wrong, surgeons can’t just cut out the scar and start over as they might when revising, say, a facelift scar behind the ear. Lip lift “errors are much harder to address,” he adds, “because the real estate is very limited in the upper lip.”
Other surgeons take a wait-and-see approach with scars, finding that the percentage of patients who truly need scar therapy is very low—“probably on the order of five percent,” says Dr. Linkov. According to Dr. Alemi, “when patients do have an issue with a scar, it's either visible because of pigment, which we treat with intense pulsed light, or they may see a faint line, which we address with microneedling or CO2 laser.” If the scar is raised, doctors can flatten it with steroid injections, “but it can sometimes take four, five, or six sessions,” notes Dr. Linkov.
Overall, the healing time with a lip lift can be substantial. It usually takes about three weeks for the scar to be “disguisable,” says Dr. Talei, and three months to be “wedding- or photo-ready.”
8. Poor scarring isn’t the only risk of a lip lift.
Other risks include asymmetry, under- and over-correction, infections (very rare), and viral reactivation in those prone to herpes (a prophylactic dose of Valtrex can help prevent it). While some degree of temporary stiffness is normal, if too much skin is removed during surgery or if the orbicularis muscle is aggressively manipulated, the mouth may move awkwardly and the smile can be restricted for weeks to months or even permanently.
9. A botched lip lift can be impossible to fix.
“The lip lift is not a reversible procedure,” says Dr. Talei. “We can usually fix an asymmetry. We can maybe fix a scar. But we can’t reverse an overshortened lip—it’s just not possible and that’s where the danger comes in.” Occasionally, if the central lip was lifted a bit too high, surgeons can raise the corners slightly to make the lip look less arched and more balanced overall. In other cases, restoring form and function can require extreme measures. Dr. Talei tells me about two patients who came to him after having aggressive lip lifts elsewhere: One had to have all of her veneers “reduced tremendously” in order to be able to close her mouth. The other required surgery to move her jaw bone back so that her lip could sit in a better position. “These are situations you don’t want to get yourself into,” he says.