Surgical Lip Lift (Subnasal / Bullhorn)
Surgical upper-lip shortening to increase vermilion and maxillary-incisor show
About This Treatment
A surgical lip lift usually removes a bullhorn-shaped strip of skin beneath the nose and secures the upper lip higher, shortening the cutaneous distance from the nasal base to the vermilion. It can increase vermilion and maxillary-incisor show and rebalance lower-face proportions in an aging or naturally long upper lip. Excision, alar-base and columellar transitions, deep fixation, and nostril-sill management are individualized.
This differs from volumizing lip filler and a toxin “lip flip” in target, durability, and scar risk. It may be inappropriate when the upper lip is already short, gingival show or lip incompetence is present, or maxillary and dental position is the primary cause. Dynamic smile assessment is essential. Dedicated sessions and large-series technique presentations at the 2026 Japan Society of Aesthetic Surgery meeting provide a current regional trend signal, not proof of efficacy.
Mechanism of Action
Excess subnasal skin is excised, and tissue superficial to the orbicularis or a deeper layer is fixed to the nasal base to distribute tension. Shortening the cutaneous upper lip produces vermilion eversion and can increase maxillary-incisor show at rest. Variants use skin-only excision, deeper fixation, or extensions into the nostril sill; excessive resection or uneven tension can distort the alae, nostrils, or smile.
Indications
Expected Results
Swelling and upper-lip tightness improve over several weeks, while the redness and firmness of the subnasal scar may mature over 6-12 months. A 2026 systematic review (7 studies, 1,754 patients) reported philtral shortening from 14.0-14.5 mm to 10.8-12.0 mm, vermilion-height increase from 5.0-6.0 mm to 7.0-9.0 mm, mean GAIS 4.4/5, and revision rates of 0.6%-6.7%. Evidence quality was moderate and technique and follow-up heterogeneity prevented meta-analysis. Excised skin does not return, but aging, scar contracture, or asymmetry can affect the long-term appearance.
Clinical Evidence
Risks & Side Effects
A permanent subnasal scar remains and may show prolonged redness, firmness, hypertrophy, or depression. Swelling, bruising, pain, infection, wound separation, numbness, asymmetry, over- or under-resection, lip incompetence, altered smile or speech, alar widening, and nostril or columellar distortion can occur. Revision is often delayed until scar maturation. Keloid tendency, smoking, an already short upper lip, and marked gingival show require especially cautious selection.
Interested in this treatment?
Start with an AI skin analysis to check your current skin condition