Of all the facial features that entice and emote, the lips, at least in my opinion, are where it’s at. My fascination with all things lips — making them appear larger with liner, stinging them with ginger-spiked gloss to make them swell, plumping them with hyaluronic acid fillers — comes from the fact that I was not born with the fullest pair.
Lip filler, above all, has been a game changer for me, and was my first foray into the world of injectables. Over the past six years, my lips have been injected seemingly countless times with Juvéderm, Restylane, even Botox for a “lip flip” that rolls the upper lip up and out a bit to make it look fuller. Lip Fillers On Small Lips
But I have also dissolved my lip filler, with Hylenex, once: Last summer, I experienced one of the possible, unfortunate side effects of lip filler when mine migrated, making my lips look incredibly unnatural. After spending so much time and energy on the lip-filler roller coaster, I felt like I had never quite gotten the fuller, lifted look I had desired for so long. I decided to turn to a permanent surgical option: a lip lift.
After doing a lot of research, and looking at the before-and-after pictures of numerous patients and many images of celebrities rumored to have had the procedure, I scheduled a consultation with Anthony Taglienti, MD, a board-certified plastic surgeon and director of plastic surgery at Advanced Dermatology PC Center for Laser and Cosmetic Surgery in New York City to determine if I was a good candidate for the lip lift procedure. After about five minutes, Dr. Taglienti had a verdict: I was.
My surgery was scheduled for within two weeks. Over the three weeks after that, I carefully tracked my post-operative results for this story and documented my progress through (many, many) photos.
A lip lift is a surgical procedure that shortens the distance between the nose and the top of the upper lip, so the red part of the lip rolls outward and the lip appears fuller. The procedure is often done during a facelift — one plastic surgeon told me he performs a lip lift on about half of his facelift patients — but now younger people are asking for lip lifts by name, says Lyle Leipziger, MD, chief of plastic surgery at North Shore University Hospital in Manhasset, New York, and Long Island Jewish Medical Center in Queens. He attributes the uptick in part to, you guessed it, social media.
Today, many lip lift patients are 20-somethings and 30-somethings (like me) trying to get the pillowy lips (yes, an aesthetic often seen in our various feeds) we wish we had been born with. And many, like me, have been getting filler for several years and are just over the upkeep, the variable results, and potential complications.
But there’s another factor that has put this decades-old procedure in the spotlight: Surgeons have gained a greater understanding of the facial aging process, especially around the mouth and lower part of the face, says Oren Tepper, MD, director of cosmetic and reconstructive surgery at Montefiore Einstein Advanced Care in the Bronx.
Historically, plastic surgeons have put much of their focus on lifting brows and tightening jawlines to create a more youthful look, but there’s new appreciation for what Dr. Tepper calls the “centrofacial region,” the triangular area that includes the eyes, nose, mouth, and chin. “Rejuvenation of the centrofacial region has become an important part of the overall treatment of facial aging,” Dr. Tepper says, “and lip lifts are a powerful tool.”
There are four basic types of lip lifts, Dr. Taglienti explains, whatever a patient’s motivation may be. Choosing the appropriate lip lift depends on a patient’s individual goals, as well as where a patient is comfortable with potential scarring.
Similar to the bullhorn lip lift, this procedure involves removing a small amount of skin from under the nose to elevate the upper lip and expose more of the red portion. For the upper lip lift, though, the removed tissue is cut straight across the upper lip and tapered at the edge of the nostrils.
This type of lip lift involves removing a small amount of skin at the mouth’s corners to turn the mouth upward for a more youthful appearance.
In this procedure, a wedge-shaped section of skin just above the upper lip is cut away to both lift and create a more defined Cupid’s bow.
This is the type of lip lift I had, in which a crescent-shaped section of skin is removed from right beneath the nose to elevate the upper lip and expose more of the red portion. The removed tissue flares at certain points along the nostrils, creating a more natural look.
Before we get into the specifics of what my lip lift entailed — the process, the pain, the healing, and the overall results — here is a set of my before-and-after photos:
The cost of a lip lift varies depending on geography and the plastic surgeon, but patients can expect to spend, on average, $2,000 to $6,500 for the procedure.
“An ideal candidate for a lip lift is someone who has a thin upper lip; someone who has a very long space between their nose and lip; or someone who has lateral lip collapse near the corners of the mouth,” says Dr. Taglienti. (“Lateral lip collapse” is a slightly more ominous-sounding term for referring to the volume and collagen loss that happens in and around the lips as we age.)
It sounds ludicrous — and I hesitate to even mention it — but in the world of medical aesthetics, there is apparently an unofficial “ideal” length from the nose to the top of the lip. “It’s approximately 11-13 mm for females and 13-15 mm for males,” says Dr. Taglienti. He stresses that, for him, it’s more about how the upper lip looks in relation to the rest of the face that indicates whether a person is a good candidate for a lip lift. “If someone has a very small distance between their nose and upper lip, say 7-8 mm, I will likely not operate on them as the result may look odd or pulled, and the scar may thicken or hypertrophy due to excess tension.” Those patients are usually better served by Botox or lip fillers.
During my first consultation with Dr. Taglienti, he explained what I could expect in terms of results and the procedure itself. As I held a hand mirror, he lifted and rolled up my upper lip to demonstrate the type of effect I would get. He said the procedure would take about 45 minutes, that I would have about 35 stitches (internal and external) at the incision site, right below my nose, and that the scar would be hidden there once it was fully healed, which usually takes about a year.
In most cases, lip lift scars can be hidden, but younger patients like me can sometimes have a trickier healing process. Says Dr. Leipziger, “They may produce scars that stay pink longer, requiring further scar care.”
If you have been getting lip filler, as I had, you don’t necessarily need to dissolve it before getting a lip lift, notes Dr. Taglienti, but ideally, you would be filler-free for the procedure: “Having lip filler does not preclude having the procedure. It’s really up to the discretion of the surgeon.” (I had gotten half a syringe of Juvéderm injected into my lips about four or five months before my lip lift.)
About a week before my lip lift, Dr. Taglienti sent five prescriptions to my pharmacy that I was instructed to bring with me the day of surgery: Valium, to be taken right before surgery to calm me (I would be awake during the entire procedure, but more on that in a few); Cefadroxil, an oral antibiotic to prevent infection; Mupirocin, a topical antibiotic to be placed directly onto the incision area until suture removal; Medrol, an oral steroid to help with swelling (I did not end up taking this one); and Percocet, an oral pain medication that I could take as needed in the hours and days following the procedure.
Dr. Taglienti also recommended I get arnica gel to prevent additional bruising, and to avoid aspirin and ibuprofen for a week prior to surgery and three days after to minimize potential bruising.
I arrived at the surgery center early, anxious, and with all my prescriptions in hand. Though I knew what to expect, I had never had surgery before. I was taken into the exam room pretty quickly, where I signed several consent forms, got pre-surgery photos taken, and was instructed to take the prescribed Valium. Dr. Taglienti then mapped out on my face, in purple ink, where the incisions would be made.
I cannot express how much the Valium was needed; it relieved my nerves and left me feeling on a cloud as I walked into the procedure room, where I settled into the almost fully reclined surgery chair.
Within a few minutes, Dr. Taglienti injected a local anesthetic below my nose and above my lip. A lip lift is typically done using only a local anesthetic, unless the procedure is performed in tandem with a more invasive surgery, such as a facelift.
The anesthetic took effect almost immediately, and can be described as similar to but much stronger than getting novocaine at the dentist. As Dr. Taglienti began to cut around my nose, I felt no pain, just the sensation that comes with knowing someone is cutting into you (though you’re not sure exactly where and how deep the cut is). This continued for about 45 minutes. Thank you, Valium.
30 minutes after lip lift surgery
After the procedure, Dr. Taglienti briefed me on the specifics of the surgery in medical, but comprehensible, terms: “I excised a wedge of skin under your nose, advanced the inferior portion of the incision upward, and sutured the dermal and epidermal layers. The area was then cleansed, a topical ointment placed over the incision, and a dressing applied.”
My lip lift involved mostly the dermal and epidermal layers of the skin, but there are some more invasive lip lifts, depending on the needs and goals of each patient. Explains Dr. Tepper, “In certain cases, the skin is dissected off the muscle, to create more of a gliding plane, which can roll up the lip.”
Dr. Taglienti instructed me to keep the bandage placed beneath my nose for at least 24 hours, and to avoid getting water or product in and around the area until it was removed. I left the surgery center looking forward to a quick recovery.
Bandaged and ready to go home, about an hour after surgery
As soon as my brother brought me home (no driving post-Valium), I took my first antibiotic pill and collapsed on the couch. (The full course of antibiotics lasted for four days.)
The most uncomfortable period of the recovery process was directly after the surgery until the following afternoon. The large bandage beneath my nose was almost blocking my airway, and I was afraid the stitches would come apart if I spoke too much or opened my mouth too wide. Also, my lips swelled rather dramatically in the hours following the procedure. To relieve the pain and discomfort, I took a Percocet, which I regretted the next morning when I woke up with one of the worst migraines of my life.
Dr. Taglienti had provided me with detailed instructions on how to care for the incision, including eating only soft foods for the first couple of days and trying not to open my mouth more than one inch for about a week to prevent opening the incision site. After I removed the bandage, I needed to clean the incision site with soap and water twice a day, then apply the topical antibiotic. I was also told to minimize sun exposure for six weeks as it can irritate the incision and cause permanent scar discoloration — and to always wear SPF 50 sunscreen on the scar site for at least a year.
After my migraine went away on day two, I switched to Advil for treating the soreness in my upper lip. That afternoon I removed the bandage, stared at the stitches under my nose, cleaned the incision area, applied the topical antibiotic, and went about my day — while wearing a surgical mask to avoid getting looks from strangers on the street. Wearing a mask was normalized during the pandemic, and I took full advantage of that to hide my stitches; I also avoided seeing friends or socializing until after the stitches had been removed.
As days passed, it became easier to manage the incision, and the swelling began to subside. I figured out a completely new way to wash my face — dividing it into top and bottom — out of sheer terror that I might get any product close to the incision area and cause an infection. Before I knew it, it was day five, and I was back at Dr. Taglienti’s office for stitches removal.
Right after the stitches were removed on day 5
While sitting in the chair in the exam room, I felt nervous and excited to finally have the stitches removed. Turns out the nerves were unnecessary — the removal process was virtually painless, and the incision site was already hardly noticeable. Before I left the office, Dr. Taglienti told me to continue applying moisturizer to the suture line and expect the swelling and bruising to be gone by the end of week two.
Indeed, most of my swelling had gone down by week two; but week three post-op, I still felt a bit of discomfort at the incision site, plus tightness, slight numbness, and pulling when I moved my mouth or made any kind of expression.
I diligently kept the incision area moist with Aquaphor Healing Ointment, and by the middle of week two, I was able to use a little concealer to cover up redness in and around the incision area.
At the end of week two and into week three, I noticed the incision area was fully closed and the redness and related scarring was fading. There was still some rawness to the area, though. “It may take approximately six weeks for all the residual swelling to dissipate, and can take one year for the scar to disappear as much as it ever will,” Dr. Taglienti explained.
“Some potential complications of the lip lift procedure could be scarring and upper lip asymmetry,” says Dr. Leipziger. “It is extremely important to perform the procedure as symmetrically as possible to avoid lip distortion.” Other risks can include the lip lift being underdone or overdone, meaning you are left with an unnatural shape or position, adds Dr. Tepper.
To minimize scarring, Dr. Taglienti says, you absolutely must follow your surgeon’s post-procedure instructions. After being given the all-clear, massaging the scar with a moisturizer and using an over-the-counter scar gel will also help. Later in the healing process, lasers can be used to fade scars further, if necessary.
Truly, I love the results of my lip lift — but I’m also disappointed. Let me explain.
Though my top lip now appears slightly fuller and more rolled up around Cupid’s bow, I had thought I would see more of a difference. But I fully realize that any letdown on my part is not a reflection of Dr. Taglienti’s skills as a surgeon, but rather of expectations that were anatomically unrealistic.
With the distance between my nose and the top of my lip already being on the shorter side, there was only so much skin for Dr. Taglienti to remove. And he took a conservative approach, because once you remove skin, there is no placing it back. With any surgical procedure, it’s certainly better to be underdone than overdone.
I’ve returned to Dr. Taglienti’s office for several follow-up appointments (every two weeks post-surgery), and haven’t had any issues with healing. It’s now been about three months since my surgery and my upper lip is settling in, appearing more lifted than it did in the first few weeks after surgery. I do plan to enhance my results further with a little lip filler, though, which is not uncommon.
With any surgical procedure, it’s better to be underdone than overdone.
I’m even considering additional surgery with Dr. Taglienti, this time to lift the outer part of my upper lip so that it will appear more rolled up. Revision surgery is not unheard of — Dr. Taglienti says about 10 to 20% of his lip lift patients return for another procedure — and is far preferable to going too far the first time and looking permanently overdone.
Also, it’s worth noting that no plastic surgery procedure can stop the aging process. So if you get a lip lift at age 30, by age 55 that space between your nose and upper lip will have lengthened again (about 1 mm per decade) and you may need another procedure if you want to maintain your original results.
Read more on plastic surgery:
Watch as a dermatologist explains how fillers work:
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By Jolene Edgar and Emily Rekstis
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