By Dr Scott J Turner, Specialist Plastic Surgeon | Sydney, Brisbane & Canberra
The upper lip lift has become incredibly popular over recent years. Scroll through social media, and you’ll find endless before-and-after photos making the procedure look straightforward—a simple way to shorten the distance between nose and lip. But here’s what those curated images don’t show you: a significant number of patients experience real regret after this permanent, irreversible surgery.
The research tells a sobering story. Studies show that around 60% of dissatisfied patients cite scar-related concerns as their main complaint. Nearly 60% report severe psychological distress following procedures that didn’t meet expectations. These aren’t just numbers—they’re real people who made decisions they now wish they could take back.
What Is an Upper Lip Lift?
An upper lip lift is a permanent surgical procedure that shortens the philtrum—that’s the vertical space between the base of your nose and your upper lip. The surgery removes a strip of skin beneath the nose and repositions the lip upward. The goal? To increase the visible pink lip (the vermillion), improve tooth show, and create better Cupid’s bow definition.
The most common technique is the bullhorn or subnasal lip lift, named for the incision shape that follows the natural contours where the nose meets the lip. When it’s done on the right patients using proper surgical technique, the procedure works well for addressing age-related changes. As you get older, your upper lip naturally elongates, the pink portion thins, and you show fewer teeth when you speak or smile.
Understanding ideal proportions helps here. In women, the philtrum typically measures between 11 and 13 millimetres; for men, it’s roughly 13 to 15 millimetres. A shorter vertical distance allows natural eversion of the lip border and appropriate visibility of upper teeth—generally 1 to 5 millimetres when your mouth is relaxed.
But here’s the thing: unlike cosmetic injectables that can be dissolved if results disappoint, a lip lift permanently removes tissue. Once that skin is gone, it’s gone for good. This irreversibility is exactly why proper patient selection and surgical technique matter so much.
Why Are Younger Patients Increasingly Seeking This Procedure?
Traditionally, lip lift surgery was done on patients aged 40 to 65 with clear age-related changes: elongated philtrum, thinning vermillion, decreased tooth show, and existing facial lines that could hide scars.
That’s changed dramatically. Recent studies show mean patient ages of just 28 years, with nearly half falling within the 20-35 age bracket. What’s behind this shift? Social media.
Instagram hosts millions of lip enhancement posts. Research comparing Instagram content to actual clinic populations found stark differences—social media over-represents fuller lip types at 64 to 70 per cent, compared to only 12 to 15 per cent in real patient populations. This creates “perception drift,” where seeing filtered, edited images over and over recalibrates what you consider normal.
The “Kylie Jenner effect” is a perfect example. When the young reality star admitted to cosmetic injectables, clinics reported enquiry surges as high as 70 per cent within 24 hours—showing just how powerfully social media can drive demand regardless of whether a procedure is actually right for someone.
Why Younger Patients Are Poor Candidates
The core problem with doing lip lifts on younger patients comes down to two things: scarring visibility and whether there’s actually a good reason for the surgery.
The Scarring Problem
Older patients with existing facial lines and natural skin texture can effectively hide lip lift scars. The incision blends into the landscape of the face.
Younger patients? Quite the opposite. Smooth, flawless skin offers nowhere for a scar to hide. The incision sits right at the nose-lip junction, and if the surgery isn’t expertly performed and a poor scar develops, it becomes very obvious. Studies show over 13 per cent of patients develop poorly positioned scars that need revision.
The vibrant, reactive collagen in younger skin actually works against you during healing. Rather than forming a fine, nearly invisible line, younger skin may respond with a prominent, raised scar that’s difficult to cover even with makeup.
The Indication Problem
Here’s a question worth asking: if you’re in your twenties with a short philtrum, full lips, and plenty of tooth show—what exactly are you trying to fix?
The lip lift was designed to address specific anatomical changes that come with facial ageing—elongation, thinning, descent. Doing this surgery on someone who hasn’t experienced these changes doesn’t make much clinical sense.
What’s more, your face keeps changing over the decades. A lip that looks “ideal” at 25 may appear unnaturally short as surrounding tissues age. This “over-resection” in youth leaves no good options for lengthening later, and often leads to permanent regret.
The Irreversibility Problem: Why Revision Has Severe Limitations
Many patients assume a “bad” lip lift can simply be “fixed” with more surgery. The reality is far more complicated.
What Can Go Wrong
Research shows several recurring complications:
Scar-Related Issues: Hypertrophic scarring, scar migration, asymmetric positioning, widened scars from too much tension, and persistent redness.
Structural Complications: Nasal distortion (24% of dissatisfied patients), lip asymmetry (20%), excessive shortening that prevents comfortable mouth closure, and distortion of natural contours.
Functional Problems: Difficulty closing lips causing dryness, impaired speech, nasal flaring, and persistent numbness.
The Scar Revision Paradox
When patients seek scar correction, they hit a cruel paradox. Proper scar revision requires removing at least 3 millimetres of tissue, which necessarily shortens the upper lip even further.
For patients already dealing with excessive shortening, scar revision makes things worse rather than better. In some cases, revision becomes technically impossible, meaning surgical options simply don’t exist anymore.
One study found an overall revision rate of around 25%—significantly higher than many other facial procedures. And these figures only capture patients who actually pursued corrective surgery, not those who couldn’t afford revision or were told meaningful correction wasn’t possible.
The Procedure Problem: Clinic Techniques vs Hospital-Based Deep Plane Approaches
A big factor in lip lift complications comes down to where and how the surgery is done. The rise in poor outcomes lines up directly with simplified “skin-only” techniques performed in office settings.
The Simplified Clinic Approach
Some practitioners offer lip lifts as quick office procedures: local anaesthesia only, simple skin removal, basic closure, and limited work on underlying structures.
Whilst convenient, this approach doesn’t address the deeper anatomical structures that provide lasting support. When the lip’s weight hangs solely on skin sutures, tension leads to scar widening. The downward pull causes nasal distortion—widening the nostrils, pulling down the columella, and blunting the nasal sill.
The Evolution from Skin to Deep Plane
This mirrors the historical evolution of facelift surgery. Early facelifts relied on skin tightening and produced temporary results with visible tension and an artificial look. We now understand that durable correction requires repositioning the SMAS layer and releasing the retaining ligaments.
The same principles apply to lip lifts. Just as modern facelifts moved to deep plane techniques, optimal lip lift surgery demands comparable sophistication.
The Hospital-Based Deep Plane Technique
Advanced lip lift surgery applies these principles through comprehensive approaches performed in accredited hospital settings with general anaesthesia or IV sedation and a qualified anaesthetist present.
The deep plane technique addresses multiple anatomical layers:
- Orbicularis oris muscle management supports the new lip position
- Pyriform aperture fixation secures mobilised tissue to the bony nasal base, providing permanent anchorage
- Multi-layered closure incorporates deep, intermediate, and superficial layers with minimal skin tension
By anchoring deep tissues to immobile bony structures, the skin closure bears essentially zero tension. The resulting scar heals as a fine, barely noticeable line.
Properly performed deep plane procedures take 60 to 90 minutes—considerably longer than 30 to 45 minute simplified techniques. Surgeons offering “quick” lip lifts are almost certainly using simplified techniques with predictably inferior results.
The Qualification Gap
The growing popularity of lip lifts among non-specialist practitioners is a real safety concern. The complex anatomy and technical demands require specialised training on par with facelift surgery.
In Australia, becoming a Specialist Plastic Surgeon takes 12-14 years of training beyond high school, including FRACS fellowship through the Royal Australasian College of Surgeons. Some practitioners offering lip lifts lack this level of training, which can lead to complications that require expensive revision by qualified specialists—if revision is even possible.
True Indications: Who Should Actually Consider a Lip Lift?
The upper lip lift is a positional procedure designed for specific anatomical issues—not general lip augmentation.
Appropriate Candidate Profile
- Aged 40-65 with clear age-related changes
- Philtrum length over 15 millimetres
- Thin vermillion with minimal pink lip show at rest
- Reduced upper tooth visibility when speaking or smiling
- Existing facial lines that can help hide scars
- Non-smoker or willing to stop 6 weeks before and after surgery
- Realistic expectations about what’s achievable
Who Should NOT Have a Lip Lift
- Short philtrum (under 15mm)—further shortening creates unnatural proportions
- Already full upper lip with good tooth show
- Age under 30 with smooth skin (scars will be too visible)
- History of keloid or hypertrophic scarring
- Chasing social media aesthetics rather than addressing genuine age-related changes
What This Means for You
If you’re thinking about upper lip lift surgery, here are some principles worth keeping in mind.
Question whether it’s right for you. If you don’t have age-related elongation, thinning, and tooth-show issues, you may not be a good candidate—regardless of what you’ve seen on social media.
Check your surgeon’s qualifications. Confirm FRACS plastic surgery specialisation and specific expertise in facial surgery.
Understand the technique being used. Ask about deep plane dissection, muscle management, and suspension methods. Find out where the procedure will be done and what anaesthesia will be used.
Accept that it’s permanent. Understand that unsatisfactory results may be difficult or impossible to fix.
Choose quality over convenience. Hospital-based procedures with a comprehensive technique produce better results than simplified clinic approaches.
A Final Thought
Lip lift regrets follow a consistent pattern: wrong patient, inadequate technique, undertrained surgeon.
When the procedure is done on the right candidates with clear age-related changes, using deep plane technique by qualified Specialist Plastic Surgeons in proper surgical settings, upper lip lifts can successfully restore proportion with acceptable scarring and high satisfaction.
It comes down to a simple principle: cosmetic surgery should address genuine anatomical concerns through evidence-based techniques—not create permanent changes chasing fleeting social media trends in people who weren’t candidates in the first place.
About Dr Scott J Turner
Dr Scott J Turner is a Specialist Plastic Surgeon and Fellow of the Royal Australasian College of Surgeons (FRACS). He practises from clinics in Sydney (Manly and Bondi Junction), Brisbane, and Canberra, specialising in facial plastic surgery including facelift, rhinoplasty, and lip lift procedures.
To discuss whether you may be a suitable candidate for lip lift surgery, contact us to arrange a consultation.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. All surgical procedures carry risks and potential complications. Individual results vary. A comprehensive consultation is required to determine suitability for any procedure.
