For concerns such as a long philtrum or a mouth area that looks elongated and slack, one option is philtrum reduction (lip lift).
This article gives an overview of what philtrum reduction is, how it is performed, what effects you can expect, who it suits, and the risks and downtime involved.
What Philtrum Reduction (Lip Lift) Is
Philtrum reduction (lip lift) is a procedure in which the skin below the nose is excised and sutured, physically shortening the philtrum itself.
As the philtrum becomes shorter, the upper lip is lifted slightly, the space between the nose and mouth tightens, and the mouth area takes on a more defined impression. It is a procedure chosen by people whose philtrum looks long due to aging or bone structure, or whose upper lip appears thin.
Methods / Surgical Techniques for Philtrum Reduction
Typical philtrum reduction is performed by incising below the nose and excising skin. The general flow is as follows:
Draw the incision design below the nose (along the curve at the base of the alae)
Excise the excess skin in a strip
Lift and suture the skin, finishing so the scar is less noticeable
For the incision design, there are methods that follow the line at the base of the alae to keep the scar inconspicuous (the so-called bullhorn type, etc.), chosen to fit the balance of the nose and mouth. The width to be excised is designed according to "how much shorter you want it" and "the original length of the philtrum."
Effects of Philtrum Reduction
The main changes you can expect from philtrum reduction are:
The philtrum becomes shorter, easing the elongated, slack feel between the nose and mouth
The upper lip is lifted slightly upward, so the mouth area looks more defined
When smiling and in similar expressions, the upper teeth show more naturally
The area around the mouth tends to take on a more youthful impression
How the effect appears and the final result vary by individual, depending on the original bone structure, skin condition, and amount excised. There is no one-size-fits-all answer such as "shorten it by X millimeters"; a design suited to the balance of the whole face is what determines the outcome.
Who It Suits (Indications)
This procedure is often considered by people such as:
Those bothered that their philtrum is long, or that the mouth area looks elongated and slack
Those whose upper lip looks thin, or whose upper teeth are hard to see
Those who feel their philtrum has lengthened with age
Those who feel it is hard to change the impression of the mouth area with makeup
On the other hand, for those whose philtrum was originally short, or for whom the philtrum "merely looks long" because of a drooping nasal tip or the nasolabial angle, philtrum reduction is not necessarily the best fit. When the cause lies on the nose side, an approach that designs the nose as well (Philtrum-Nose) may be more appropriate.
Risks / Downtime (Points to Note)
Because philtrum reduction is a surgical procedure that incises the skin, it is important to consider it only after understanding the following points.
Swelling / bruising: continues for a while after surgery and settles over time
Scar: a scar remains below the nose, but its location makes it inconspicuous, and it generally fades gradually over time
Suture removal: sutures need to be removed after a certain period
Possibility of overcorrection: if too much is excised, the gums may show excessively or the mouth may look unnatural
Others: risks such as asymmetry, changes in sensation, and infection
The degree of downtime, the final result, and the risks vary by individual. Please make your decision only after receiving a physician's consultation and explanation of the specific course and precautions.
The Difference Between Philtrum Reduction and Philtrum-Nose
Philtrum reduction is a procedure that "shortens the philtrum skin itself." Philtrum-Nose, by contrast, does not treat the philtrum in isolation; it analyzes and corrects the nasal lines—such as the bridge and tip—together with the nasolabial angle, making the philtrum look shorter by shaping the nose.
The philtrum skin is genuinely long → philtrum reduction is often the better fit
The philtrum "looks" long due to a drooping tip or a sharp nasolabial angle → a Philtrum-Nose design may be the better fit
Which one suits you depends on the cause, so it is determined after checking the balance of the philtrum, nose, and whole face in a consultation.
Summary
Philtrum reduction (lip lift) is a procedure that incises below the nose to physically shorten the philtrum.
As the philtrum shortens, the upper lip lifts, and you can expect the mouth area to look more defined.
It suits people whose philtrum is genuinely long; when it looks long because of the nose, a Philtrum-Nose design may be more appropriate.
Because it involves an incision, it is important to consider it only after understanding the risks—scarring, swelling, overcorrection—and the downtime.
The best approach to a philtrum concern changes with its cause. Start by confirming the length and cause of your own philtrum in a consultation.
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