Is it possible to shorten the area between the nose and the upper lip?

Hi Dr. Irwin- The area between my nose and upper lip has elongated and has a very aging and unattractive look - coupled with a very thin upper lip. I have read about a surgical lip lift but I know that all surgeons are not in favor of this procedure, but am anxious to hear your opinion. If fillers are used instead, what are your suggestions please?? I do see a fine dermatologist with an expertise in fillers but do so trust your opinion !!!!!!! I am so upset that it's making me sick - HELP PLEASE !!!!!!!!!!!! Thank you so much !!! Sandy

This is a tough question and it’s where the idiom “long at the tooth” comes from partly. MRIs done on, okay I hate to say this, but cadavers, seem to indicate some of this is actual rotation of our facial bones as we age. Some of it is certainly loss of bone and soft tissue in the jaw as well.

At this point, nonsurgical options are not great. It remains to be seen if the upper lip tissue can be tightened with radiofrequency devices but so far, I would not recommend spending money on Exilis or Thermage for this purpose. Fillers done well can create the illusion of a shorter upper lip by restoring the “ski jump” contour to the upper lip. And, there’s a way to use fillers to lengthen the chin a little so that proportion looks different.

I only have one patient thus far who opted for the surgery and she wasn’t happy initially, the surgeon redid it, and then we blended and improved the scar with fractionated CO2 and now it looks great but it was a lot of work. If you do opt for surgery, try to find someone who does these frequently (NY or LA?) and also ask if they can minimize the scar with fractionated CO2 like the DEKA DOT or Affirm.

Hope this helps,  Dr. I

Read Dr. Irwin’s article Quick Introduction to Cosmetic Skin Treatments on skin care products.

Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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