This is a great case example of an upper lip lift procedure using a subnasale approach. This particular patient from San Diego, CA came to our office to consult about her excessively long upper lip. She is a very attractive female who simply did not like the fact that her upper lip was too long for her face. As you can see in the photos below taken prior to surgery, her upper lip did, in fact, appear too long. Some people describe this as an excessively long upper lip while others call it an elongated upper lip. What this really refers to is the vertical height of the upper lip being excessive in relation to the remainder of the lower one-third of the face.
Subnasale Upper Lip Lift
After consulting with her, our facial plastic surgeon, Dr. John Hilinski, recommended that she undergo a subnasale upper lip lift procedure. Subnasale refers to placement of the incision under (sub) the nose (nasale) where the upper lip meets the base of the nose. Some facial plastic surgeons refer to this as a bullhorn incision since the outline of the skin being removed mimics the shape of bullhorns. In this particular patient, the upper lip was measured carefully prior to the upper lip lift to determine how much skin would be left behind. Ultimately, we decided to leave approximately 14 mm of upper lip skin behind while removing the remainder using the subnasale approach. The actual upper lip shortening procedure was performed under local anesthesia in our own ambulatory surgery center procedure room. After placement of the numbing medication along the upper lip, an incision was made along the natural contour of the base of the nose.
The bullhorn subnasale approach was completed by extending the incision across the remaining portion of the upper lip. Once the excess upper lip skin was removed, the lip was lifted upward. Effectively, this shortens the vertical height of the upper lip – which is why many call this an upper lip shortening procedure. Small sutures (stitches) were hidden under the skin while lifting the lip, which adds stability to the tissue so that scarring is minimized. Even finer sutures are then carefully placed to close the skin edges together. To give you an idea of what this looks like just prior to removing the sutures 5-6 days later, I have provided the adjacent photo. As you can see, the final incision (scar) is fairly well concealed under the nose in the natural junction zone where the upper lip meets up. At 5-6 days out, you can still see some redness and swelling, which is completely normal healing for this stage of the healing process. But even with that present, she looks quite presentable overall. The blue strings that can be seen in the photos are the finer skin sutures that were placed during the final closure of the upper lip lift.
Before and After Photos
This patient’s before and after photos of her subnasale upper lip shortening procedure are shown below. As you can see, her upper lip has been lifted up to create a shorter vertical height overall. When you look at her upper lip now, you simply do not see anything unusual or abnormal. The length of her upper lip is now much more appropriate for her facial proportions and appears very natural looking. If you look specifically at the lip itself, you can also appreciate how the pink portion of the upper lip has been turned up and out in a modest fashion – to give a slightly more pouty and feminine look. If you look closely, you can see a hint of where the incision was made underneath the nose, but it is not really obvious to someone who did not know what she had done.
Consultation for Subnasale Upper Lip Lift
If you happen to have an upper lip that is excessively long for your face, come visit with one of the experts in the subnasale upper lip lift, or lip shortening procedure. We are conveniently located in central San Diego in the Bankers Hill area. We look forward to meeting you!
Dr. John Hilinski has either authored or reviewed and approved this content.