Subnasal Lip Lift

Q: Dr. Eppley, I am interested in a subnasal lip lift.  I’ve measured my philtral length from the base of the nose to the upper vermillion border and it is 16mm. I know this isn’t a great distance but it looks large on my small face. I suppose following the 25% rule, 4mm of upper lip shortening would be germane. Am I correct in saying that making the philtrum 4mm shorter will result in 4mm of extra upper vermillion pout to make up for the distance? This does appear to be a lot, but I am not sure how it works. The examples I linked appeared to show very little increase in vermillion show compared to the reduction in upper lip length.

A: In a subnasal lip lift, It is not a direct correlation between the amount of skin under the nose removed and the amount of lip increase that occurs below. Usually it translates to less than 50% and often just 25%. This means that about 1 to 1.5mms of central pout lip increase occurs for a 4mm or 25% vertical lip length reduction in your cases. It is important to remember that tissues do not respond like a block wood. They are elastic and stretch which is why it is not a 1:1 correlation as one would understandably think.

Dr. Barry Eppley

Indianapolis, Indiana