The philtrum is the vertical groove between the base of your nose and the top of your upper lip. When the distance between the nose and the lip is long, the upper lip can look flat and thin, and the top teeth may disappear when your face is at rest. A long philtrum is common and can be something you are born with, or it can develop gradually with age.
What counts as a long philtrum?
There is no single ‘correct’ length, because the ideal depends on your overall facial proportions, sex and ethnicity. As a rough guide, many surgeons consider an upper lip height (from the base of the nose to the lip border) of more than about 15 mm in women to be long. Equally important is how much of your upper teeth show when your lips are relaxed: a youthful upper lip usually shows a few millimetres of tooth, whereas a long upper lip often shows none.
What causes a long philtrum?
- Genetics: some people naturally have a longer upper lip.
- Ageing: from middle age the upper lip lengthens and thins as collagen and fat are lost, the lip rolls inwards and the red part of the lip shows less.
- Dental changes: tooth wear and bone loss reduce the support behind the lip.
- Previous surgery or trauma to the nose or lip can alter lip length.
A long philtrum is also a recognised feature of some genetic syndromes, which is why it is discussed in medical textbooks, but on its own in an adult it is usually simply a normal variation or a sign of ageing.
Can filler fix a long philtrum?
Lip filler adds volume and can make the lip look fuller, but it does not shorten the distance between the nose and the lip. In a long upper lip, adding too much filler can make the lip look heavy or ‘duck-like’. Filler works best when the problem is volume rather than length.
Surgical lip lift
A surgical lip lift (subnasal ‘bullhorn’ lip lift) removes a carefully measured strip of skin just beneath the nose. The lip is lifted, more of the red lip shows and the upper teeth become visible again at rest. The scar sits in the natural crease under the nose. It is usually performed under local anaesthetic as a day case and takes around an hour.
Recovery and scars
Expect swelling and some tightness for one to two weeks, and stitches are usually removed after about five to seven days. The scar is pink at first and fades over several months; careful planning and closure help keep it discreet. As with any surgery there are risks, including a visible scar, asymmetry and over- or under-correction, which Mr Nassab will discuss at consultation.
Frequently Asked Questions
What is a normal philtrum length?
It varies with facial proportions, but in women an upper lip height of roughly 11–15 mm is often regarded as youthful. How much tooth shows at rest is just as useful a guide.
Does the philtrum get longer with age?
Yes. The upper lip lengthens and thins with age, which is why a lip lift is often part of facial rejuvenation.
Is a lip lift permanent?
The skin removed does not come back, so the change is long-lasting, although natural ageing continues.
Can a lip lift be combined with a facelift?
Yes, a lip lift is often combined with a facelift or other facial procedures.
