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CosmeticSurg Blog

Dr. Rodriguez discusses Plastic Surgery, Medicine, and Stem Cell Research

Lip Lift Technique: Lifting Skin Only vs Muscle

Patients today are doing a lot of research about the upper Lip Lift. One of the most frequent questions I get is if the surgery involves the muscle of the upper lip. Patients want to know if my technique involves only the skin, or if I lift the muscle in any way. My Lip Lift technique involves lifting the skin only, and I do not involve the muscle.

It seems one of the biggest proponents of technique incorporating the muscle is Dr. Randal Haworth in California. In 2008, he and I met on a trip to China representing the American Society of Plastic Surgeons, and I enjoyed his company. But I have a different approach to the upper lip lift and I will explain why.


Muscles around the Lip

Muscles around the Lip

On this photo you can see an artistic representation of the muscles around the mouth. As you can well see it is not just one muscle. All those muscles act in concert when your mouth is moving to speak, eat, or express your emotions. They act in a complex balance of forces, each one acting independently and contributing to the unique way your facial expression works. If they are working well, I see very little reason to mess around with them. Sort of like if it ain’t broke, don’t fix it. You do not need to alter the muscle, because the muscle is not the problem. The problem is the skin.
Secondly, even if I decided for some reason that I definitely must deal with the muscle, there is the issue of the possibility of nerve damage.


Lip Lift nerves

Nerves (yellow) around Lip

If the Lip Lift technique does involve the muscle, consider this photo which shows the anatomy of nerves around the lip area, where the surgery is performed.

You can see the nerves in yellow going thru the upper lip right where the muscle is being worked on. The potential for damage is too much for my taste. I have been performing this procedure with this technique for over 10 years, and I have always been very happy with the results!


If your upper lip is too long, the muscle (or nerve) is not the problem–it’s the long length of the skin space. My mantra is, ‘don’t go looking for trouble where there is none.’ For this reason, I just cut the skin, I leave the muscle alone.

The lift in a Lip Lift comes from fixing the skin of the lip to the septum cartilage of the nose and the though membrane surrounding the nasal bone openings. It is this fixation that prevents distortion of the nose, thickening of the scar, or migration of the scar.

Just take a look at our patients’ results, and remember that after the procedure what your friends will see is not just a picture of your lip, but how it moves.

By Dr. Ricardo L Rodriguez
Board Certified Plastic Surgeon
Baltimore, Maryland
Ricardo L Rodriguez, MD on Google +

Posted in Face

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  • wrote
    August 18, 2014 at 9:59 am

    Dear Help me please:
    It looks like the surgeon did not anchor the lip skin to deeper and stable structures such as periosteum or cartilage.
    For that reason the normal pull of the lips puts traction on the nostrils and creates the flaring (which widens the nostril) and pull down (that causes the “big cave” effect) that you are seeing.
    We need to set up a virtual consult to plan next steps.
    We CAN help you, and would be glad to do so.
    Contact Kelly at kelly@cosmeticsurg.net

  • wrote
    August 17, 2014 at 7:26 pm

    Dear Dr Rodriguez,
    I am hoping you may be able to help me. I had a muscle hemming lip lift and now my philtrum columns are asymetrical. My upper lip is pulled to one side and the upper lip is not centered over my teeth. Also the bottom of my nostrils have been changed in a negative way. Is it possible to center my lip and is there anything that can be done to build up my nostril base. It looks like I have big caves as nostrils now.

  • wrote
    July 1, 2014 at 11:35 am

    These are a lot of questions and requires an involved discussion. This can be done with a virtual consult. I’ll let Kelly know you are interested.
    In general, I prefer fat transfer to v-y advancements as these can result in somewhat boggy appearance.
    As far as multiple procedures, yes we do them, it depends on what you are trying to achieve.

  • wrote
    May 28, 2014 at 2:15 am

    GM Dr R. Have been doing a lot of research for lip lifts, smile lifts and implants. Had lip augmentation back in 1995/96. It was not as sucessful as I would have hoped. The dr used the fascia from scalp for implant material in both lips. As soon as swelling went down, I could not even tell I had lip augmentation (top lip was still to long, I guess back then lip lifts were not as common as they are today…although I would stare in the mirror and push the skin under my nose upward and think if only I could get some of this skin removed). The second procedure was to implant thin strips of gortex into my lips for volume, unfortunately the gortex popped out of my bottom lip, it was never sutured, and to even out my top lip the dr used long strips across my entire top lip but then to justify the thinner side of the right side he cut strips in half to pump up the volume. This has caused the half strips to become encapsulated so the when I purse my lips one can see a point in my lip under the cupid’s bow. So here are my questions, can/will you remove the gortex strips from top lip, do a lip lift and add the soft lips material? What are your thoughts on the vy procedure for lip fullness for both top and bottom lips? AND after all of that, can you perform a smile lift, an upper lip lift (perhaps with either vy or “soft lips” material for both upper and lower lips) all at the same time? If not, would the gortex need to be removed and my lip allowed to heal before any of the other procedures? I ask this as I will be an out of town patient. But after doing my research, I want you to perform my lip surgeries!!!! How long will recovery be and what would the cost of these 3, possibly 4 surgeries cost? By the way I will hit the big 5 0 at the end of this year and am tired of always looking angry/mad. (or has my husband would say having a “sour puss” look. Thx! Diana.

  • wrote
    April 12, 2014 at 1:16 pm

    I would need to see pictures to be able to suggest the best alternative for you. In general, when there is so much tooth show, the best thing to do is filler. Have you tried fillers? Even if the lip looks too long, once you add vermillion (the red part of the lip) with a filler the proportions may change. one may also consider filing down the teeth if they appear too long. All of these are wild guesses and I would have to see your pictures to give you an accurate idea of what to do.
    And yes we do multiple procedures often and a discount applies to the second procedure.
    I’ll put you in contact with Kelly to see if we can review your pictures. She is at kelly@cosmeticsurg.net

  • wrote
    April 1, 2014 at 1:25 am

    Would you do a lip lift on a 44 yr old female where the distance is 1.55 cm, but when the lips are relaxed you still see half the upper teeth? My upper lip is very thin and the distance to the nose seems too long, but would the lip lift give a buck teeth type of look in this situation?

    I’m considering doing the lip lift with a brow lift to correct eyelid hooding and assume that you can do them together and possibly give a discount for 2 procedures at once.

  • wrote
    September 12, 2013 at 5:31 pm

    One could possibly release the scar and inject some fat in between so the muscle would not reattach.
    But this is conjecture. To really know more specifically I would need to see pictures and do a Skype to see your lip move. That would amount to a virtual consult. If interested, contact Kelly at kelly@cosmeticsurg.net

  • wrote
    September 12, 2013 at 5:19 pm

    I answered on your other post but just want to add that racial background is not as important in the face and if you use proper technique.
    I have done hundreds of these and scarring has not been a problem.

  • wrote
    July 22, 2013 at 7:25 pm

    I had a liplift that involved the muscle and then the doctor attached the muscle to the periosteum. Now I can’t move my upper lip normally. I cannot lift it from the center at all. Can this be reversed?

  • wrote
    July 15, 2013 at 6:34 pm

    Hi Dr Rodriguez,
    I may have posted my question on the wrong section. Sorry if this is repeat.
    I am prone to scars. What is the likelihood that i will get scarring with this procedure? Are there times where patients may be better off not doing a lip lift if the changes of scarring are significant?
    I am Hispanis background.



  • wrote
    February 28, 2013 at 1:31 am

    Interestingly enough, yes.
    I have had an uptick both in requests for information as well as patients booking surgery.
    For men I recommend a lip length more on the order of 1.3-1.5 cm depending on circumstances.

  • wrote
    February 27, 2013 at 3:20 am

    Very interesting post Ricardo. I’ve noticed that this surgery has become quite popular even with men recently. Have you had many male clients over the past few months?

  • wrote
    January 29, 2013 at 2:03 pm


  • wrote
    January 29, 2013 at 2:00 pm

    Only minimally. There is a procedure called the corner lip lift that lifts the corner.
    You can also inject botox to the muscle that depresses the corner of the mouth. I do this quite a bit and it works well but is temporary (3 to 6 months).
    That muscle can also be resected, but I don’t do that procedure.
    If you are interested in a virtual consult to see what is appropriate for you contact Kelly at kelly@cosmeticsurg.net

  • wrote
    January 24, 2013 at 1:40 am

    Excellent information Dr. Rodriguez you are a master doing upper lip lift I am very happy with my results. Thanks!!!

  • wrote
    January 22, 2013 at 9:41 pm

    Does this improve droop at the corner of the mouth in any way?