Lip Lift and Augmentation

A lip lift results in a more youthful, voluminous lip and smile by raising the upper lip’s position. A lip lift feminizes the lips. Lip augmentation adds fullness to both the upper and lower lips giving natural, soft, beautiful lips.

A lip lift with or without lip augmentation is a safe and effective procedure with a short recovery period that delivers incredibly long lasting results. Our Craniofacial Plastic Surgeon, Dr. Costa, enjoys lip lifts as they are powerful procedures which patients love and derive great benefit with inconspicuous scars. Dr. Costa performs lip lifts for patients from San Jose, the Bay Area, California, and outside California.

Lip Feminization in the San Francisco Bay Area

Feminizing the appearance of the lips helps create a feminine identifying gender marker. There are multiple considerations that are involved with lip feminization. The main components of lip feminization involve lifting the lip, volumizing the lip with lip augmentation, and sometimes, resurfacing the lip to reduce lines with perioral resurfacing.

Surgical Lip Lift

A surgical upper Lip Lift feminizes the lip by shortening the lip and increasing visibility of the teeth and the pink portion of the top lip, or vermillion. It also increases the prominence of the pink portion of the upper lip.

Tissue Graft Lip Augmentation

Lip Augmentation contributes to feminization by producing a fuller vermillion (pink lip). Both the upper and lower lips are typically augmented. Tissue grafts produce a very natural and long lasting result.  Fillers also augment the lip and require repeated visits as the product goes away with time.

Lip Resurfacing

Lip resurfacing, or perioral resurfacing, helps to smooth the skin and reduce the appearance of fine lines and wrinkles in the skin around the lips. Laser resurfacing effectively accomplishes this. Laser resurfacing can also improve the skin of the entire face as well.

What Does a Lip Lift Do? 

Also known as a smile lift, or lip flip surgery, this procedure feminizes and rejuvenates the lip and provides long term changes. As the name suggests, the procedure lifts the upper lip, doing so by removing skin between the lip and the nose. 

Treatment Goals

The goal in a lip lift procedure is individualized to each patient. In general, the goal is to create a more feminine and/or youthful lip. In some patients, another goal is correcting downturned mouth corners; patients often dislike the frowned appearance this causes.

Precision Bay Area Lip Flip Surgery :

Any scars are hidden. Dr. Costa’s technique places the incision precisely where it needs to go to give a narrow nearly undetectable scar.

Another goal is to restore tooth show below the upper lip, which is a feature of a feminine and youthful lip.

What are the Benefits of a Lip Lift in San Jose California? 

The lip lift is a simple yet transformative procedure – it produces clear improvements in the aesthetics of the lip and facial harmony and is a critical component in lip feminization. 

The lip lift is a powerful, long lasting procedure. Your results will last for over a decade. It is a reliable procedure that consistently produces the desired result. 

Benefits include optimizing the harmony, proportion and lip shape:

  • Elevates lip, correcting lip ptosis, or lip hanging
  • Shortens upper lip 
  • Increases tooth visibility, enhancing the smile
  • Produces a fuller lip
  • Corrects lip asymmetries
  • Natural results
  • Hidden scar
  • Long lasting
  • Decreased use of fillers
  • Short procedure (1 hour)
  • Simple recovery

Choosing a Lip Lift

You may want a plastic surgery lip lift if you:

  • Have or are transitioning from male to female and desire a more feminine lip
  • Lack visibility of the center upper teeth with your lips slightly parted
  • Would like to increase the prominence of the pink portion of the lips
  • Have a long distance between your upper lip and nose; have a hanging lip appearance
  • Have been getting fillers and want a longer lasting, more consistent result
  • Would like to minimize signs of aging of the lips: a top lip that has fallen; the top lip is rolled under itself; thinned lips
  • Appearance of downturned mouth corners, a persistent frown or sad face appearance

Gender Differences in the Lip 

There are different characteristics of a masculine and feminine lip. Masculine lips tend to be longer than that of females. The difference is typically between 1.5 to 2 millimeters (mm). The distance between the top of the pink lip (vermillion) and the nose is the philtral length. Feminine lips in young individuals range from a philtral length of 13 mm to 16 mm. 

Another difference is that in general, the lip tends to be fuller in females. Males tend to have thinner lips. In addition, a feminine appearing lip has a few millimeters of the central upper teeth visible when the lips are in repose; slightly apart and relaxed. This is known as incisal show. When the mouth is gently opened and relaxed, seeing a portion of the central upper teeth gives brightens the appearance of the mouth region.

A surgical upper lip lift addresses all of these differences. By removing skin from the upper lip at the junction between the nose and the lip, the lip becomes elevated. Closing the incision often increases the tooth show as well as shortens the lip. This feminizes the lip, making it appear more youthful, and giving a brighter smile. 

Aesthetic Considerations of the Lip

A young and feminine lip has what is known as tooth show, or upper incisal show. The central upper teeth are visible with the lips held slightly apart and relaxed. A feminine, youthful lip has 2-3 millimeters (mm) of tooth show. 

With age, a lip that otherwise had 3 mm of upper central teeth visible at rest may lose this tooth visibility. 

In addition, with age, the cutaneous, or skin bearing portion of the lip, will lengthen. This results in a more aged appearance in both males and in females. 

The vermillion, or pink lip, decreases in height with age. The vermillion also loses volume and thins. 

The skin bearing portion of the lips develop lines from age and from the underlying muscle over time 

Proportions: as the upper lip lengthens, the proportions between the height of the upper lip compared with the lower lip and chin change, bringing the lower face out of harmony.

In summary: with time, as our faces age, the lip becomes longer, the pink portion rolls under, and the upper front teeth disappear from sight, and the distance between the pink lip and nose lengthens. This results in a more masculine, aged appearance. The lip lift restores a more youthful appearance to the lip.  

Plastic Surgery on the Lip: Types of Lip Lifts


There is more than one type of incision that can be used in a surgical lip lift. Dr. Costa will work with you to determine the optimal method based on your individual anatomy and goals.  

Subnasal Bullhorn Lip Lift

The subnasal incision is the most common one and excellent as it conceals the incision within natural creases. This type of lip lift is known as a “bull horn” lift due to the shape of the skin pattern. Dr. Costa places the incision such that the resulting scar lies at the border between the lip and nose. The pattern of skin removed resembles that of a bull horn. The skin pattern hides the scar in this natural skin crease. This procedure does not distort the nose when done properly. Dr. Costa finds the bull horn particularly rewarding for its reliable results, ability to vary the amount of lift in the center and on the sides, and how it conceals the scar so inconspicuously below the nose. 

Of note, it is important that your surgeon have expertise in performing lip lifts. The placement of the incision is critical to produce a hidden surgical scar. The closure is also fundamental in ensuring the scar does not spread and there is no distortion of the nose. 

Corner Lip Lift and Korean Smile Lift

A corner lip lift addresses the downturned corners of the mouth. With age many patients complain about the corners of the mouth, as they become rolled under. Downturned corners can also be a natural mouth shape in individuals. This can give the appearance of a frown or a sad face. For this reason, it is often referred to as a “grin lift.” Dr. Costa places the incision at the upper border of the lip in the corners rather than across the entire lip. A triangular pattern is removed and is often referred to as a “banner” or “pennant” corner lip lift. This type of surgical upper lip lift works well for patients who feel they have a regular frown with turned down lips and would like a move even appearance to the pink vermillion of the top lip. 

A Korean lip lift or Korean smile lift removes skin from the upper and bottom corners of your lips. This gives a more uplifted appearance to the mouth corners. It also lengthens the mouth, making it a great option for those looking to change a short mouth.

Direct Lip Lift

A direct lip lift, or gull wing incision, is another approach that defines the lip border. Here, the scar is placed at the upper border of the lip. A small amount of skin is removed from just above the upper lip. This gives greater definition at the vermillion border, or upper border of the top pink lip.

Lip Lift in the Bay Area Surgical Treatment: Lip Lift Operation

An upper lip lift creates upper tooth show and a shorter, fuller upper lip. Lip augmentation is quite often done at the same time as the lift.

What is the Operation like?

The lip lift can be done in the office under local anesthesia. It may also be done in the operating room, particularly if it is combined with other procedures. Our patients often combine a lip lift with other facial feminizing procedures or a face lift. The lip lift is generally done as an outpatient procedure. This means you will go home the same day, unless combining the procedure as part of a larger operation, in which case you may stay overnight,

The procedure takes one hour. Dr. Costa carefully marks the pattern of skin to be removed. After you are numb from anesthesia, skin above your lip is removed. The more skin that is removed, the more elevated your lip will be, the more tooth show and the more your pink lip will be seen. This elevation also helps to restore the natural rolling up of the top of the lip border. Dr. Costa takes diligent care to remove the right amount of skin, elevating your lip to a level that you and Dr. Costa agree upon during the presurgical process. Ultimately, your lip is elevated into a more feminine, youthful appearance.

Lip Lift Recovery and Aftercare

There is some initial swelling and bruising that are present for a few days after the procedure. Sutures are removed one week after the procedure. Lipstick can be worn following suture removal. No dressing is needed, and antibiotic ointment is used over the suture line under the sutures are removed. Most patients who are not working from home wait until suture removal to return to work. Patients who work from home can return to work in 1-2 days. 

What is the Scar from a Lip Lift Like?

Is there a scarless lip lift? With the subnasal, or bullhorn approach, Dr. Costa carefully places the scar precisely at the junction where the lip and bottom of the nose meet. In the way, the incision is hidden in this natural crease. As the scar matures with time, this approach allows the scar to be virtually indetectable. The scar may be pink early in the healing process and can be easily concealed with makeup. 

Dr. Costa uses anchoring sutures at the base of the nose, placed in the deep tissues, to secure the repair. This prevents any distortion of the nose and also produces a narrow inconspicuous scar, producing a beautiful result. With the gullwing, or direct lip lift approach, the scar is in a different location – it is located at the top border of the pink lip. With a corner lip lift, the scar is also at the top border of the pink lip, and only at the corners of the lip. 

*Dr. Costa’s expertise as a Craniofacial Plastic Surgeon, having done numerous cleft lip and nasal repairs on infants, that require meticulous technique and attention to detail, transfer over to procedures such as the lip lift. Read about Dr. Costa’s expertise and training here

How will a Lip Lift Change My Smile?

Because a lip lift elevates the entire lip, in the case of a subnasal and direct lip lift, your tooth show will increase. This means that you will have a brighter, enhanced smile showing your teeth. In a corner lip lift, you will no longer have downturned corners, or a frown appearance to your mouth.

A lip lift will not change your ability to smile. Dr. Costa leaves your muscles undisturbed in the procedure. 

Is Much of My Lip Skin Removed?

Dr. Costa will remove the amount of skin necessary to achieve your desired result given your individual lip anatomy and characteristics. Care is taken not to remove an excess amount of skin.

Will the Lip Lift Affect the Muscle Around My Mouth?

No, it will not. The muscle is not cut during a lip lift using Dr. Costa’s technique. The muscle fascia, a sheet of tissue overlying the muscle, is tightened, which contributes to the long lasting results. Healing time and discomfort are minimized because the muscle is not disturbed. 

Procedures Combined with a Lip Lift

A lip lift is often paired with tissue graft Lip Augmentation and Feminizing Forehead Reduction Surgery as well as other Facial Feminization procedures. 

Rhinoplasty, or nose reshaping, can also be performed at the same time as a lip lift. 

Patients greatly benefit and will have a facelift along with a lip lift. A facelift cannot address the upper lip area. The combination of a facelift with a lip lift provides the best outcome for facial harmony and rejuvenation. 

Other procedures that can be combined with a lip lift as an in office procedure under local anesthesia include upper blepharoplasty and skin resurfacing procedures

Who is a Candidate for a Lip Lift?

As a powerful procedure for feminizing the lip, the lip lift is a key procedure in gender affirming facial surgery, or facial feminization surgery (FFS). 

Cis gender women who want to feminize their lip are also candidates for a lip lift. 

And because the lip lift rejuvenates the lip, it is a wonderful procedure for individuals with an aging lip, regardless of gender. Both cisgender and transgender men, non-binary individuals, and cisgender women can benefit from a lip lift. 

Will Everyone Benefit from a Lip Lift?

If your philtrum, the distance between the nose and the top lip upper border, is already short, with a large amount of the teeth showing, a lip lift would not be advisable. Further shortening an already short lip could result in excess tooth or gum visibility. If you are referred to an aesthetic dentist and your teeth are shortened, you may become a candidate for a lip lift.  Otherwise, Dr. Costa will work with you to plan a different procedure to achieve your goals. 

Lip Lift in Males

Cisgender men also undergo lip lifts. The lip lift is an excellent rejuvenating operation in males. Just as with females, males can have thinner lips, either naturally or as a result of age. A lip lift can create more volume and address thinning lips in males. By removing excess skin and elevating the lip, the lip appears more youthful immediately. Males may appreciate avoiding repeated office visits required with injectable fillers. Male lip lifts can also improve symmetry for patients with uneven appearing lips. 

Lip Lift Revision

If you feel that your scar is noticeable, Dr. Costa may revise your scar to made it nearly undetectable. Placement of the incision and technique is important in obtaining the best results. Revisions may also be done in patients that want additional elevation or to correct asymmetry.

Lip Feminization Surgery Compared with Non-Surgical Treatments

Lip Augmentation can be accomplished with autogenous grafts from your own body, silicone implants, and dermal injectable fillers. Many individuals use fillers to plump and shape their lips. Many also use fillers to minimize the lines around the upper lip. Hyaluronic acid (HA) fillers are recommended for lip injection. Benefits of HA fillers include ease of use with an off the shelf product and the ability to dissolve the product. Fillers absorb over time and require repeat visits for injection. When fillers are place in the skin above the upper lip, one result that can happen, is that the upper lip can lengthen and turn downward, producing a more aged appearing lip. 

In contrast to fillers, both a surgical lip lift and autologous tissue grafting give long lasting results. The result is consistent, whereas with fillers, there can be variations each time the filler is placed. With respect to cost, a lip lift compared to multiple filler injections is more cost effective over time. 

LIP AUGMENTATION | San Jose | San Francisco Bay Area

A lip augmentation is often done at the same time as a lip lift to give fuller lips. Fuller lips are often associated with a more feminine appearance. Dr. Costa mostly uses tissue grafts known as a dermal fat grafts. The dermal fat graft is composed of skin, fat, and fascia, another type of soft tissue. Tissue grafting using dermal fat grafts provide long lasting, natural results. Lip feminization with a surgical upper Lip Lift with Lip Augmentation are often done at the same time as Feminizing Forehead Reduction Surgery. In this case, dermal fat grafts from the scalp are use to augment the lips. 

If performed in conjunction with a facelift, grafts from the subcutaneous fat and fascia at the SMAS are often use for lip augmentation. 

Other methods used to augment the lips include injectable fillers consisted of hyaluronic acid and injectable fat grafting.

Benefits of Tissue Graft Augmentation

Tissue grafts are very well accepted by the body and are a great way to augment the lips, providing a soft, natural result. Using a tissue from your own body means that the infection rate and other reactions are quite unlikely. When material such as silicone implants are used, there is a higher risk of problems, such as migration, being able to feel the implant giving an unnatural feel to the lip, and infection. Dermal fillers, or injectable fillers, are another option used for lip augmentation. Hyaluronic acid fillers are most appropriate for the lip and will need to be repeated over time as they go away and the cost over time can be quite significant. Another method of lip augmentation is injectable autologous fat grafting. This method is well tolerated and also the grafts resorb and are often unreliable, needing multiple rounds of grafting to obtain the desired fullness. 

What is the Consultation Process Like?

Dr. Costa, Craniofacial Plastic Surgery expert, will discuss your goals and go over all aspects of the lip lift as well as related, complimentary procedures such as tissue grafts. During your consultation, Dr. Costa will help you generate a customized surgical plan that fits your needs and maximizes outcomes including facial and lip harmony and minimizing downtime. She will help you choose the method of lip lift and augmentation type to give you a beautiful result.

Lip Lift Cost in California

A lip lift and graft augmentation for facial feminization, for transgender patients, is typically covered by insurance. Your cost will depend on your individual co-insurance and deductible. 

Otherwise, these procedures are considered aesthetic and are an out of pocket expense. The smile lift surgery cost varies nationally. Our office works with lending institutions such as CareCredit® and that provide plastic surgery financing in order to help patients obtain their desired procedures while working within their budget. 

Comparing injectable fillers with a lip lift and tissue graft lip augmentation, the cost of an injectable filler is higher than the surgical procedures. However, over time, the costs outweigh that of the surgical procedures. This is because injectable fillers need to be repeated over time due to absorption. Patients can also get filler fatigue for all the times needed to return for another injection. Surgical lip lifts and tissue graft augmentation provide durable, very long lasting results. 

before and after lip lift and tissue graft augmentation
Early results following a sub nasal, or bullhorn, lip lift and tissue graft augmentation of the upper and lower lips. A lip augmentation is commonly performed with fat grafts or artificial filling material. This rejuvenates and feminizes the lips. Lip feminization can involve a lip lift, lip augmentation, or both.