You have read all eight names and somehow understand less than before
Search for a lip lift and the names pour out. Bullhorn, subnasal, Italian, gullwing, direct, central, V-Y, corner. One clinic calls the bullhorn the standard. One review swears the Italian leaves no scar. Somewhere else the whole thing is simply called philtrum reduction. I imagine that even after memorising every name, the one question that matters — which one is mine — was still unanswered.
I do not think the cause of that confusion is missing information. There are eight names, and those names are borrowed from different categories. One comes from the shape of the incision (bullhorn), one from its location (subnasal), one from the country where the technique was written up (Italian). Line up names drawn from different logics and no comparison will resolve.
What I actually do in the consulting room is not recommend one of eight. I measure the philtrum, I measure the height of the upper vermilion, and I look at how many millimetres of gum appear when you smile fully. Once those three numbers exist, most of the eight eliminate themselves. What remains is usually one, at most two.
So this is not a catalogue. It is a differential worksheet. First I will define what a lip lift actually shortens. Then I will reduce the incision sites to four anatomical locations and place the eight types back onto them. After that come the three measurements we take, and the branches those numbers lead to. At the end I will be direct about where the scars land and when I decline to operate.
Before the names, you need to see what tissue this operation touches.
What a lip lift actually shortens
To answer directly: a lip lift does not enlarge the lip, it removes skin between the nose and the lip. Formally it is an upper lip lift; in Korea it is called philtrum reduction or philtrum shortening, and in English it also appears as upper lip shortening surgery. Its mechanism is the opposite of filler or a lip flip. Nothing is added. Something is taken away.
That difference sets the character of the result. Three points.
① What shrinks is skin. A planned strip of skin between the nasal base and the lip border is excised and closed, and the philtrum becomes physically shorter. Filler cannot produce this change at all.
② The lip looking fuller is a side effect. As the skin is drawn upward, vermilion that was rolled inward rotates outward. Literature and clinical experience put that gain at roughly 1–3mm. No tissue was created; the lip you already had became visible. That is exactly why the result reads as natural.
③ Gum show can increase. The upper lip rises structurally, so a patient who already shows a lot of gum when smiling may show more. This becomes one of the most important branch points among the eight types.
That is the shared principle. What genuinely separates the results, however, is not the principle but where the skin is removed from.
There are only four places the incision can sit
Reduce all eight names to anatomy and you get four locations. In consultation I hold up a mirror and point to each one. You do not need to memorise eight techniques; understand these four sites and the rest follows.
① The nasal sill and the alar base — from the floor of the nostril to where the nostril rim meets the cheek
Lift the nose and you will find a flat platform on the nostril floor, the nasal sill, with the alar crease running out to each side. An incision placed along this line hides the scar inside a border the face already has. Every technique that truly shortens the philtrum begins here.
② The white roll — the ridge at the vermilion border
Where lip meets skin there is a raised pale line. It is called the white roll, and aligning it precisely at closure is a foundational rule of lip surgery. Excise skin immediately above this line and vermilion show increases substantially, but the scar sits on the most conspicuous line of the face.
③ The oral commissure — the hinge at the corner of the mouth
At the mouth corner several muscles converge on a single point, the modiolus. Removing a small triangle of skin above it elevates the corner alone. This has nothing to do with philtrum length.
④ The intraoral mucosa — the inner surface of the lip
Open the mouth and evert the upper lip and you reach mucosa. Work here and there is no external scar at all. Also, the philtrum does not shorten by a single millimetre.
📌 Half the field is already gone. If your concern is philtrum length, your only candidates are the techniques at site ①. If you want a fuller lip, it is ② and ④. If the mouth corner is the problem, it is ③. A clinic proposing a mucosal procedure for a long philtrum is performing a different operation than the one you came for.
Now let us stand the eight types on those four sites.
The 8 lip lift types, rearranged by incision site
| Technique | Incision site | Main change | Philtrum shortening | Vermilion gain | Scar location | Visible from front | Fits | Does not fit |
|---|---|---|---|---|---|---|---|---|
| Subnasal (bullhorn) lip lift | One bullhorn curve from alar base across the nasal sill to the other side | Shortening + upper lip eversion | Typically 5–8mm | 1–3mm | Nostril floor and inside the alar crease | Low | Long philtrum with a low vermilion | Already short philtrum, heavy gum show |
| Italian lip lift | Two separate incisions in the nostril floors, columellar base preserved | Shortening + relatively more lateral eversion | Typically 4–7mm | 1–3mm | Two sites on the nostril floors | Low | Anyone determined to avoid a scar under the columella | Very flat philtral ridges, narrow nostril sills |
| Central lip lift | Nasal sill, central portion only | Elevates the centre of the cupid's bow | 2–4mm | Around 1mm | Under the columella, centrally | Low | Philtrum not markedly long, centre only drooping | Whole-length philtrum excess |
| Direct lip lift | Directly above the white roll | Vermilion show only, sharply increased | Almost none | 2–4mm | On the lip border line | High | Shortening impossible and vermilion extremely thin | Anyone at all worried about scar visibility |
| Gullwing lip lift | Above the white roll, in a gull-wing shape | Vermilion show + reshaping the cupid's bow | Almost none | 2–4mm | On the lip border line | High | Those who also need the bow rebuilt | Same as direct |
| V-Y lip lift | Intraoral mucosa, V opened and advanced as Y | Vermilion volume and eversion | None | 1–3mm | None (intraoral) | None | Anyone for whom an external scar is unacceptable; inverted lips | Anyone whose core concern is philtrum length |
| Corner lip lift | Triangle above the oral commissure | Mouth corner elevation only | Not applicable | Not applicable | Just outside the mouth corner | Moderate | Downturned corners that read as angry | Vermilion or philtrum concerns |
| Lower lip lift | Above the white roll of the lower lip | Lower vermilion show | Not applicable | Lower lip 1–3mm | Lower lip border | High | Upper lip enlarged and the balance broken | Most cases as a standalone procedure |
Two things stand out once the table exists.
First, only the top three actually shorten the philtrum. The remaining five never touch philtrum length. Patients agonising over eight options were in fact choosing among three.
Second, something I should say plainly. Direct and gullwing are essentially the same family. Same incision line, same principle, different excision geometry. Eight names do not mean eight mechanisms. Merge those two and the real menu is seven — and for someone who wants the philtrum shortened, three.
📍 Bottom line: The task is not choosing a name. It is confirming which incision your face can actually accommodate.
The three measurements we take in the consulting room
This is where the differential begins. We do not select a technique from photographs. We put a ruler to three numbers, and those numbers cross out most of the cells in the table above.
| Measurement | Landmarks | Usual range | Where this value sends you |
|---|---|---|---|
| Philtrum length | Subnasale to labrale superius | Women 18–20mm · Men 20–22mm | 22mm and above puts shortening techniques in play · 15mm or below makes shortening a contraindication |
| Upper vermilion height | White roll to the fullest central point | Women 8–10mm | 6mm or below argues for combining an eversion-oriented approach |
| Gum show | Gum visible above the upper incisors at maximum smile | 0–2mm | 3mm and above calls for caution about shortening as a solo procedure |
No single number rules. The combination of the three produces the answer. A patient with a 22mm philtrum, 9mm vermilion and 1mm of gum show and a patient with a 22mm philtrum, 5mm vermilion and 4mm of gum show have identical philtrum length and completely different plans.
One further rule follows directly from measurement. Excision is planned at one quarter to one third of philtrum length. Take 8mm from a 20mm philtrum and the arithmetic looks satisfying, but the nostrils splay, tension loads the closure, and the scar thickens. I have never crossed that limit, and it is a principle I do not intend to cross.
Most patients already know the answer by the time the measuring is done. The real branching, though, goes one step further.
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✅✅ We measure philtrum length, vermilion height and gum show, then compare every one of the 8 lip lift types that is possible for you and every one that is ruled out
✅✅ We give you an honest opinion whether or not you have surgery
📲 Dr.Tak Plastic Surgery official site — chat icon at the bottom right → live consultation
Four branches the measurements lead to
Feed in those three numbers and the field divides like this. These are the four combinations we meet most often.
Branch 1 — long philtrum, normal vermilion, minimal gum show
The textbook combination, and the most predictable result. The subnasal bullhorn becomes the standard choice. The Italian is the alternative when you want the columellar base left alone; the difference in shortening between the two is small, and it is more accurate to read it as a difference in where the scar is placed.
Branch 2 — long philtrum with a very thin vermilion
Shortening alone leaves the philtrum shorter and the lip still thin. Here I frame shortening as the primary operation and ask patients to expect only the 1–3mm of vermilion gain that comes with it. Chasing more by adding a white roll incision brings the scar to the front of the face. In practice, this is the point at which a plan often gets dialled back a level.
Branch 3 — long philtrum but gum show above 3mm
The combination that demands the most caution. Shortening can increase gum show, so we either keep the excision conservative or consider addressing the gum show first. I do not book a surgery date at the first consultation in these cases. Reviewing the smile from several angles before deciding is the principle.
Branch 4 — philtrum within normal range, but thin lips or downturned corners
A surprisingly high proportion of people searching lip lift types belong here. Shorten an 18mm philtrum and the proportion between nose and lip goes wrong instead. The answer is a V-Y family procedure, a corner lip lift, or a non-surgical option. Sometimes the answer I give is that none of the lip lift types is the right operation.
📌 One thing is common to all four branches. When a measurement sits on a borderline, we take less. An under-corrected result can be added to; an over-shortened philtrum has no straightforward way back.
Where does the scar land — this question is half of the decision
More people ask about scars than about techniques. I consider that reasonable and I welcome the question, because understanding scar position organises the choice of technique by itself.
| Incision site | Where the scar lies | From the front | Usual course at 6 months | Care demand |
|---|---|---|---|---|
| Nasal sill and alar base | Nostril floor and inside the alar crease | Barely visible unless the head is tilted back | Approaches surrounding skin tone | Low |
| Two separated sills | Two nostril floors, centre preserved | Concealed the same way | Same | Low |
| Above the white roll | On the ridge where lip meets skin | Can read under certain light and expressions | Colour and texture difference may persist | High |
| Above the commissure | Triangle outside the mouth corner | Softened within the smile crease | Generally softens | Moderate |
| Intraoral mucosa | Inside the lip | None | Not applicable | None |
The critical row is the third. A white roll incision delivers vermilion show more reliably than anything else, and it places the scar on the single most visible line of the face. Direct and gullwing appear often in Western material because they are a valid choice for older patients with thinned skin. Apply that same logic to a Korean patient in her twenties or thirties and the result reads differently.
Three factors make the same incision heal differently: tension at the closure, how precisely the incision follows an anatomical border that already exists, and the six months of care afterwards. The first two are mine. The third is shared, which is why we run scar care as a separate six-month programme.
📍 Bottom line: There is no method that leaves no scar, only a method for deciding where it goes.
When I do not recommend this surgery
This surgery does not suit everyone. There are cases where I decline after consultation, and saying so is part of my job.
✅ Philtrum length already 15mm or below — rules out every shortening technique
✅ Gum show already heavy and itself the main concern — the order has to change
✅ Recent rhinoplasty with the nasal base not yet settled — we wait
✅ Wanting a large vermilion gain while unable to accept any scar visibility — the goal and the method are in conflict
✅ Growth not yet complete — facial proportions are still moving
✅ A history of keloid, or a condition that delays wound healing — separate judgement required
Many patients ask about cost. I cannot state an exact figure here. The range shifts with the technique, the extent of excision and the number of closure layers, the anaesthesia method, and whether it is a revision. If sedation is used, a base anaesthesia fee may apply separately. All of it is explained together in consultation, after measurement.
How recovery actually unfolds
Here is what is normal at each stage and what to avoid. The width varies slightly by technique; the shape of the curve does not.
| Stage | What to expect | What to do | What to avoid |
|---|---|---|---|
| Day 0–3 | Swelling and tightness at their peak | Cold compress, rest with the head elevated | Opening the upper lip wide |
| Day 4–7 | Swelling visibly starting to settle | Soft diet, prescribed ointment | Smoking, alcohol, hard exercise |
| Week 1–2 | Suture removal | Attend on the scheduled date | Self-removal, rubbing the site |
| Week 2–1 month | Most of the swelling resolves | Begin sun protection | Irritating the scar, over-exercising expressions |
| Month 1–3 | The scar may look red and raised | Keep taping | Judging the result early |
| Month 3–6 | Scar maturation proceeds | Continue the scar care programme | Stopping care |
The row I stress most is months one to three. Patients see the scar turn red in this window and conclude the surgery failed; in most cases this is the scheduled course. Conversely, drop the care in this window and the six-month result changes. I would say the scar is made not on the day of surgery but across these six months.
Why we measure first
Dr.Tak Plastic Surgery has spent over 15 years of practice in Korea as a lip and philtrum specialist clinic. Repeating the same operation long enough teaches you one thing: what separates results is not the name of the technique but the patient's measurements.
🏥 Four grounds for trust
- A lip and philtrum specialist clinic in Korea with over 15 years of practice — we know all eight techniques and we judge which to rule out
- Over 200 Google reviews, rated 5 out of 5 — covering the consultation process, not only the results
- 1:1 consultation and surgery by the chief surgeon — the person who measures operates
- Six-month scar care and a one-year complimentary A/S — a system designed on the premise that there is an "after"
💬 "To make people smile."
The Dr.Tak 4S Patient Care System — focused on the person, not the procedure
Solution — a 1:1 master plan with Dr. Seungwan Tak
- Genuine empathy and communication: your wishes reflected fully in the surgical plan
- Precise facial golden-ratio analysis: philtrum length, vermilion height and gum show measured to establish which of the 8 lip lift types are possible and which are excluded
- Simulation of the expected post-surgical change
Support — a global 1:1 dedicated coordinator
- A dedicated coordinator assigned by country (no language barrier)
- Accompaniment through consultation, surgery and aftercare
- 100% appointment-only (a private clinical environment)
Scar Care — six months of intensive scar management
| Item | Duration | Purpose |
|---|---|---|
| Control taping | 3–6 months | Prevents scar widening |
| Scar-softening injection | 6 months (monthly) | Softens a raised scar |
| Laser treatment | 6 months | Reduces redness at the surgical site |
Service — one-year complimentary A/S guarantee
- Complimentary A/S guaranteed within one year of surgery
- Cared for to the end
- ※ A base anaesthesia fee may apply if sedation is used
If you would like to know more — official channels
🌐 Official site drtakprs.com — technique information and consultation
📝 Blog — detailed records by procedure across the lip and philtrum field
📹 Video — incision design and the recovery course explained
Six things to settle for yourself before deciding
✅ Is what I want reduced the philtrum length, the lip thickness, or the mouth corner — these are three different operations
✅ Have I actually checked in photographs how much gum shows when I smile
✅ If a scar remains, where am I able to accept it
✅ Is there anything in my schedule during recovery that makes being seen difficult
✅ When will I judge the result — not at one month, at six
✅ Is the size of change I want possible within my measurements
Settle these six and half the consultation time is saved. If they are not settled, that is fine too. Settling them together is what the consultation is for.
Frequently Asked Questions (FAQ)
The questions we receive most often at Dr.Tak Plastic Surgery.
Q1. Is there a single best type of lip lift
There is not. This is the question I hear most, and it is not that the answer is hidden — the question does not hold. The best technique for a 22mm philtrum and the best technique for a 17mm philtrum are different. If you want it in terms of frequency, among patients who come wanting the philtrum shortened, the subnasal bullhorn family is what is actually performed most often. Cost also varies by technique, extent of excision and anaesthesia method, so I would not advise choosing on the basis of which technique is cheapest.
Q2. What exactly is the difference between an Italian lip lift and a bullhorn
Whether the incision is one line or two. The bullhorn runs a single curve from one alar base across the columellar base to the other; the Italian places an incision in each nostril floor and leaves the area under the columella untouched. It matters to patients with well-defined philtral ridges who do not want a scar sitting on that line. Because the difference in shortening itself is small, I explain these two not as better and worse but as two answers to the question of where to put the scar.
Q3. My philtrum is long but my upper lip is also thick — which type fits
It is feasible, but the plan changes. In a patient with a long philtrum and thin vermilion, shortening delivers both gains at once; in a patient whose vermilion is already thick, the upper lip can look fuller still after shortening, so we keep the excision conservative. Clinically, for the same 22mm I tend to design closer to one quarter than one third. Conversely, a philtrum of 15mm or less, incomplete growth, or a history of keloid places every shortening technique in the unsuitable column.
Q4. Scars land in different places depending on the technique — are there types that show from the front
There are. The direct and the gullwing, which cut above the white roll, and the lower lip lift. The scar sits on the border between lip and skin, so it can read depending on light and expression. Nasal sill techniques, by contrast, hide inside the nostril floor and the alar crease and are hard to see unless the head is tipped back. Direct-family procedures appear often in Western material because they are a sound choice for older patients with thinned skin, and I want to stress that transferring that logic directly to a younger patient changes the outcome.
Q5. What if it looks obviously done — and will it get stranger as I age
The most common worry, and the most understandable one. A result that announces itself usually comes from excessive excision. An over-shortened philtrum splays the nostrils and leaves the upper teeth permanently exposed, which is what makes an expression look off; that is why I hold to never exceeding one third of philtrum length. As we age, skin lengthens and the philtrum tends to drift longer again, so a conservatively planned surgery moves toward looking more natural over time rather than less. That said, I state plainly that individual variation exists.
Dr.Tak Plastic Surgery | Korea Face Lifting · Lip · Philtrum Specialist Clinic
"To make people smile."