Avoiding regrets with lip lift: scarring and nasal shape—what you should know before proceeding

Common regrets after lip lift include noticeable scarring below the nose and changes in the shape of the nostrils or alar wings. Severe complications are reported to be rare, but scarring always remains; the key consideration is minimizing how visible it becomes. When the cause of upper lip length stems from skeletal structure, shortening the lip alone may not result in the desired lip appearance.

What are the most common reasons for regret?

Scarring is by far the most common. A study analyzing 25 reviews written after surgery dissatisfaction found that concerns about scarring were highest at 15 people (60%)[1]. The next most common were changes in nostril/alar wing shape in 6 people and asymmetry of the lips in 5 people[1].

This study collected only people who expressed dissatisfaction and does not indicate the rate at which these occur. However, it does provide a clue to what tends to lead to regret. Many of those who posted experienced significant emotional distress as well[1].

How often do scarring and nasal shape changes occur?

According to a review of multiple studies, for lip lift with an incision under the nose, noticeable scarring occurred in 4.36%, alar asymmetry in 4.87%, and deformity of the rim below the nostril in 5.13%[2].

. Additionally, widening of the area below the nostril rim was reported in 3.72%, lowering of the area under the nose making nostrils more visible in 2.05%, and insufficient shortening in 3.21%[2]. No reports of severe complications were found[2].

Does technique matter in minimizing visible scarring?

Some reports show that changes in cutting and suturing technique affect satisfaction. The method of lifting at three deep layers (193 patients) showed "marked improvement" in 78.7%, compared to 43% with the conventional method (50 patients)[3].

. However, this is a report from a single surgeon and not a randomized comparison[3]. Z-plasty and other techniques that modify scar shape showed no direct comparative studies within the range reviewed. According to textbooks, laser resurfacing is helpful when scarring becomes prominent[4].

Why doesn't shortening always produce the desired lip appearance?

The appearance of the mouth is determined not only by lip length but also by bone and tooth position. Shortening the lip while leaving skeletal issues unaddressed—such as a protruding upper jaw or vertical elongation—may result in an unnatural tooth display, according to reports[5].

. In such cases, bone surgery to correct skeletal structure may be performed first, followed later by lip lift[5]. Distinguishing whether your upper lip length is due to skin or skeletal factors is the first step in reducing regret.

What should I be aware of if having nasal surgery at the same time?

A summary of 6 studies and 361 patients who underwent combined procedures showed high satisfaction, with complications limited mainly to minor scarring and temporary numbness[6]. On the other hand, performing procedures simultaneously also increases the burden, such as additional scarring[6].

Nasal surgery also affects the angle between the nose and lip[6]. Whether to have procedures done together or separately can be thought through by considering which change you want to observe first.

What to confirm before proceeding

Three key points to consider: First, the location of scarring and what to do if it becomes noticeable[2][4]. Second, whether upper lip length is caused by the lip or skeletal structure[5]. Third, how the nostril and alar wing shapes may change[2][1].

According to textbooks, complications are rare with correct diagnosis and proper patient selection[4]. How much to shorten and how scarring might appear on your skin should be confirmed with your surgeon during the actual consultation.