What does research show about the effectiveness of philtrum shortening?

The fact that the upper lip becomes shorter with philtrum shortening is shown numerically. However, most of that data consists of retrospective reports from a single facility by a single surgeon, and prospective studies tracking patients for more than one year are not found[1]. Because the method of measuring effectiveness is not standardized, numbers cannot be directly compared across facilities[2].

How much shortening has been reported?

There are reports, but they are limited in number. In a study of a modified technique that suspends deeper layers, 193 patients who underwent that procedure and 50 patients who underwent the conventional method were compared before and after surgery for philtrum length, height of the red lip, and amount of tooth display[1]. Philtrum length showed an average of 14.50 mm and 14.02 mm before surgery, and was reported to have shortened with statistical significance after surgery[1]. However, this is the result from a single surgeon at a single facility[1].

Is the amount removed proportional to the amount of shortening?

No, it is not proportional. A review article introduces the finding that the amount of philtrum shortening is not proportional to the amount of tissue removed, and the amount the upper lip is lifted is greater than the amount of resection[2]. Simply calculating 'if X mm is removed, shortening will be Y mm' is not possible[2]. Even if you only hear the amount of resection, the final result cannot be predicted.

Are there guidelines for the length to preserve?

Textbooks cite a guideline of preserving a minimum of 10–15 mm, but the same textbook notes that this figure is arbitrary[3]. Since aesthetic balance involves other factors, merely adhering to this measurement does not guarantee a good result[3]. The number is a starting point for judgment, not a conclusion.

How reliable is satisfaction data?

Data specific to lip lift itself is still limited. In a study that developed a FACE-Q scale answered by patients themselves, the group receiving lip treatment showed major changes in psychological satisfaction and moderate changes in social functioning[4]. However, this study covered lip treatments in general, including injections, and was not limited to surgical procedures involving cutting[4]. Many reports are evaluations by surgeons of their own techniques, and independent verification is insufficient[1].

Is there data on dissatisfaction or regret?

It is insufficient. A thematic analysis of reviews on consumer sites states that while high satisfaction rates are reported, patient dissatisfaction regarding aesthetic outcomes and psychological effects has been scarcely investigated in the literature[5]. Complications include over-resection, under-resection, wound dehiscence, and postoperative lip swelling for several days[6]. Because over-resection cannot be corrected, the decision on where to stop determines the outcome.[3].

Is it known how long the results last?

It is not known. Prospective studies tracking patients for more than one year were not identified within the scope of materials gathered this time. Whether scars settle over time, whether the philtrum lengthens again with aging, and how long satisfaction persists remain unanswered.[5].

Numbers in this field are not yet settled facts. During consultation, ask your physician what and how they are measuring, by how much shortening is expected after surgery, and what length they plan to preserve. Whether they can explain the basis for those numbers becomes your material for judgment.