# Upper Lip Aging: Why Does My Upper Lip Look Smaller? Not every change around the mouth is a loss of volume: how the upper lip changes with age and where a lip lift fits in. [Dr. Walter Zamarian Jr.](https://www.walterzamarianjr.com/us/walter-zamarian/) · CRM-PR 17.388 · RQE 15.688 Published October 3, 2026 · Updated October 4, 2026 Topics: [Facelift](https://www.walterzamarianjr.com/us/blog/category/facelift/) [Read the article ↓](#leitura) ## At a glance: why does the upper lip look smaller with age? With age, the upper lip tends to get longer and thinner: the skin between the nose and the mouth lengthens, and less of the red lip shows. So a lip that looks smaller has not necessarily lost volume. I assess length, thickness, your smile and how much of your teeth show before discussing any treatment. - Length: in an MRI study, the upper lip was 18% to 19% longer in people aged 65 to 80. - Thickness and volume: the same study found a thinner lip with less volume. - Shortening or filling: a lip lift removes skin to shorten the lip; it doesn’t add volume. - In my practice: I only perform a lip lift together with a facelift, and it doesn’t increase the surgical fee; I don’t offer fillers. - Assessment: with your mouth at rest, while you talk and smile, not from a photo. The operation that shortens the upper lip is explained on my [lip lift](https://www.walterzamarianjr.com/us/face/lip-lift/) page. Here I cover the question that comes first: what has actually changed in your lip. ## How the lip changes with age Ramaut and colleagues measured the upper lip on MRI scans of 200 adults, comparing a group aged 20 to 30 with one aged 65 to 80. In the older group, the lip was 18% to 19% longer, up to 33% to 41% thinner at some points and had about 17% to 21% less volume, estimated from the area of one image slice [1]. The authors conclude that aging in this area combines lengthening, thinning and volume loss. The study compared different groups of white adults and did not follow the same people over time. The percentages can’t predict how much your own lip will change; they show why a single measurement doesn’t explain the concern. ## Three concerns that look alike ### The distance between nose and mouth The upper lip includes the skin above the red lip, with the philtrum in the center. When that skin lengthens, less of the red lip and the upper teeth shows, even without volume loss. This is the concern a lip lift addresses. ### A thinner lip If what bothers you is the lip’s thickness or projection, shortening the skin won’t add volume. I don’t offer fillers. During a facelift, when it is indicated, I place microfat in the lip’s mucosa to restore volume. ### Lines around the mouth These are a skin-surface concern. A lip lift changes the proportions of the lip and doesn’t erase these lines; it’s important to know that before you decide. During a facelift, I can treat them with nanofat placed into the vertical lines, often called “barcode lines.” ## Where a lip lift fits in A lip lift removes a strip of skin just below the nose, in a bullhorn pattern, to shorten the upper lip and show more of the red lip. In my practice, I only perform it together with a facelift: it adds about 45 minutes to the operation, and the stitches come out at 10 days. When indicated, it doesn’t increase the surgical fee. A systematic review included seven studies with 1,754 patients. After a lip lift, philtrum length went from 14.0–14.5 mm to 10.8–12.0 mm, more of the red lip showed, and revision rates ranged from 0.6% to 6.7%. The studies were too different to pool in a meta-analysis [2]. These figures describe groups, not an ideal measurement for everyone, and the scar at the base of the nose is part of the decision. ## What to bring to the consultation Tell me about any fillers or surgery in the area, and when; bring whatever you know about the product. Mention dental work you’ve had or are planning, since it changes how much of your teeth shows when you smile. An old photo can help show what has changed, but I assess you with your mouth at rest, while you talk and smile. An online consultation is a good start from abroad; the plan is confirmed in person before surgery. ## Frequently asked questions Are thin lips always a sign of aging? No. Some lips are naturally thin. What matters is whether something has changed and whether it bothers you. Can I have a lip lift on its own? Not with me: I only perform a lip lift together with a facelift. Does everyone having a facelift need a lip lift? No. It is only added when a long upper lip is a concern and the examination confirms it is indicated. Will a lip lift remove the lines around my mouth? No. It changes the proportions of the lip, not the skin surface. ## Let’s look at your lip together If your mouth is part of what has changed in your face, [write to us on WhatsApp](https://www.walterzamarianjr.com/us/contact/): Bruna, my AI assistant, handles the first contact and then puts you in touch with Isanna to arrange a consultation with me. You don’t need to name the change; just show me what bothers you and what you want to keep. ## References - Ramaut L, Tonnard P, Verpaele A, Verstraete K, Blondeel P. [Aging of the Upper Lip: Part I: A Retrospective Analysis of Metric Changes in Soft Tissue on Magnetic Resonance Imaging](https://pubmed.ncbi.nlm.nih.gov/30688885/). Plast Reconstr Surg. 2019;143(2):440–446. - Komisarek O, Banasiak Ł, Olichwer V, Burduk P. [The Bullhorn and Beyond: Evidence-Based Review and Clinical Recommendations for Lip Lift Techniques](https://pubmed.ncbi.nlm.nih.gov/41731334/). J Cosmet Dermatol. 2026;25(3):e70703. ## About the author I am Dr. Walter Zamarian Jr., a plastic surgeon in Londrina, Brazil. My practice focuses on deep plane facelift surgery with fat grafting. Here I explain my approach, the available evidence, and the limits of each treatment. CRM-PR 17.388 · RQE 15.688 [Read about my training and practice →](https://www.walterzamarianjr.com/us/walter-zamarian/) This article provides general information and does not replace an individual medical consultation. 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