In short
- At this age three things have happened at once and they are the same thing: the philtrum has lengthened, the vermilion has thinned as it rolled inwards and the tooth has stopped showing at rest.
- 🔑 The tooth is the detail almost nobody can name and the one that most ages a mouth. In the studies, upper incisor show went from 1.5-2.0 mm to 3.5-5.0 mm after surgery.
- 🚨 And the fact that most surprises this profile: a facelift does not rejuvenate the upper lip. It acts on the cheek, the jawline and the neck; the central perioral area falls outside its reach.
- That explains a frequent dissatisfaction: well-executed facelifts on faces with the same mouth as always.
- The most useful comparison is not with anyone else: it is with yourself. Your photographs from twenty years ago say more than any table of measurements.
- The surgery is a day case under local anaesthetic, which at this age usually weighs more in the decision than it does at thirty.
- ⚠️ And what does not change with age: the scar is permanent, it is in the middle of the face and lifting too much cannot be undone.
- Ageing carries on afterwards. “Permanent” refers to the excised skin, not to the face standing still.
From a certain age, a lot of people notice something in photographs they cannot name: the mouth has changed. It looks smaller, flatter, and when they talk the upper teeth no longer show the way they used to.
It is the classic profile for this surgery, and also the one that arrives best informed about almost everything else to do with the face — and worst informed about this.
What has happened to your mouth
Three simultaneous phenomena that are really only one: a covering of skin that has grown longer.
The philtrum lengthens. The stretch between the base of the nose and the lip stretches over the years. It is the underlying change.
The vermilion thins. The red lip rolls inwards and its visible height decreases. 🔑 And here is the expensive misunderstanding: there may be just as much lip as at thirty. What has changed is how much of it is on show — which is why filling disappoints so many people in this profile.
The tooth stops showing. At rest, with the mouth relaxed, a young upper lip lets a few millimetres of incisor show. When the skin lengthens, it covers them.
All three are described in the literature as the age-related changes of the lip: elongation of the philtrum, thinning of the vermilion and reduced upper incisor show. The whole mechanism is in why the upper lip lengthens with age.
🔑 The tooth: the detail nobody can name
It deserves a section of its own because it is what most rejuvenates or ages a mouth without most people knowing why.
When someone looks at a photograph of themselves from twenty years ago and says “more of my mouth used to show”, what they are almost always seeing is this: a few millimetres of upper incisor showing at rest. It is a feature we associate with youth without consciously identifying it.
In the studies gathered by the systematic review, that show went from 1.5-2.0 mm before surgery to 3.5-5.0 mm after. That is two or three millimetres — and they are the ones that show when you talk.
⚠️ With the usual warning: these are ranges of means from seven different studies, not an individual prognosis, and the methodological quality of the set is moderate.
🚨 Why a facelift does not fix it
This is the point that generates most enquiries in this profile, and it explains a very particular dissatisfaction: people who have had a facelift, happy with the result, who still see the same mouth.
A facelift acts on the tissues of the cheek, the jawline and the neck, repositioning deep planes upwards and backwards. The central perioral area — the philtrum, the lip, the region around the mouth — falls outside its territory.
🔑 It is not a poor result: it is the reach of the technique. And it produces a characteristic disharmony — middle and lateral lower thirds rejuvenated, mouth untouched.
The same happens the other way round with the upper third: a blepharoplasty resolves the eyelids and does not reach the mouth. Each operation has its territory, and gaps are left between them.
It is set out in full in combined lip lift, along with the possibility of doing them at the same time. And our facelift page explains which areas it does treat.
The comparison that does work
There is no “correct” philtrum measurement, and anyone who gives you one is simplifying. The systematic review says so without hedging: patient selection in this surgery remains unstandardised.
🔑 What does work, and works very well, is a comparison only you can make: your own photographs from fifteen or twenty years ago.
Looking at a photograph of yourself from back then and one from now, with your face relaxed in both:
- How much space is there between your nose and your mouth?
- How much red lip shows?
- Does the tooth show?
That comparison needs no figures and it is what is used in the consulting room. And it has an added advantage: it defines a realistic aim, which is going back towards where you were — not towards another face.
What weighs differently at this age
In favour:
- It is a day case under local anaesthetic. No overnight stay and no general anaesthetic, which from a certain age and with certain medical history counts for a good deal.
- The reference is concrete. You know what your mouth used to be like, which makes the expectation much easier to calibrate than in someone of twenty.
- The aim is modest and that works in your favour: returning two or three millimetres to where they were is exactly what this surgery knows how to do.
Against, or at least worth bearing in mind:
- The quality of the skin affects the scar, and at this age it is a real factor to be assessed at the examination.
- Ageing carries on. The excised skin does not come back, but the lip keeps changing. It is covered in results and duration.
- And the scar is still permanent and visible for months, with everything that implies socially. It is covered in the lip lift scar.
And the criterion for pre-operative tests is specific: where there is good general health and no relevant comorbidities and the surgery is done under local anaesthetic, no pre-operative tests are required. If sedation or a general anaesthetic is proposed, always blood tests and an ECG.
🔑 That is: what determines the work-up is not your age, it is the type of anaesthetic and your state of health.
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You can book your own appointment. Pick the day and time from the free slots in the diary, in a panel that opens right here, without leaving this page.
Frequently asked questions
Is there an upper age limit?
No. And the centre’s criterion is explicit: it depends on your state of health and your comorbidities, not on the years. A person of 75 in good health may be a better candidate than one of 60 with poorly controlled disease.
I have already had a facelift — can I have this as well?
Yes. They are different territories and they do not overlap, and the interval applied is 3 months from the facelift.
Will my teeth end up looking very big?
What changes is not the size of the tooth but how much of it shows. The amount is calculated at the assessment, and here the golden rule of this surgery returns: falling short can be adjusted; overshooting cannot. That is why a prudent surgeon proposes less than you expect.
And if I show gum when I smile?
It changes the conversation completely, because a lip lift increases the visible gum. It is covered in lip lift, gummy smile and teeth.
Would filler not suit me better?
It depends what you are missing. If the lip has volume but sits low, filler raises nothing. If tissue is missing as well, combining may make sense. It is covered in lip lift or hyaluronic acid.
Is the change very noticeable?
It is two or three millimetres. It does not change a face: it restores a proportion. Anyone looking for a transformation will be disappointed, and anyone looking to resemble themselves of twenty years ago has the expectation better adjusted.
Sources
- Komisarek O, Banasiak Ł, Olichwer V, Burduk P. The Bullhorn and Beyond: Evidence-Based Review and Clinical Recommendations for Lip Lift Techniques. Journal of Cosmetic Dermatology, 2026. PMID 41731334. — PRISMA 2020 systematic review of 7 studies and 1,754 patients; the age-related changes of the lip include elongation of the philtrum, thinning of the vermilion and reduced upper incisor show; subnasal techniques increased that show from 1.5-2.0 mm to 3.5-5.0 mm; patient selection and outcome assessment remain unstandardised; moderate methodological quality.
- Sun F, Liu Y, Zhang T. Aging of the Human Lip: Current Knowledge and Clinical Implications. Journal of Cosmetic Dermatology, 2025. PMID 40735924. — The lip differs from facial skin in barrier function, melanin content, transepidermal absorption capacity, frequency of physiological activity and fat distribution, with ageing features of its own and differences by sex.
Book your consultation
If looking at old photographs you can see that your mouth has changed and you do not know exactly how, take those photographs to the consultation: they are the best assessment tool there is for this profile. With them in front of you it becomes possible to say what has changed, how many millimetres of margin there are and whether this surgery is right for you.
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Last reviewed: 6 September 2026. This content is for information only and does not replace an individual assessment by a healthcare professional.
