Hello, this is Woori Plastic Surgery.
One of the most common concerns many people ask about during consultations is the length of the philtrum. When the philtrum appears relatively long, some people feel they look older than they really are, or that their expression looks awkward when they smile. Today, based on what we often explain in the clinic, I’ll organize when a philtrum reduction procedure may be considered, how the surgical methods differ, and how to understand scars and the recovery process.
When the philtrum looks long
During consultations, many people consider philtrum reduction for the following reasons.
✔️ When the upper lip is barely visible while smiling
✔️ When the philtrum looks long and gives a generally older impression
✔️ When the upper lip is thin and the expression feels unnatural
✔️ When they think the philtrum has become longer after orthodontic treatment or aging
✔️ When they are very concerned about scars or left-right asymmetry
However, rather than judging only by the number measured, it is important to look at where the philtrum sits within the overall proportions of the face.
Changes after surgery
In general, the plan is often made within a range of about 20–30% of the current length. However, the decision to undergo philtrum reduction is not made based on numbers alone.
During consultation, the design is determined by comprehensively considering the proportions of the upper face, the relationship between the nose and lips, and the overall face shape. The commonly mentioned 1:1:1 ratio can be a reference, but it is not a formula that applies equally to everyone. In the end, what matters is balance that fits each person’s facial structure.
Internal philtrum reduction and external philtrum reduction
Philtrum reduction can be broadly explained in two directions.
✔️ Internal philtrum reduction
This is a method that shortens the inner philtrum length directly below the nose. It is usually approached from the nose area with an incision, and is considered when the central philtrum appears long.
✔️ External philtrum reduction
This method adjusts the outer area of the philtrum and improves the length by making an incision along the upper lip edge. It may also be chosen when lip line refinement is needed at the same time.
Depending on the case, procedures such as correction of the nasolabial angle, nose-related surgery, mouth-corner correction, or adjustment of lip shape may also be performed together. However, such combination procedures must be decided carefully only after a thorough analysis of the facial structure.
Where will the scar remain?
The part people worry about most is the scar. Generally, when people think of philtrum reduction, they imagine an incision under the nose, but when possible, an approach through the inside of the nose may be considered to reduce visible scarring.
Also, rather than simply suturing only the skin, a step-by-step fixation method down to the deeper layers is used to try to reduce the chance of the scar widening over time. However, the same method is not applied to everyone, and the approach may vary depending on skin condition and anatomical structure.
Changes in the upper lip
After surgery, the upper lip may appear a little more visible. Because of this, some people feel that the lip width looks more natural, and others expect a slight adjustment to the nasolabial angle. This also varies greatly from person to person, so it is important to explain the expected changes sufficiently during the consultation process.
Recovery process
After philtrum reduction, redness usually fades gradually over about 3 to 6 months, though this varies from person to person.
Sutures are usually removed about one week after surgery, and light makeup is possible from then on. However, recovery speed and management methods can differ, so it is important to follow the post-surgery instructions carefully.
A surgery to reduce the philtrum is not simply about shortening the length, but should be understood as a process of adjusting the overall impression by considering the proportions of the nose, lips, and midface together. Reducing it as much as possible is not always the answer; what is most important is determining how much adjustment is appropriate for the facial structure.
If you are concerned about philtrum length, rather than deciding based on limited information, it is recommended that you first check your current facial proportions and then calmly consult about which type of philtrum reduction would be suitable.
