When you look in the mirror, do you always feel like the lower half of your face is a bit “long,” photos always make you look mature, and when you smile, your upper lip doesn’t seem full enough? Many people don’t realize that the problem may lie in the philtrum. The philtrum is the vertical distance from the base of the nose to the upper lip, with a standard length of approximately 14-15mm. Once this distance is too long, the proportions of the entire face are elongated, making you look older than your actual age.
In the Korean medical aesthetics field, philtrum shortening is already a quite mature and refined procedure. Many Korean plastic surgeons call it “the art of facial proportions” — it’s not simply cutting away a piece of skin, but through precise incision design, upward lifting and fixation of the orbicularis oris muscle, and layered suturing, allowing the upper lip to naturally move upward and improving tooth show and lip contour. Today, from the perspective of Korean medical aesthetics, let’s talk about how Korean philtrum shortening is actually performed, who it’s suitable for, approximate costs, and those details that doctors won’t proactively mention.
Not everyone needs philtrum shortening surgery. Generally, the following three groups will seriously consider it:
First group: Those born with a naturally long philtrum and uncoordinated mid-facial proportions. Some people have no problems with their individual features, but the distance from the nose to the upper lip is noticeably long, causing the entire face to look “stretched,” appearing mature and serious.
Second group: Those whose philtrum gradually lengthens with age. As collagen is lost and skin loosens, the philtrum area slowly elongates, the upper lip becomes thinner, the corners of the mouth droop, and the whole person looks more “collapsed” than when they were young.
Third group: Those who feel the proportions are still not coordinated after rhinoplasty or facial lifting. After the nose becomes more defined, the philtrum appears relatively longer, so many people choose to combine philtrum shortening to balance the overall proportions.
It should be noted that for people with maxillary protrusion, excessively high central upper lip, or steep red lip slope, surgical results may not be ideal and require careful decision after consultation evaluation.
The core principle of philtrum shortening surgery is actually not complicated: an incision is made below the nasal base, 4-9mm of excess skin is excised, then the orbicularis oris muscle is suspended and fixed upward, and finally finely sutured. But the position and method of the incision directly determine the visibility of postoperative scarring and the naturalness of the results.
Currently, the two mainstream methods in Korea are:
External Incision (Subnasal Incision): The incision is between the nasal columella base and the lower margin of the alar wings, directly excising excess skin before suturing. The advantage is direct operation with obvious results; the doctor can simultaneously handle the gathering suture of the philtrum ridge and the adjustment of the lip peak curvature. The disadvantage is that a fine linear scar will be left at the nasal base. Although most people are basically unable to see it at social distance, there is indeed a risk of scarring.
Internal Incision (Intranasal Incision): The incision is approximately 1mm above the nasal sill, belonging to a “scarless” operation. All operations that the external incision can perform — skin excision, muscle lifting, philtrum concavity deepening — the internal incision can also complete, but it places higher demands on the doctor’s operational precision. The greatest advantage is that the scar is completely hidden inside the nostril, and it can also be combined with operations such as alar foot retraction to achieve overall harmony of the nose and lips.
Neither method is absolutely “better”; the key depends on individual foundation and the doctor’s area of expertise. In many plastic surgery clinics in Gangnam, Seoul, doctors will combine the Bullhorn Lift technique, customizing the incision plan based on each person’s philtrum length, lip thickness, tooth exposure amount, and smile dynamics.
Many people assume that “philtrum shortening” must involve surgery. In fact, in the Korean medical aesthetics market, non-surgical methods also account for a considerable proportion. Each has its applicable scenarios; the key is your expectations and the recovery period you can accept.
| Comparison Dimension | Surgical Philtrum Shortening | Non-Surgical Philtrum Shortening |
|---|---|---|
| Principle | Skin excision + upward suspension and fixation of orbicularis oris | Hyaluronic acid filler or Botox relaxation of downward-pulling muscles |
| Results | Permanent shortening, stable results | Visual shortening, lasts 3-6 months |
| Scarring | Fine linear scar at nasal base (internal incision is basically scarless) | No scarring |
| Recovery Period | 1-2 weeks swelling subsides, 3-6 months fully stable | Basically no downtime |
| Reference Price (KRW) | Approx. 2,500,000 – 5,000,000 | Approx. 500,000 – 1,500,000 (depending on injection volume) |
| Suitable For | Those with obviously long philtrum seeking permanent improvement | Those with mildly long philtrum wanting to try results first |
Among non-surgical methods, hyaluronic acid filler makes the upper lip fuller by filling it, thereby visually shortening the philtrum distance; Botox reduces the phenomenon of the philtrum being elongated when speaking or smiling by relaxing the muscles that pull the upper lip upward (such as the levator labii). The two methods can be used alone or in combination.
Taking Gangnam, Seoul as an example, a standard Korean philtrum shortening consultation and surgical procedure is roughly as follows:
Step 1: Consultation and Treatment Planning.
The doctor will measure your philtrum length, upper lip thickness, tooth show, and combine your nasal base morphology, smile dynamics, and skin elasticity to determine the excision range and incision position. This process usually takes 30-60 minutes.
Step 2: Surgery Day.
Local anesthesia is used, with a surgery duration of approximately 45-90 minutes. The doctor excises excess skin according to preoperative markings, suspends the orbicularis oris muscle, and then performs layered closure. Discharge is possible on the same day.
Step 3: Postoperative Recovery.
Ice pack application is needed within 72 hours postoperatively to reduce swelling. Sutures are removed 5-7 days after surgery. Swelling and mild bruising basically subside within 1-2 weeks. Exaggerated lip expressions need to be reduced for 3 months postoperatively. Full stabilization takes approximately 3-6 months.
Many people who have undergone the procedure in Korea report that they can resume normal social activities and light work 1-2 weeks postoperatively. However, it should be noted that there may be temporary upper lip numbness or hypoesthesia in the short term postoperatively, which generally gradually recovers around half a year.
Surgical results can typically last more than 10 years, but are affected by individual constitution, skin elasticity, and postoperative care; maintenance time varies among different people. As age increases, skin will naturally loosen and sag, and the philtrum may gradually lengthen again. If the effect weakens, re-surgery can be considered after consulting a doctor.
Non-surgical results are temporary — hyaluronic acid generally lasts 6-12 months, and Botox lasts 3-6 months. Suitable for those who want to first experience the effect or have only mild improvement needs.
A phrase Korean doctors often say is: “Philtrum shortening doesn’t turn you into another person, but brings your features back to the proportions they should have.” The naturalness of the result is often more important than “how many millimeters were shortened.”
Philtrum shortening surgery is a refined facial plastic procedure. Although the technique is mature, there are still certain side effects and risks that require a rational perspective:
Common Side Effects:
Rational Recommendations: