Summary

• The philtrum is the slightly grooved area between the base of the nose and the top of the upper lip
• A long philtrum is typically seen as over 11-13mm for women and 13-15mm for men
• It is important to see philtrum length in the context of overall facial proportions and ratios
• Cadogan Clinic’s team of Consultant Facial Surgeons are experts in philtrum shortening surgery

What is a Long Philtrum?

A long philtrum describes a longer-than-average distance between the base of the nose and the top of the upper lip. The philtrum is the grooved vertical area which runs between the base of the nose and the upper lip. In some cases, this groove is more distinct, whereas some individuals have a smooth philtrum.

Cadogan Clinic’s team of specialist Consultant Facial Surgeons are experts in all areas of facial surgery. 100% of Cadogan Clinic’s surgical patients would recommend the Clinic to their family and friends.

Although the philtrum is a small and often overlooked facial feature, a prominent philtrum can have a significant impact on the overall appearance of the face, affecting overall facial proportions and expression. This can negatively affect an individual's confidence, especially when speaking or smiling, which may cause self-consciousness in personal and professional settings, or lead to an over-reliance on makeup and other temporary measures to change their appearance.

It is generally suggested that the ideal philtrum length should be:

• 11-13mm for women
• 13-15mm for men

However, this varies depending on natural anatomy, facial proportions and personal aesthetic preferences.

While facial proportions are typically determined during childhood and adolescence, various life events and processes can alter them. The underlying cause may influence how someone feels about having a long philtrum and whether they wish to address it.

If you are looking for a solution to a long philtrum affecting facial proportions, Cadogan Clinic’s team of specialist patient advisors are on hand to discuss your concerns and match you with the best Consultant Facial Surgeon to meet for a consultation.

A long philtrum is a disproportionately long area between the upper lip and nose, affecting overall facial proportions and expression, and potentially reducing confidence and self-image.

What Causes a Long Philtrum?

There are several long philtrum causes, and it is important to understand why the philtrum is elongated to create the best treatment plan.

Most patients with a long philtrum will know the cause. However, some patients may require an assessment and diagnosis by a Consultant Facial Surgeon.

Long philtrum causes include:

Genetics

Genetics are the most common cause of a long philtrum. Individuals with close relatives who have a long philtrum are more likely to be born with similar facial features and proportions.

It isn’t possible to know how genetics may affect a person’s appearance. A long philtrum, caused by genetics, typically appears during childhood and adolescence as the face develops, but doesn’t usually have any medical implications.

Ageing

Ageing is another common cause of a long philtrum. It is normal for facial features and proportions to change over time as the underlying bone and tissue naturally recede, resulting in:

• The lips losing volume
• The lower face dropping

This causes the area between the nose and upper lip to become longer.

Natural ageing affects everyone to varying degrees, and it isn’t always possible to predict which facial features may be impacted. Ageing can have a significant effect on confidence and self-image, reducing quality of life.

Previous Surgery

In some cases, previous surgical procedures can alter facial proportions, causing an elongated philtrum.

If you are considering any facial procedure, it is important to understand the potential concerns that can arise and may impact the overall appearance of the face. Your surgeon should discuss this with you during your consultation and make you aware if they feel your procedure may risk altering your facial proportions in an unexpected or unwanted way.

Procedures which are associated with causing a long philtrum include:

• Rhinoplasty: If the tissue between the nostrils (the columella) is lowered too far during a Rhinoplasty, it can cause the philtrum to be pushed downwards
• Lip Fillers: Overfilled lips, caused by excessive use of Dermal Filler, can stretch the skin, resulting in skin laxity and the philtrum being pulled downwards

The best way to avoid lengthening the philtrum after Rhinoplasty or Lip Fillers is to find a qualified and experienced Consultant Facial Surgeon with extensive knowledge of facial anatomy and a comprehensive understanding of the results that are possible for you.

Medical Conditions

There are a number of medical conditions that have a long philtrum as a known clinical feature:

• Williams Syndrome: A rare genetic disorder, caused by abnormal chromosome development
• Cornelia de Lange Syndrome: A rare genetic disorder caused by spontaneous gene mutations
• Smith-Lemli-Opitz Syndrome: A rare genetic disorder which prevents the body from producing cholesterol effectively
• DiGeorge Syndrome: A rare genetic disorder caused by a missing segment of a chromosome
• Fetal Alcohol Spectrum Disorders: A group of conditions caused by drinking alcohol during pregnancy

Medical conditions of this nature require specialist management, usually from birth.

It is important to understand the cause of a long philtrum in order to determine the best treatment plan and the results that can be achieved.

How to Fix a Long Philtrum?

Cadogan Clinic, London’s team of expert Consultant Facial Surgeons, are specialists in surgical and non-surgical Philtrum Reduction procedures and long philtrum treatment.

All procedures at Cadogan Clinic, London, are overseen by a leadership team rated Outstanding by the CQC.

Non-Surgical Long Philtrum Treatments

Non-Surgical treatments for a long philtrum offer an effective solution without the commitment of a surgical procedure.

Lip Filler for Long Philtrum

Lip Filler is a highly popular treatment which helps to balance the proportions of the mouth and nose area and shorten the philtrum.

The International Society of Aesthetic Plastic Surgeons reports that between 2020 and 2024, there was a 56.4% increase in the number of Dermal Filler procedures performed globally.

During a Lip Filler for long philtrum treatment, Dermal Filler made from Hyaluronic Acid, a natural substance, is carefully injected into the lips to increase their volume and vertical height. This allows the lips to sit higher, shortening the philtrum and balancing the facial proportions.

Lip Fillers with a long philtrum are a temporary solution, which typically lasts 6-12 months. Repeat treatments are required to maintain results.

Although Lip Filler is a highly effective option for treating a long philtrum, it is important to remember that overfilling the lips may cause the skin to stretch, causing the philtrum to look even longer over time. Your Consultant will discuss any risk with you during your initial consultation, but depending on your personal circumstances, they may suggest an alternative solution.

Lip Flip for Long Philtrum

A Lip Flip is another injectable treatment, which uses Anti-Ageing Injectables to move the position of the upper lip.

Placing Anti-Ageing Injectables in the area surrounding the upper lip causes the underlying muscles to relax. This allows the upper lip to curl upwards, increasing its vertical height and shortening the philtrum.

The results of a Lip Flip for a long philtrum typically last 2-3 months and require follow-up treatments to maintain results. Over time, the body can become resistant to the effects of Anti-Ageing Injectables, meaning it may not be an effective long-term solution for every patient.

Your surgeon will discuss whether a Lip Flip is a suitable option to address your long philtrum and offer alternative treatment options to consider.

Philtrum Shortening Surgery

Surgical procedures are the gold standard for addressing a long philtrum.

Lip Lift for Long Philtrum

A Lip Lift, is a surgical procedure which enhances the shape and proportions of the lips and mouth area. To treat a long philtrum, a Bullhorn Lip Lift, is likely to be the most suitable option.

During a Lip Lift to address a long philtrum, the surgeon removes a small amount of skin from the philtrum area and closes the incision just under the base of the nose. This allows the lip to be pulled upwards, increasing its height and shortening the philtrum.

Crucially, compared to non-surgical treatments for a long philtrum, the results of a Lip Lift are permanent, making this an appealing option for many patients. However, it is important to consider that there is a recovery period of 4-6 weeks to take into account.

100% of Cadogan Clinic’s surgical patients would recommend the Clinic to their family and friends.

Lip Fillers, Lip Flip and Lip Lift are the three best treatment options to address a long philtrum, but speaking with a Consultant Facial Surgeon is the best way to decide which is the right treatment option for you.

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