Why the philtrum lengthens with age
As we grow older, our bodies undergo a series of changes that impact our appearance. In the face, one of the most notable—though often overlooked—changes is the elongation of the philtrum, the vertical groove between the nose and the upper lip. This is not a matter of skin just 'sagging' but a complex process involving multiple structural and biochemical changes.
Several key factors contribute to this lengthening over time:
- Loss of volume and elasticity: With age, the body produces less collagen and elastin, the proteins responsible for skin's firmness and elasticity. The facial fat pads, particularly those around the mouth and cheeks, also diminish in volume. This combination of decreased support and reduced elasticity causes the skin to stretch and thin, pulling the upper lip downward and lengthening the philtrum.
- Gravitational pull: The constant downward pull of gravity over decades has a noticeable effect on facial tissues. The philtrum area is no exception, and this force gradually stretches the skin, further contributing to its elongation.
- Bone resorption: The underlying bone structure also changes with age. The maxilla, or mid-face bone, slowly resorbs and collapses inward. This structural shift contributes to deepening nasolabial folds and causes the upper lip to stretch and lengthen.
- Muscle and ligament changes: Facial muscles and ligaments weaken over time, losing their ability to provide firm support to the surrounding tissues. This laxity allows the area to droop, creating a longer vertical space between the nose and the lip.
Comparison of treatment options for philtrum elongation
For those concerned about an elongated philtrum, a range of cosmetic options is available, from non-invasive temporary solutions to permanent surgical procedures. The right choice depends on the desired result, budget, and tolerance for recovery.
| Feature | Non-Surgical Options (Fillers/Flips) | Surgical Options (Lip Lift) |
|---|---|---|
| Best for | Mild elongation, subtle enhancement, or temporary results | Significant elongation, seeking a permanent solution |
| Longevity | Temporary, lasting several months to a year or more | Permanent, though natural aging will continue |
| Mechanism | Adds volume to the upper lip to create the illusion of a shorter philtrum | Removes a small strip of skin from under the nose to physically shorten the philtrum |
| Cost | Less expensive per session, but requires repeat treatments | Higher initial cost, but is a one-time procedure |
| Invasiveness | Minimally invasive injectable treatment | Surgical procedure with local anesthesia |
| Recovery Time | Minimal downtime, typically 1-7 days for swelling/bruising | 1-2 weeks for initial recovery, with longer fading of swelling and bruising |
| Scarring | None | Concealed scar along the base of the nose |
Techniques for addressing an elongated philtrum
- Surgical Lip Lift: This is the most effective and permanent solution for philtrum lengthening. The surgeon removes a precise, bullhorn-shaped strip of skin from the base of the nose. The skin is then lifted and sutured, physically shortening the distance to the upper lip and e-verting the lip to increase the pink vermilion show. The procedure can significantly improve facial balance and restore a more youthful appearance. For some patients, it can be combined with philtrum contouring to define the vertical columns.
- Dermal Fillers: For less pronounced cases, hyaluronic acid fillers can add volume to the upper lip, particularly the cupid's bow, which creates the illusion of a shorter philtrum. However, it's crucial to use fillers conservatively, as excessive amounts can actually weigh the lip down and cause migration, known as a "milk mustache".
- Botox Lip Flip: A "lip flip" involves injecting small amounts of Botox into the muscle above the upper lip (orbicularis oris). This relaxes the muscle, causing the lip to roll slightly upward and outward, enhancing its shape and making the philtrum appear shorter. This is a temporary option, lasting only a few months.
- Makeup and styling: Non-medical solutions include strategically applied makeup and hairstyles. Overlining the cupid's bow and contouring the lip area can make the lips look plumper and draw attention away from the philtrum. Similarly, wearing your hair in a voluminous updo or adding bangs can shift the focus higher on the face. For men, growing a mustache can effectively camouflage the area.
The long-term impact of an elongated philtrum
An elongated philtrum is often associated with other signs of facial aging. Research shows that older adults tend to have both longer and thinner upper lips compared to their younger counterparts. This change affects the overall harmony and proportions of the face. In younger individuals with a naturally long philtrum, it can make them appear older than their actual age. Addressing this specific concern can have a profound impact on overall facial aesthetics and a person's self-perception. It is one of many facial structures that undergo natural changes over time, and modern cosmetic procedures offer various ways to manage or reverse these effects, depending on personal preference.
Conclusion
In conclusion, the philtrum does indeed lengthen with age as a result of diminishing collagen and elastin, gravitational pull, underlying bone changes, and muscle weakening. While this is a normal part of the aging process, a range of aesthetic options exists for those who wish to reverse its effects. From temporary, non-surgical fixes like dermal fillers and Botox lip flips to the more permanent solution of a surgical lip lift, individuals can choose a treatment that best fits their needs. Ultimately, the decision to address an elongated philtrum is a personal one, but understanding its causes and potential solutions is the first step toward exploring those options. For the most effective and safe procedure, it is recommended to consult a board-certified plastic surgeon. Note: Always consult with a certified medical professional for any surgical or non-surgical cosmetic procedure.
Additional resources
- The American Society of Plastic Surgeons: https://www.plasticsurgery.org/
- NCBI Bookshelf: Excessive Gingival Display: https://www.ncbi.nlm.nih.gov/books/NBK470437/
- Journal of Plastic, Reconstructive & Aesthetic Surgery: https://www.jprasurg.com/
- Harvard Medical School: https://hms.harvard.edu/
