Philtrum Botox (Lip Flip): How to Refine the Midface Without Shortening the Philtrum

Let me start with the core of non-surgical lip-shortening Botox, commonly referred to as a Lip Flip. Non-surgical lip-shortening Botox is a non-surgical procedure that injects a very small amount of botulinum toxin into the orbicularis oris muscle (the muscle surrounding the mouth), which is the inner muscle of the upper lip, to slightly unfold the upper lip line that was curled inward. It does not physically shorten the actual philtrum length because it temporarily relaxes the muscle tension rather than cutting the philtrum skin or tissue. However, it can give the impression that the distance between the nose and lips appears shorter while the red part of the upper lip looks slightly plumper, meaning the midface feels tidier.

So, before worrying about whether you need to cut your philtrum, it is worth considering first as an option to refine your impression without using a scalpel. The procedure takes only about 5 to 10 minutes, and there is almost no downtime, so you can return to your daily life immediately on that day. However, it is important to note that it is not a permanent procedure, and because the lips are a sensitive area, dosage control determines the result.

🔎 How exactly does non-surgical lip-shortening Botox work?

Botulinum Toxin Type A works on the principle of blocking the release of a neurotransmitter called Acetylcholine at nerve endings, temporarily blocking muscle contraction. When the muscle relaxes, the skin and tissue above it relax as well.

In non-surgical lip-shortening Botox, the main muscle into which the toxin is injected is the **Orbicularis Oris**. When this muscle relaxes slightly, the upper lip, which used to curl inward when smiling or talking, unfolds slightly outward. As a result, the exposure above the Vermilion Border, the boundary of the lip mucosa, increases, making the upper lip look plumper and relatively shortening the appearance of the philtrum.

The injection points are 2 to 6 spots around the Cupid's Bow, above the upper lip. The dosage used is very small, approximately **4 to 10 Units** based on the upper lip. If you also have concerns about a gummy smile (where gums show excessively), the **Levator Labii Superioris**, which lifts the upper lip, may also be considered.

📌 Key Summary: Non-surgical lip-shortening Botox relaxes the orbicularis oris muscle in small amounts, unfolding the upper lip outward and making the philtrum look shorter. It is a procedure that changes the impression, not physically shortening the length.

⏱️ When do the effects appear and how long do they last?

The effects do not appear immediately. They gradually start to be felt 2 to 5 days after the procedure and reach maximum effect in about 1 to 2 weeks. Therefore, you do not need to feel disappointed or anxious looking at the mirror on the day of the procedure.

The maintenance period is on average 2 to 4 months. However, because the area around the lips moves a lot for eating, speaking, and smiling, it can feel shorter than other facial areas, about 2 to 3 months. The toxin naturally breaks down over time and returns to its original state.

If you are considering maintenance treatments, it is helpful to get a consultation again just before the effect completely disappears (around 2.5 to 3 months) to stably maintain the line.

📌 Key Summary: The effects begin after 2 to 5 days and peak at 1 to 2 weeks, with an average maintenance period of 2 to 4 months, which may feel shorter due to lip characteristics.

💉 Non-surgical Lip-Shortening Botox vs. Lip Filler vs. Philtrum Reduction Surgery

Even though they look similar, these procedures have different purposes and principles. Let's summarize them in a table.

A Lip Flip and lip fillers can also be performed together. Muscle relaxation (Botox) and volume addition (filler) are often used together to aim for synergy. On the other hand, if the philtrum is structurally long and physical shortening is desired, philtrum reduction surgery can be discussed, but it carries the burden of incision, recovery, and irreversibility. If structural problems are not significant, we recommend first looking at non-surgical options to refine the area before using a scalpel.

📌 Key Summary: Fillers are for volume, Botox is for muscle relaxation, and surgery is for permanent shortening. Since only fillers can be reversed, Botox should be done carefully, starting with small amounts.

⚠️ Side Effects and Cases to Be Cautious

If the dose is controlled well, side effects are rare, but if an excessive dose is injected, functional inconvenience may occur.

• A feeling that pronouncing lip plosives like b, m, and p becomes awkward

• Inconvenience when using straws or a feeling of leaking water when drinking

• Asymmetry in expression when smiling

• Drooling, discomfort during meals

Although rare, adverse reactions such as difficulty swallowing, difficulty breathing, and systemic muscle weakness may occur. If you experience these symptoms, contact a medical institution without delay.

In particular, those whose lip function is professionally important, such as announcers, singers, lecturers, and wind instrument players, must approach this more cautiously. If you have a history of drooling or swallowing disorders, or neuromuscular diseases, you must inform us in advance. Botulinum toxin cosmetic procedures are not recommended during pregnancy or breastfeeding.

📌 Key Summary: Excessive dosage can cause pronunciation and expression discomfort, and those with professions where lip function is important, or during pregnancy/breastfeeding, must be cautious. Contact a medical institution immediately in case of severe adverse reactions.

🧬 Products, Resistance, and Useful Information

There are several types of botulinum toxin products used in Korea. There is the original Botox (Allergan), and Xeomin which has no complex proteins.

Here is a point that is easy to misunderstand. Because the potency and dilution method differ for each product, simply comparing the number of 'units' across products is not accurate. 1U of Botox and 1U of another product cannot be viewed as producing the same power. Therefore, rather than judging purely by the unit number, what your goal is and how much is injected where is far more important.

Another thing: Repeated, high-dosage, or too-frequent treatments can lead to resistance, where the effect decreases due to the formation of neutralizing antibodies. It is best not to get them more often or in larger amounts than necessary. For reference, botulinum toxin treatments in Korea are classified as medical acts and can only be legally performed at medical institutions.

📌 Key Summary: Units per product cannot be simply compared, and frequent, high-dose treatments increase the risk of resistance. Small doses and appropriate intervals are the rule.

✨ Onlif's Approach — Refining, Not Transforming

Gangnam Onlif Clinic does not aim for plastic surgery that changes the shape of the eyes, nose, and mouth, but rather directs toward saving the inherent balance. The same goes for the philtrum and lips. The goal is not to cut and shorten the philtrum, but to gently relax muscle tension to naturally refine the midface impression.

Onlif focuses on non-surgical treatments from a dermatological perspective. We aim for moderate improvement through treatments such as lip/nasolabial fold fillers, Botox, skin boosters, and thread lifts. Operating a medical specialization system where doctors in charge perform the procedures they are best at in each field, based on the belief that one doctor cannot do everything perfectly, is also in the same context.

For sensitive areas like the philtrum, starting with small amounts and recording and judging expression status (expressionless, smiling, side view) from multiple angles is the key conservative approach to reducing side effects.

📌 Key Summary: Onlif prioritizes 'refining' the philtrum through non-surgical methods rather than 'transforming' it, adhering to the principle of small-dose and conservative approaches.

❓ Frequently Asked Questions (FAQ)

Does non-surgical lip-shortening Botox actually shorten the philtrum?

The actual length of the philtrum does not physically decrease. It is closer to a visual change where the philtrum looks shorter as the upper lip unfolds slightly by relaxing the orbicularis oris muscle. If you want a physical reduction, you should consider other methods.

When will I feel the effect and how long does it last?

It gradually appears 2 to 5 days after the treatment and reaches its peak effect in 1 to 2 weeks. The average duration is 2 to 4 months, and because the lips move frequently, it can feel shorter, about 2 to 3 months.

If I don't like the result, can I reverse it immediately?

Unlike fillers, there is no way to erase Botox immediately. Fillers can be dissolved with hyaluronidase, but for Botox, you must wait for it to naturally dissipate over time. Therefore, it is safe to start with a small amount.

Can my pronunciation become awkward or can using a straw become difficult?

It is rare with an appropriate dose, but if an excessive dose is injected, the pronunciation of b, m, and p plosives can become awkward, or using a straw/drinking water can become uncomfortable. It recovers over time.

Can someone with a profession where pronunciation is important, like an announcer or singer, get it?

It is not impossible, but you must be very cautious. If lip function is professionally important, it is recommended to approach with a very small amount or to make a decision after sufficient consultation on whether to get the treatment at all.

Can I receive it at the same time as lip fillers?

Yes, it is possible. Combined procedures that aim for synergy by using muscle relaxation (Botox) and volume addition (filler) together are common. It is performed alone or in combination depending on the purpose.

If I get it frequently, will I develop resistance?

Repeated, high-dose, or overly frequent treatments can increase the risk of resistance, where the effect decreases due to neutralizing antibody formation. It is best to get treated as needed at appropriate intervals.

Can I get the treatment while pregnant or breastfeeding?

Botulinum toxin cosmetic treatments are not recommended during pregnancy or breastfeeding. If you have plans for treatment, you must inform us of your condition through consultation in advance.