Tag: best lip lift surgeon

The “Neonatal Deformity” is the Upper Lip Lift’s Unwanted Offspring

Posted on by Randal Haworth

To think that when Dr. Randal Haworth started his practice over 30 years ago, he was one of only a handful of leading plastic surgeons who specialized in lip reshaping surgery. Now, as one of the world’s most renowned lip lift experts, he has witnessed how upper lip lifts have exploded in popularity thanks to the influence of social media on the young and old alike. However, as with any trend, unintended consequences may arise such as the “neonatal deformity,” which originates from the congenital Apostrophe Lip. I first described this latter labial morphology in a chapter I authored for “Aesthetic Surgery of the Facial Skeleton”, a textbook edited by Dr. Steven Baker in 2019.

What Is an Apostrophe Lip?

You might not recognize the name, but you’ve likely seen the effect: the pink vermilion (the visible part of the lip) is full and prominent only in the center, while the outer thirds taper off or even disappear. This narrowing gives the mouth a stylized, doll-like appearance reminiscent of Kabuki makeup, where the lips are intentionally painted small and central.

While deliberate in performance art, this effect is aesthetically unflattering when unintentional—and unfortunately, upper lip lifts performed without addressing corner anatomy often exaggerate this deformity.

Kabuki performance artist's lips
Kabuki-style makeup mimicking an Apostrophe lip — note the abrupt loss of vermilion toward the corners, creating a slit-like mouth.

Kabuki lips
Another example of a stylized Kabuki “rosebud” mouth, often unintentionally replicated by improper upper lip lifts.

Overfilled lips due to both patient and practitioner perception drift
Before and after correction of an apostrophe lip using a medialized corner lip lift. This patient had chronic filler injections that exacerbated the deformity, narrowing the vermilion into a slit-like central zone.

How an Upper Lip Lift Can Create A Neonatal Lip

Lips of a Neonate
The neonatal deformity gets its name from the naturally recessed corners and centralized vermilion seen in newborns—charming in infants, but unflattering in adults.

Regardless of type, if an upper lip lift is performed without taking into account the oral commissures and lateral upper vermilion, a preexisting apostrophe lip can be exacerbated. The slope from the Cupid’s bow to the oral commissure (mouth corners) becomes unnaturally steep. The outer pink vermilion rolls inward or disappears entirely, leading to a pinched, slit-like appearance akin to that of a newborn. In essence, a neonatal deformity. Patients from around the world have come to me distressed by this outcome, often feeling disfigured and despondent.

Classic Neonatal deformity
Classic Neonatal lip deformity after an upper lip lift without regards to the oral commissures
A moderate neonatal lip deformity
A moderate neonatal lip deformity after an upper lip lift and an inadequate traditional corner lip lift

The Medialized Corner Lip Lift: A Powerful Solution

Enter the medialized corner lip lift—a precise, elegant surgical solution I’ve refined over the years to correct these issues. It not only repositions the corners of the mouth upward but also:

  • Restores lost vermilion by rolling it outward, eliminating that paradoxically tightlipped “rosebud” look.
  • Corrects asymmetry, which is present in the majority of mouths.
  • Improves the marionette folds (those stubborn lines running from the corners of the mouth downward) that facelifts often miss.
  • Softens the harsh slope from Cupid’s bow to oral commissure, restoring a balanced, natural curvature.

This is a high-precision procedure involving design and execution tolerances as fine as a quarter millimeter. But when done correctly, the results are not only restorative—they are transformative.

Neonatal lip deformity stemming from past upper lip lift.
This patient required a direct revision of her previous upper lip lift to correct pleating at the nasal base and a medialized corner lip lift to correct the neonatal deformity. A lower V–Y plasty was also performed.
Asymmetrical, neonatal, deformity after upper lip lift and simultaneous rhinoplasty
Another case of asymmetrical neonatal lip deformity after having undergone a previous upper lip lift simultaneous with a rhinoplasty. Dr. Randal Haworth corrected this with a medialized corner lip lift along with medical dermabrasion of her upper lip lift and nasal base/past rhinoplasty scars.. The vermilion was central and collapsed at the corners.

Final Thoughts

If you’ve undergone an upper lip lift and are unhappy with the corner distortion or feel like your lip looks smaller or more “pursed” than before—know that you’re not alone. These issues are more common than many realize, but they are entirely correctable.

Performed under local anesthesia, the medialized corner lip lift offers a sophisticated solution to restore harmony and confidence to your face.

Dr Randal Haworth

Beverly Hills 2025

Beautiful Upper Lip Lifts without scars?

Posted on by Randal Haworth
When we choose to undergo a plastic surgical procedure, we do so to get a beautiful result which is balanced for the face and one that is as permanent as possible and one which doesn’t interfere with function. I don’t think anyone would argue with the above. Lips are a unique anatomical future. They connote youth, beauty and sexuality. However, their job is not only to look beautiful, they have to also function. This is contrast to a nose or an ear which have no moving parts. And as a plastic surgeon helping to advance the field of lip reshaping surgery (LRS), this is where the challenge lays. When a patient asks me to make them a beautiful set of lips, I have to ensure:
  • a. A beautiful upper lip
  • b. A beautiful lower lip
  • c. Both upper and lower lips harmonize with each other
  • d. The harmonizing upper and lower lips harmonize with the surrounding face in terms of shape and scale (volume)
  • e. The upper and lower lips continue to harmonize well into the future (akin to a long-lasting result)
  • f. Scars are as imperceptible as they can be
  • g. The chance of nasal distortion and other complications are kept to a bare minimum
  • h. Lip function is retained (perhaps even improved with the new found confidence!)
  • i. Recovery is minimized whenever possible
  • j. A patient’s expectations are aligned with reality.
(Of course, “j.” should be at the top of the list. If a patient has unrealistic expectations, then no matter how successful a surgery is, if a patient in the end is dissatisfied, the surgery is a failure to them). One of the cornerstones of lip reshaping surgery is the upper lip lift. Most of us appreciate that beauty is mostly conferred through shape and less so by colour and volume. The lips are no exception. An upper lip that is considered beautiful on a primal, instinctual level is one comprised of a short nose-to-lip distance, a beautiful “O” arch, a visible vermilion balanced with the size of the lower and, of course, an appropriate upper tooth exposure. Sexy After performing thousands of upper, corner and lower lip lifts, the secret to unparalleled longevity and a naturally beautiful lip shape is stability. One must understand that, like the hands, the lips move hundreds of thousands of times a day- eating, talking, expressing and other things that shall go unmentioned in this post. Therefore, for an upper lip lift to be successful in terms of beauty and longevity, it should not only resist the downward pull of gravity but also be stabilized against everyday movement (which contributes to re-stretching of the lip, obvious wide scarring and downward pull on the nose). The OOS (Orbicularis Oris Suspension) superficial muscle technique provides this very stabilization by anchoring the superficial layer of Orbicularis Oris just below the dermis to the periosteum (or lining of the bone) below the nose. (The Orbicularis Oris is the circumferential, sphincter muscle that surrounds the oral aperture). By stabilizing the lip in two directions bilaterally I am able to customize the curl and expression of the upper lip to make it not only youthful but sensual as well. The two direction approach is analogous to the way a marionette can come to life by the hands and strings which control it. The skin-only lip lift is a far simpler operation to perform and solely involves removing skin and sewing the skin edge of the lip to that of the bottom of the nose. The only thing holding the skin-only lip lift in position are the dissolvable stitches in the dermis which are no match against constant daily mouth movement and gravity’s pull. As a result, there is a far greater likelihood of the nostrils being pulled downwards, obvious scarring, significantly decreased longevity and suboptimal aesthetics.
After a "modified "upper lip lift
After a “modified “upper lip lift by another Beverly Hills Plastic surgeon, which is basically a skin-only lip lift marketed as something other than it really is. Note severe right nostril pulldown with bizarre pleat along with an “A frame” deformity and an exacerbation of her downward slanting can’t of her upper lips.
I can personally attest to the dramatically decreased longevity, unremarkable results, worse scarring and nasal distortion from the thousand or so skin-only lip lifts I performed in the 90s. Though the skin-only  recovery is easier, the current version of the OOS upper lip lift may allow the patient to appreciate results as early as 10 days. Not only does the OOS technique shorten the distance between the nose and lip but it also allows upper tooth show( that goes without saying really), subtle added rollout of the upper lip’s pink vermilion, welcomed narrowing of the aperture of the mouth (that gets wider with age) and even noticeable reduction in the nasolabial folds. Contrary to some misperceptions, no muscle is removed and no cases of permanent numbness or any paralysis ever encountered.
After an OOS upper lip lift by Dr Haworth. Note minimal scar and no nostril descent
Upper lip lift enhancement
After an OOS upper lip lift by Dr Haworth. Note minimal scar and no nostril descent
More and more people are realizing that the upper lip lift( and other LRS techniques) may play as important a role as a facelift and eyelid surgery in facial rejuvenation. Choosing proper techniques, performing them well and understanding how all elements of the lip work together can be the ultimate magic trick to transform a face from “Meh to Mwah”! Dr Haworth July 2018