The philtrum is the small groove between the nose base and upper lip border — seemingly minor, yet a key structure determining lip-nose proportions and facial refinement. Common Asian philtrum concerns include: (1) Short philtrum — the distance from nose base to upper lip is too short, creating an appearance of the upper lip being ‘pushed up,’ with a large lip-nose angle in profile, making the upper lip look everted. (2) Unclear philtral groove — the vertical groove is blurry, lacking a defined central concave line. (3) Disproportionate philtrum — the standard philtrum length is about 1/3 to 1/2 of the nose base; too short or too long disrupts facial thirds. Previously, only surgery (philtrum lengthening) could improve a short philtrum — now HA filler offers non-surgical refinement: precise micro-injections between the upper lip border and nose base, visually lengthening the philtrum and softening the lip-nose angle. Rappoel Dermatology near Gangnam Station, Seoul, performs HA philtrum lengthening — non-surgical, 10 minutes.
Technical Principles of HA Philtrum Lengthening
- Visual lengthening, not physical stretching: HA cannot actually stretch skin — the principle is adjusting light-shadow and contour: micro-injection above the upper lip red border (lower end of the philtrum) corrects the visual receding of the upper lip edge, combined with supportive injection at the nose base (columella base), overall lengthening the visual distance of the philtrum area while softening the lip-nose junction angle
- Precise dual-point injection: The typical plan uses two key points: (1) Columella base — 0.05-0.1ml for nose base support, subtly elevating the columella appearance; (2) Above the upper lip red border at the lower philtrum — 0.05-0.1ml filling the depression, making the upper lip border contour clearer and softer. Combined, the philtrum area visually lengthens 1-2mm
- Soft small-molecule HA: The philtrum area has thin, frequently moving skin — soft small-molecule HA (gel-like texture) is used, feeling natural after injection, unaffected by speaking and smiling
- Reversible and adjustable: If unsatisfied or wanting to return to the original state, hyaluronidase completely dissolves it — one of the most attractive features of the non-surgical approach
- Synergy with lip sculpting: Philtrum lengthening often combines with lip sculpting (tubercle, cupid’s bow definition) — one session synchronously adjusts lip-nose proportion and lip refinement for a more harmonious overall result
Treatment Strategies for Different Philtrum Concerns
- Short philtrum type: Everted upper lip, large lip-nose angle. Strategy: columella base injection of 0.05-0.1ml (nose base support) plus 0.05-0.1ml above the upper lip border (softening edge), visually lengthening the philtrum 1-2mm; severe short philtrum (under 8mm) may combine minimal inner-upper-lip HA to reduce upper lip protrusion
- Unclear philtral groove type: The vertical groove is indistinct, the upper lip center lacks dimension. Strategy: micro-injections of 0.02-0.05ml along each philtral column, strengthening the columns’ dimension so the central groove appears clearer — creating refined ‘philtral lines’
- Everted upper lip type: The upper lip visibly protrudes in profile. Strategy: focus on nose base support (0.1ml at columella base) and avoid overfilling the upper lip — elevating the nose base changes the lip-nose angle, indirectly improving the everted look
- Combined philtrum-lip type: Short philtrum with flat lips. Strategy: philtrum lengthening (dual-point) plus lip tubercle shaping (0.1ml lower lip center) and cupid’s bow definition (0.05ml each upper lip side) — one session for comprehensive lip-nose proportion and lip contour adjustment
Rappoel Philtrum Lengthening Treatment Protocol
- Consultation assessment (5 min): Evaluate philtrum length (standard about 8-13mm), lip-nose angle, upper lip condition, groove clarity → understand patient expectations (length or line refinement) → design injection plan (points and volumes)
- Cleansing and anesthesia (5 min): Local makeup removal → alcohol disinfection → topical anesthetic cream or local cooling (the philtrum has fewer nerves; discomfort is minimal)
- Precise injection (8-10 min): Columella base 0.05-0.1ml → above the upper lip red border 0.05-0.1ml → micro-injection along philtral columns (if needed) → gentle shaping and pressing for even distribution
- Result confirmation (2 min): Patient checks mirror for philtrum length and lip-nose proportion → observe naturalness while smiling and speaking → micro-adjustment if needed
- Post-care instructions (2 min): Avoid pressing the injection area for 24 hours → avoid high-temperature environments and spicy food for 48 hours → avoid facial massage and beauty devices for 1 week → 2-week follow-up
Philtrum lengthening takes about 15 minutes with immediate improvement in lip-nose proportion, lasting 6-9 months. Located 3 minutes from Gangnam Station Exit 10, with seamless English and Chinese consultation.
Frequently Asked Questions
What’s the difference between HA philtrum lengthening and surgical philtrum lengthening?
Different principles and scope: (1) HA approach — non-surgical, 10-15 minutes, no downtime; dual-point injection (nose base support + upper lip border softening) visually lengthens the philtrum 1-2mm; suitable for mild-to-moderate short philtrum (those wanting fine proportion adjustment within the 8-13mm range). Lasts 6-9 months, reversible (dissolvable). (2) Surgical approach — philtrum lengthening surgery excises part of the nose base skin and sutures, 2-3 weeks recovery, lengthens 3-5mm, suitable for severely short philtrum (under 8mm) or permanent change. Rappoel’s recommendation: most patients’ lip-nose concerns are mild-to-moderate — the non-surgical HA approach is sufficient; try non-surgical first to see the effect before deciding on surgery.
Does philtrum lengthening injection hurt? How long is recovery?
The philtrum has fewer nerves — among the least uncomfortable facial injection sites: (1) Pain — most feel only mild stinging or soreness; nearly painless with topical anesthetic or cooling. (2) Swelling — mild swelling or small bumps may occur, subsiding within 24-48 hours, fully natural within one week. (3) Bruising — this area has fewer vessels, low bruising rate; even if it occurs, resolves in 5-7 days. (4) Downtime — virtually none; normal life immediately, just avoid pressing for 24 hours. For important events, treat one week in advance for full swelling resolution.
How long does HA philtrum lengthening last? Does it look natural?
Duration and naturalness: (1) Duration — the philtrum area moves less, HA metabolizes slower than the lips, typically lasting 6-9 months, more durable than lip augmentation. (2) Naturalness — the key is volume control: philtrum lengthening uses only 0.1-0.2ml total per session, a fine-tuning injection with very natural results — others will simply notice your lip-nose proportion looks better without seeing injection traces. (3) Standard — a good result is ‘a softer profile lip-nose angle without the upper lip everted look,’ not an obviously stretched philtrum. Rappoel’s principle: understated results over dramatic change.
Can philtrum lengthening be combined with lip augmentation?
Yes, it’s a common combination — lip-nose proportion is a whole: (1) Philtrum lengthening (nose base + upper lip border injection) primarily adjusts ‘distance.’ (2) Lip sculpting (tubercle, cupid’s bow) primarily adjusts ‘shape.’ (3) Combined — one session synchronously improves lip-nose proportion and lip refinement, with far better harmony than separate treatments. (4) Note — combined total volume should be controlled (generally 0.6-1.0ml total); over-injection loses naturalness. Rappoel physicians assess overall proportions for the most harmonious combined plan.
Who is not suitable for HA philtrum lengthening?
The following should be cautious or avoid: (1) Severely short philtrum (under 8mm) — HA only visually lengthens 1-2mm; severe cases should be evaluated for surgery. (2) Severely everted upper lip with gum show (gummy smile) — root causes are skeletal or muscular; HA cannot solve these, requiring toxin or surgery evaluation first. (3) Active lip infection (herpes, ulcers) — wait for full healing. (4) Pregnancy and breastfeeding — postpone. (5) HA allergy. Rappoel physicians conduct a full assessment during consultation and honestly advise against or recommend alternatives when unsuitable.
Short philtrum with everted upper lip? Rappoel HA philtrum lengthening — 10 minutes for the lip-nose golden ratio!
📍 77, Seocho-daero, Seocho-gu, Seoul, South Korea
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