Characteristics and Causes of a Long Philtrum | Recommended Cosmetic Treatments for Philtrum Shortening

"My philtrum is long, making my face look stretched out…"
"My philtrum seems longer than it used to be…"

The philtrum, located in the center of the face, is a feature that can dramatically change facial impressions with just a few millimeters of difference.

This article explains the causes of a longer-looking philtrum, the risks of self-care approaches, and cosmetic medical treatments for fundamental improvement.

Characteristics of people whose philtrum appears long

First, we explain the general standard for a long philtrum and how philtrum length affects facial impression.

Average length and the standard for "long"

As a general guideline, the average philtrum length is around 1.5 cm.

The ideal balance is said to be a ratio of "philtrum length : chin = 1 : 2." When the philtrum is longer than this ratio, or measures 2 cm or more, it is often perceived visually as "long."

Visual impressions such as an elongated face and looking older

A long philtrum tends to draw the eye to the lower half of the face, easily creating the following impressions.

• Elongated face: The overall face looks stretched vertically, giving a drawn-out impression
• Looking older: When skin has sagged due to aging, one tends to look older than their actual age
• Flat appearance: The face looks lacking in dimension, with a loose, undefined expression
• Thin upper lip: The skin below the nose pushes against the upper lip, causing the lip mucosa (the red part) to recede into the mouth, making it look thin

Main causes of a long-looking philtrum

Why does the philtrum appear long? The main causes can be grouped into three categories: "bone structure," "aging," and "habits."

Influence of congenital bone structure

Due to genetic factors, individuals whose maxilla (upper jaw) has developed vertically or whose upper jaw protrudes forward (commonly known as buck teeth) have skin that is pulled forward, making the philtrum physically appear longer.

Bone atrophy and soft tissue sagging due to aging

As we age, the underlying bone shrinks through a process called "bone resorption."

In addition to bone resorption, weakening of the orbicularis oris muscle around the mouth and loosening of the soft tissue surrounding the ligaments cause a loss of skin firmness, resulting in a longer philtrum.

Orthodontic treatment and balance with other facial features

When the front teeth are moved backward through orthodontic treatment, excess skin can make the philtrum appear relatively longer.

Additionally, a reduction in upper lip volume due to aging is also one of the factors that accentuates philtrum length.

Risks and Limitations of Self-Care for the Philtrum

Many people who research the length of their philtrum eventually come across self-care methods.

However, not only does no self-care method exist that can physically shorten the philtrum, but such attempts can actually be counterproductive.

【Massage】Sagging Caused by Damage to Tissue Around the Ligaments

Massaging the area under the nose with strong force can stretch or damage the soft tissue around the ligaments that support the foundation of the face.

Once soft tissue has been stretched, it cannot return to its original state on its own, and can become a cause of serious sagging across the entire face in the future.

【Massage】Hyperpigmentation and Fine Lines Caused by Frictional Stimulation

The skin around the mouth and sides of the nose is extremely thin.

Therefore, excessive physical friction acts as a stimulus that activates melanin, and can actually increase spots (hyperpigmentation) and fine lines.

【Philtrum-Shortening Exercises】Lack of Medical Evidence and Risk of Counterproductive Effects

There is no medical evidence that exercises can shorten the philtrum.

On the contrary, unnaturally moving specific muscles carries a higher risk of deepening nasolabial folds and wrinkles around the mouth.

【Makeup】Limitations of Visual Illusion

Overlining the lips and philtrum-shortening makeup techniques (such as shading) are effective ways to create a "temporary illusion" when viewed from the front.

However, they cannot conceal the profile silhouette or the unnaturalness at close range, and there are limits to shortening the actual skin distance or bone structure itself.

Cosmetic Medicine Is Essential to Shorten the Philtrum

Since the root causes of a long philtrum lie in "skeletal structure" and "tissue sagging," it is impossible to physically shorten it on your own.

Before causing damage to your skin or ligaments with ineffective self-care, why not consider a reliable approach through cosmetic medicine?

KAI CLINIC TOKYO's Cosmetic Medicine Approach for a Long Philtrum

At KAI CLINIC TOKYO, we carefully assess the overall facial balance of each patient and propose cosmetic medical treatments to improve philtrum length.

Le Fort I Osteotomy + Sagittal Split Ramus Osteotomy (SSRO)

This treatment combines the "Le Fort I osteotomy," which addresses the maxilla, with the "sagittal split ramus osteotomy (SSRO)," which addresses the mandible.

It is possible to physically reduce the philtrum length by several millimeters and dramatically change the proportions of the mid-face.

【Recovery / Downtime】
Swelling and bruising are most noticeable 2–3 days after surgery, but gradually subside over about one month, at which point you will be able to appear in public. Full recovery takes approximately 6 months.

【Risks / Side Effects】
Possible complications include swelling, asymmetry, bruising, infection, scarring, hyperpigmentation, foreign body reaction, pain, numbness, sensory abnormalities, hair loss, tissue necrosis, vision impairment, facial nerve disorder, allergic reaction, and shock reaction.

Learn more about Le Fort I Osteotomy

Lip Lift (Philtrum Shortening)

A lip lift is a surgical procedure that removes a few millimeters of skin beneath the nose to shorten the distance between the nose and lips and improve overall facial balance.

Shortening the area under the nose adds dimension to the upper lip and creates a youthful, refined appearance.

【Recovery / Downtime】
Swelling and bruising are most noticeable 2–3 days after surgery, but gradually subside over 1–2 weeks, with full recovery in about 3 months.

【Risks / Side Effects】
Possible side effects include swelling, scarring, redness, pain, bruising, edema, numbness, deformity, and allergic reaction.

Learn more about Lip Lift (Philtrum Shortening)

Botox Injection

Botox injection is a treatment that temporarily blocks nerve-to-muscle signal transmission by injecting botulinum toxin type A into specific muscles, suppressing muscle movement.

By injecting Botox to relax the muscles of the upper lip and slightly curl the lip upward (lip flip), the area under the nose can appear shorter.

Although individual results vary, the effect lasts approximately 3–6 months, so ongoing treatments are required for long-term results.

【Recovery / Downtime】
Swelling and redness may occur but generally subside within 2–3 days.

【Risks / Side Effects】
Possible side effects include bruising, mild swelling or tenderness, antibody formation with long-term continuous use, and facial asymmetry or stiffness (adjustable with correction).

Learn more about Botox Injection

Hyaluronic Acid Injection

Hyaluronic acid is a substance naturally present in the human body that retains moisture and helps maintain skin firmness and elasticity.

By injecting hyaluronic acid into the edge or cupid's bow of the upper lip, you can plump and lift the upper lip, creating an effect that changes the perceived length from the nose to the upper lip.

As hyaluronic acid is gradually absorbed by the body over time, ongoing treatments are required to maintain results, similar to Botox injections.

【Recovery / Downtime】
Swelling and redness may occur but generally subside within 2–3 days.

【Risks / Side Effects】
Possible side effects include swelling, bruising, and rarely vascular compromise (intra-vascular injection), infection, or allergic reaction.

Learn more about Hyaluronic Acid Injection

【Before & After】Philtrum Shortening by KAI CLINIC TOKYO

Here we introduce cases of patients who actually underwent philtrum shortening at KAI CLINIC TOKYO, along with before and after photos.

【Surgeon】
Mitsunori Harima
【Treatment】
Philtrum Shortening
【Risks & Side Effects】
Swelling, scarring, redness, pain, bruising, edema, numbness, deformity, allergic reactions, etc.
【Price】
¥440,000 (tax included)

If You Are Concerned About a Long Philtrum, Please Consult KAI CLINIC TOKYO

The beauty of the philtrum is not determined solely by its length in millimeters. What matters most is the balance of proportions across the entire face.

Over-adhering to general golden ratio standards can sometimes create an unnatural impression.

At KAI CLINIC TOKYO, we consider the harmony between each patient's facial bone structure and features, and strive to perform treatments that achieve the most suitable proportions for each individual.

If you are thinking, "I want to shorten my philtrum and achieve a well-balanced face," please feel free to consult with us.

Summary

Since the main causes of a long philtrum are bone structure and aging, it cannot be physically improved on your own, and attempting to do so may actually increase the risk of future sagging and wrinkles.

At KAI CLINIC TOKYO, we listen carefully to each patient's concerns about philtrum length and propose treatments to improve facial balance through thorough consultations.

Furthermore, we do not simply perform treatments — we also provide comprehensive aftercare, ensuring that patients can consult with us at any time if they have any concerns.

If you are considering correcting your philtrum length and achieving your ideal facial balance, please feel free to consult with us.