FACELIFT.STUDIO

SMAS Modifications in Subnasal Lip Lifting: Evaluation of 600 Patients

In 600 women who had a subnasal lip lift with SMAS plication or SMAS excision, 11 had minor raised scars treated with fractional CO2 laser and none needed surgical revision over a mean 14.6 months of follow-up.

2026
Aesthetic Plast Surg
0
Citations, NIH iCite
3
Authors
1
Topics

Overview

Upper lip aging includes volume loss, looser tissue, a longer skin lip and less visible red lip. Skin-only lip lifts may not fix these changes and may scar badly when the closure is under tension. The authors reviewed 600 women treated between 2020 and 2024 with SMAS-based lip lifts, choosing plication or excision by lip volume and tissue, and assessed standardized photos taken at least 12 months after surgery.

Findings

  • 600 female patients; mean age 36.4 years.
  • Mean follow-up 14.6 months; photographs at a minimum of 12 months.
  • Technique: SMAS plication or SMAS excision, chosen by lip volume and tissue characteristics.
  • Minor scar elevation in 11 patients, managed with fractionated carbon dioxide laser.
  • No surgical revisions were required.
  • Overall results and lip contour were described as clinically satisfactory.
  • Level of evidence: V.

What it means for a patient

  • A lip lift that also tightens or trims the deeper muscle layer aims to take tension off the skin scar under the nose.
  • In this group, 11 of 600 had a raised scar that was treated with laser, and none needed another operation.
  • Limits: a retrospective review, women only, mean age 36.4, no comparison with skin-only lip lifts, and results described without a measured scale.

Why this paper matters

It reports 600 SMAS-based subnasal lip lifts, with 11 minor scar problems and no revisions. It supports tailoring plication or excision to lip volume to control lip eversion while lowering skin tension.

Terms

  • Subnasal lip lift: removing a strip of skin under the nose to shorten the upper lip.
  • SMAS: here, the muscle and fibrous layer under the skin of the upper lip.
  • Plication: folding and stitching tissue to tighten it without removing it.
  • Excision: cutting tissue out.
  • Vermilion show: how much of the red part of the lip is visible.
  • Lip eversion: the upper lip turning slightly outward, showing more red lip.
  • Fractionated CO2 laser: a laser that treats tiny columns of skin, used here to flatten raised scars.

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