“Lips are the most sensual organ we are allowed to expose.”[1]

– Anonymous Dermatologist, Ebony, Apr. 1991

Think of distraught Romeo upon finding Juliet, his love, lying in her Capulet tomb. He whispers her name and rushes to her side. Bending over her, he admires the power of her beauty still, in the crimson of her lips, and chooses to die with a righteous kiss upon those rosy lips. Of course, he does not die with that kiss because there is no hint of poison left there but must take his poison from the phial provided by the apothecary. Prose writers and poets, like Shakespeare in the tragic love story of Romeo and Juliet, have long boasted the power of the lips to beguile and entice, entice even a deity.[2] Lips are a powerful part of facial design.

Indeed, the ideal set of lips is carefully designed to mathematical perfection that can differ based on ethnicity.  The ideal set of lips is about forty percent the width of the lower face.  Caucasians’ frontal view looks good with a 40:60 ratio between upper and lower lips, but ethnic-skinned patients may prefer a 50:50 proportion.

No matter the race, if one draws an imaginary line from eye pupil to opposing eye pupil, the lips are parallel to that line. From the upper lip to just below the bottom of the nose, is about one half the length of the lower lip to the bottom of the chin. The Cupid’s bow, formed at the middle of the upper lip, should be well defined, meaning that the ridges that extend from the inner opening of the nostrils should connect to the upper lip at the edges on either end of the bow. The lower lip is fuller than the upper lip, but a profile view of youthful lips will demonstrate that the upper lip extends beyond the lower lip by about a couple millimeters.[3]

Because the lips reside in the perioral complex, or the lower third of the face, several factors in the region influence the appearance of the lips as they age. The three major factors that contribute are the ageing of the skin, the loss of fat just below the skin, and the loss of bone structure. External factors can include smoking, chronic stress, unwise lifestyle choices, work habits, and diet.[4]

One major consideration for the lip area is the position and alignment of the teeth. Because the teeth support the lips, any malocclusion, defined as improper relationship between upper and lower teeth,[5] or tooth loss and consequent need for bridges, dentures, veneers, or implants, should be factored in for optimum results when choosing to revitalize the lip area.[6][7]

In addition to bone and dental structure, soft tissues play a role in changes of the lips as they age. The upper lip loses its volume, which causes it to lengthen and invert. To illustrate, looking at a youthful nose and lip in profile, the line on younger version from the nose to the lip would appear curved; whereas, the aged nose to lip would appear as a straight line with the upper lip positioned inward, closer to the teeth. The lower lip also loses volume, appearing thinner, which causes the same inward position. The outermost edges of the lips begin to droop, and the Cupid’s bow becomes less noticeable.[8]

The dynamic function of the face also contributes to the ageing of the lip area. Just as repetitive facial expressions like smiling, frowning, and squinting cause formation of the vertical lines known as 11’s between the eyes on the forehead and cause formation of crow’s feet around the eyes, those same repetitive movements change the contour of the lips.[9]

As early as the twenties to thirties, tiny vertical wrinkles, nicknamed “barcode,” can appear above the upper lip. In the thirties to forties, vertical lines or barcode above the upper lip become more pronounced and both the upper and lower lips begin to lose volume. Also, the lines between the nose and outside edges of the lips, technically known as nasolabial lines, begin to form and the fat deposits in the cheeks begin to sag over those lines, creating nasolabial folds.[10]

In the forties to sixties, the vertical lines above the upper lip become increasingly marked, and both lips lose more volume. The corners of the lips sag more, giving the appearance of marionette lines, and the nasolabial folds between nose and outer corners of lips become even more pronounced. In the sixties and seventies and beyond, deep vertical lines appear above the upper lip, and the nasolabial folds worsen further.[11]

The vertical lines above the upper lip can appear prematurely and progressively worsen more rapidly in smokers.[12] When the cigarette is placed in the mouth, the lips are pursed, which is one reason the more frequent repetitive action occurs and its consequences are more pronounced. Ageing lips can also become dry and discolored, losing some of their rosy appearance, and the lip edge and the lips become less defined.

The thing to remember is that you want your lips to be as young looking as possible. After all, they are the most sensual organ we are allowed to expose.

Can you have more youthful lips? Discuss your particular situation with your doctor.


[1] Lip Quotes IV. Notable Quotes. 2018. http://www.notable-quotes.com/l/lips_quotes_iv.html. (14 July 2018).

[2] Lip Quotes IV.

[3] Souphiyeh Samizadeh. “Perioral Ageing.” 01 April 2015. https://aestheticsjournal.com/feature/perioral-ageing.

(14 July 2018).

[4] Samizadeh.

[5] Samizadeh.

[6] Samizadeh.

[7] Norman Huefner. “More Attractive Smile and Better Lip Support…” 03 December 2011. http://www.cosmetic-dentistry-and-porcelain-veneers.com/2011/12/03/more-attractive-smile-and-better-lip-support-for-vicki-from-laguna-with-porcelain-veneers. (14 July 2018).

[8] Samizadeh.

[9] Valeria Romano. “Lip Ageing and Vertical ‘Barcode’ Wrinkles.” 2018. https://www.dr-romano-esthetique.com/en/face/aging-lips/. (14 July, 2018).

[10] Romano.

[11] Romano.

[12] Romano.