Definition & Overview

A lip reduction surgery is a cosmetic procedure performed to improve the appearance of a person’s lips by reducing their size. The goals of the procedure are to make the mouth more proportional with the rest of the facial features and to balance out the relationship between the upper and lower lips.

There are several techniques used to perform this procedure, and more recent advancements such as the “bikini lip reduction”, which was first introduced in 2007, promise excellent results in terms of aesthetic and function.

Who Should Undergo and Expected Results

Lip reduction surgery can be taken advantage of those whose lips are prominent that they disrupt the balance of the face. Prominent lips, although usually a cosmetic problem, can also have other causes, such as a medical condition called macrocheilia. In severe cases, it may cause problems with the patient’s oral function and speech patterns as well as cause drooling or lack of salivary control. Studies show that macrocheilia is more common among certain ethnic groups, namely the Afro-Caribbean/American population.

Prominent lips or macrocheilia can also be caused by other factors, such as:

  • Double lip
  • Dentofacial deformities, also known as pseudomacrocheilia
  • Hypertrophy
  • Hemangiomas
  • Inflammatory lymphedematous infiltration
  • Glandular hypertrophy
  • Tissue thickening
  • Vascular malformations, also known as port-wine macrocheilia
  • Infection
  • Trauma
  • Neoplasms
  • Miescher granulomatous macrocheilitis

Regardless of the cause, prominent lips can cause self-confidence and self-esteem issues in some people and this is the most common reasons for taking advantage of the procedure.

In addition, lip reduction surgery can also be performed to correct problems caused by a previous lip augmentation procedure, such as post-operative swelling, scar formation, or when the patient’s lips were overfilled with injectables.

Following the procedure, a patient suffering from macrocheilia is expected to have a more balanced facial appearance, with the lips no longer prominently attracting undesired attention. The lips will have a more normal-looking contour, and the size of the upper lip will be balanced and proportional with the size of the lower lip. Patients can expect to see the full results of the procedure about two to three months following the surgery, but the results can continue to improve over a period of two years.

How is the Procedure Performed?

Typically, lip reduction procedures are performed while the patient is under IV sedation and usually take between 20 and 40 minutes per lip, depending on the extent and cause of the problem.

Prior to the start of the procedure, the cosmetic surgeon puts pen markings on the patient’s lip to indicate how much tissue has to be removed. He then proceeds to make an incision on the inside of the lip to gain access to the tissue inside the lips, all while squeezing the lip between the fingers to minimise bleeding. He then removes excess fat and tissue from the lip.

Traditionally, the surgeon makes a horizontal incision. However, conventional methods were not seen as effective in producing great results, hence the introduction of the bikini lip reduction technique. Best known for producing good labial contour and balancing the two sizes of both lips, this technique works by excising a “bikini top” shaped tissue from the upper lip and a “bikini bottom” shaped tissue from the lower lip. The ‘bikini top” shape, which is made up of two lateral cups and a central strap, successfully achieves the normal soft M shape of the upper lip. The “bikini bottom” shape, on the other hand, is simply a triangle that leaves enough volume to make the lower lip just slightly bigger than the upper lip. Also known as the “Brazilian” method of lip reduction, this technique has produced highly satisfactory results.

The recovery period following a lip reduction surgery is about 7 to 10 days. The stitches (which are usually dissolvable) across the patient’s inner lip can be expected to settle and improve in appearance gradually over a period of 6 to 12 weeks.

Possible Risks and Complications

Although it is normal to experience some side effects after a lip reduction surgery, most of the reported reactions are minor and do not cause any serious complications.

Post-surgical pain is usually very mild and tends to go away quickly. Swelling is also temporary, and scarring is hardly an issue, as patients are left with an almost invisible scar hidden on the inside of the lip.


  • Fanous N., Brousseau V., Yoskovitch A. “The bikini lip reduction: A detailed approach to hypertrophic lips.” Can J Plast Surg. 2007 Winter; 15(4): 205-210.

  • Sforza M., Andjelkov K., Zacchedu R., Jovanovic M., Colic M. “The Brazilian bikini-shaped lip reduction technique: new developments in cheiloplasty.” Aesthetic Plast Surg. 2012 Aug; 36(4):827-31.

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