Dr. Juliane C. Finke
Board-certified plastic surgeon (plastic &
aesthetic surgery), Fellow of EBOPRAS
- Fellow of EBOPRAS – European board examination, 2010
- Facial surgery with an emphasis on natural proportions
- Consultations in English and Spanish
For women · Facial treatments
Bullhorn lip liftin Berlin-Prenzlauer Berg
Some upper lips are not thin — they are long. As the distance between nose and lip grows, the red of the lip rolls inward and the teeth disappear when you speak. Filler makes that worse. Shortening the distance is what actually helps.
Please note: A medical consultation is a chargeable service under the German physicians’ fee schedule (GOÄ). Online bookings are binding; the practice team will explain the expected consultation fee when arranging your appointment.
Medically reviewed by Dr. med. Juliane C. Finke and Dr. med. Stephan Frantzen · Board-certified plastic surgeons · Last reviewed:
30–60 minutes
in theatre, usually under local anaesthetic
Day surgery
no hospital stay – you go home the same day
Sutures out after 7 days
after that you are presentable again
Long-lasting
a refresh usually only becomes a question after 10 to 15 years
The finding
When the upper lip is long rather than thin
A bullhorn lip lift is a small operation that shortens the distance between the base of the nose and the upper lip. A narrow strip of skin is removed directly beneath the nose, so the red of the lip rolls outward and becomes more visible.
The distance in question is the philtrum, and it lengthens with age in almost everyone. Two things follow. The visible red of the lip appears to shrink, because it is rolling inward rather than actually losing volume. And the upper teeth stop showing when the mouth is slightly open — one of the quiet markers of an ageing face.
The measurement runs from the base of the nose to the top of the lip’s red border. What looks harmonious depends on the individual facial proportions. The distance can lengthen with age, making the upper lip appear narrower.
The distinction
Why filler does not solve this
Hyaluronic acid adds volume to the lip body. If the lip is genuinely thin, that is exactly right and we will suggest it.
If the lip is long, adding volume pushes the red forward while the distance above it stays the same. The result is a lip that projects but still sits low — the look people describe as duck-like, which is why it happens so often to lips treated repeatedly with filler when the actual problem was length.
One rule follows: the measurement comes first, the treatment second. If you have had filler and are unhappy, we would rather look at the proportions than add more.
The procedure
What happens on the day
The strip to be removed is marked while you sit upright, with your face relaxed. Its shape gives the operation its name: the outline follows the base of the nose and the nostril sills, and looks a little like a bull’s horns.
The area is numbed with local anaesthetic; you are awake throughout. The strip of skin is removed and the wound closed in layers with very fine sutures, so no tension reaches the skin surface — that is what keeps the scar narrow.
The whole thing takes 30 to 60 minutes and you go home the same day. How many millimetres are removed is decided with you beforehand, and it is deliberately conservative: three to seven is a typical range, and a small change here looks very different in the mirror.
Step by step
How your bullhorn lip lift proceeds
An outpatient procedure under local anaesthetic – usually in 30 to 60 minutes.
01
Consultation and planning
We measure the distance between nose and upper lip, discuss the result you want and decide together how wide the strip of skin to be removed should be.
02
Local anaesthetic
The treatment area below the nose is numbed locally. A general anaesthetic is not required for this procedure.
03
Incision
The incision runs along the natural skin folds below the nose – along the nostrils and the columella. This line resembles the horns of a bull and gives the procedure its name.
04
Removing the strip of skin
The previously defined strip of skin is removed. Its width is individually adapted to the degree of skin laxity and the patient’s desired result.
05
Fine suture
The wound edges are carefully sutured in the natural fold beneath the nose. Every operation leaves a scar; colour, width and visibility depend on how the individual scar matures.
06
Result
In addition to shortening the distance between nose and mouth, the upper lip is lifted and thereby appears fuller – an immediately visible rejuvenation of the area between mouth and nose.
The scar
Where the scar sits — and how visible it is
Directly in the crease where the nose meets the lip, following the natural curve of the nostril sills. That crease is already a shadow line on every face, which is why a well-placed scar there becomes very hard to find.
It is pink and slightly firm for two to three months and then fades. Silicone gel from around week three helps, sun protection matters for a year, and nicotine is the single worst thing for it.
We will not tell you the scar is invisible. It is a scar, it exists, and in the first months you will know exactly where it is. What we will say is that of all facial scars, this is one of the most forgiving locations.
The result
What actually changes
Three things, in order of how much patients notice them: more visible red on the upper lip, upper teeth showing again when the mouth is slightly open, and a shorter, more defined distance below the nose.
The operation creates a lasting anatomical change, but skin ageing and individual healing continue. The degree and duration of the visible effect vary, and no fixed interval to a possible further treatment can be promised.
It combines well with a small amount of hyaluronic acid in the lip body — first the length, then the volume, in that order and usually at separate appointments.
Safety
Risks specific to a lip lift
Possible complications include bleeding, infection, delayed healing, a visible or widened scar, asymmetry, altered sensation, stiffness, nasal-sill or nostril distortion, over- or under-correction and revision surgery. The scar matures over months and cannot be guaranteed to become barely visible.
At a glance
Bullhorn lip lift: the key facts
| How long | 30–60 minutes in theatre |
|---|---|
| Anaesthetic | Local anaesthetic – you are awake |
| Stay | Day surgery – home the same day |
| Sutures | Out after 7 days; presentable after that |
| Scar | In the crease under the nose, following the nostril sills |
| Duration | Long-lasting anatomical change; ageing continues and no fixed duration can be guaranteed |
| Where | Day surgery at our practice, Heinrich-Roller-Straße 15, Berlin-Prenzlauer Berg |
| Paid by | Private fee or private insurance benefit |
What does a bullhorn lip lift cost? There is no flat rate. Time in theatre, technique, anaesthetic and the extent of the procedure differ from person to person. You get a binding quote at the end of your consultation — in writing, with nothing hidden. And the consultation itself? Medical advice is a treatment in its own right and is invoiced under the German scale of medical fees (GOÄ) — including when you decide against a procedure afterwards. We tell you what to expect when the appointment is made.
Will insurance pay? As a rule, no: purely aesthetic procedures are paid privately. German statutory insurers only contribute where a medical indication is recognised; private insurers and international policies decide case by case. We will tell you honestly whether you have any prospect of cover.
Preparing
How do I prepare?
- Stop blood thinners such as aspirin or ibuprofen only after checking with us.
- Give up nicotine for two weeks before and after the procedure – it is the single most useful thing you can do for your own wound healing.
- Come without make-up and without jewellery; for procedures around the eyes, without contact lenses too.
- Plan to get home without driving yourself. Even under local anaesthetic, having someone with you is easier.
- Keep the first few days free of anything where you have to look your best.
These points apply generally. What applies in your case – with existing conditions or regular medication – we go through at your pre-operative consultation. That conversation is what counts.
Alternatives
What are the alternatives?
The question is whether your lip is thin or long — the answers are different. We look first at whether something smaller would do the job – and we will say so if none of these procedures fits your finding.
- Wrinkle treatment with hyaluronic acid – the right choice for a genuinely thin lip; it gives volume but does not shorten the distance.
- Facial treatments overview – what else can be done in the perioral area.
In safe hands
Your surgeons for a lip lift in Berlin
Dr. Stephan Frantzen
Board-certified plastic surgeon and
board-certified general surgeon
- Head of department for plastic surgery, Helios Klinikum Berlin-Buch, 2015–2018
- Speaker on the “Full Face Approach” at the VDÄPC annual meeting
- Board-certified in two specialties – general surgery and plastic surgery
Verifiable qualifications
Professional societies and awards
Dr. Juliane C. Finke and Dr. Stephan Frantzen are full members of the German Society of Plastic, Reconstructive and Aesthetic Surgeons (DGPRÄC) and the German Society of Senology (DGS). Dr. Finke is also a Fellow of EBOPRAS and passed the European board examination in 2010; Dr. Frantzen operates on a voluntary basis for INTERPLAST in South America. The jameda seals lead to the independent physician profiles with patient reviews of Dr. Finke and Dr. Frantzen.
Frequently asked questions
Frequently asked questions about the bullhorn lip lift
Medically reviewed by Dr. Juliane C. Finke and Dr. Stephan Frantzen
01How do I know whether I need a lip lift or filler?
Measure the distance from the base of your nose to the top of the red of your lip. Around 13 to 15 millimetres is typical in a young adult. If yours is noticeably longer, the lip is long and filler will make it look heavier rather than fuller. If the distance is normal and the lip is simply slim, filler is the right answer.
02Does it hurt?
The local anaesthetic stings for a few seconds. After that you feel pressure and pulling, not pain. Afterwards it is sore for a day or two and ordinary painkillers are enough.
03How visible is the scar?
Pink and noticeable for two to three months, then very hard to find. It lies in the crease under the nose where there is already a shadow line. We will not claim it is invisible — it is a scar, but in a forgiving place.
04How much is removed?
Usually three to seven millimetres, agreed with you beforehand. A small change here makes a large visual difference, and taking too much shortens the lip unnaturally and cannot be undone.
05Can I eat and speak normally afterwards?
Speaking yes, immediately, though it feels tight. Eating is easier with soft food for the first two or three days, and it is worth avoiding anything that requires a wide bite until the sutures are out.
06When can I wear lipstick again?
Once the sutures are out and the wound is closed, so after about seven to ten days.
07Is the result permanent?
The removed skin does not grow back, so the operation creates a lasting anatomical change. Skin ageing and individual healing continue, however, and neither the degree nor the duration of the visible effect can be guaranteed.
08Can I combine it with filler in the same lip?
Yes, and it is a common sequence — length first, volume afterwards, usually at a separate appointment once the lip has settled. Doing both at once makes it hard to judge how much volume is actually needed.
09What are the risks?
Common and temporary: swelling, bruising, tightness, numbness of the skin under the nose. Less common: a scar that stays visible, slight asymmetry of the nostril sills, or a result that is smaller than hoped. Rare: wound healing problems, greatly more likely in smokers.
Your next step
Let’s look at your proportions
Book a personal consultation. We measure the distance, show you what a few millimetres change — and tell you if filler would serve you better.
Related treatments: Wrinkle treatment · Facelift · Thread lift · Facial treatments · For women
Medically reviewed by Dr. Juliane C. Finke, board-certified plastic surgeon (plastic and aesthetic surgery), and Dr. Stephan Frantzen, board-certified plastic surgeon and board-certified general surgeon.
Last medically reviewed:
The content of this page is for general information and does not replace medical advice. A binding assessment is only possible after a personal examination.
Independent information: The German Society of Plastic, Reconstructive and Aesthetic Surgeons provides patient information on choosing a specialist, consent, limitations and possible complications. The German Medical Association explains the GOÄ fee schedule. These German-language sources supplement, but do not replace, an individual medical examination.