Why Cupid’s Bow Procedures Are The Next Generation Of Lip Augmentation

Lip augmentation is a catchall phrase that involves everything from minimally invasive lip fillers to surgical cosmetic procedures. But regardless of how you define it, treatments that improve the appearance of the lips are among the most popular cosmetic procedures in the United States.

While we've heard a lot about how to increase the size of the lips, less discussed are treatment options for contouring a shapelier pout — and there is much more to the shape of the mouth than just the upper lip and lower lip. For starters, the highly sensitive pinkish part of the lip is known as the vermillion and is separated from the skin surrounding the mouth by a white roll known as the vermillion border. The central area of the upper lip, meanwhile, is the cupid's bow, and the groove that vertically runs from the cupid's bow portion of the lip to the nose is called the philtrum.

A defined cupid's bow can have a subtle but significant impact on overall shape of the lips, and that little V-shaped area in the middle of the top lip is now being treated with a range of procedures aimed at altering its curvature, reversing signs of aging, and improving contour. Here, we've rounded up three surgical and non-surgical cupid’s bow treatment plans and spoke to patients about their experience with each kind.

1. Injectable Fillers

Dermal fillers are probably the first lip treatment option that comes to mind when you think about enhancing the mouth area. Lip injections are nothing new, but they rose to new fame when full, pillowy pouts (a la Kylie Jenner) became a must-have. But fillers aren't just good for addressing size concerns. They can also be a good option for those looking to mimic the contouring effects of lip liner in a longer lasting way.

Cupid’s bow lip fillers aim to alter the shape of the lip (as opposed to giving an all-round plumper look) for about six to 12 months (i.e. until the product wears off). The temporary nature makes it an ideal option for those looking to dip their toe in the lip enhancement arena without a big commitment. Patients can also ask for their philtrum columns to be filled to further define the cupid’s bow.

How do lip fillers work?

Just like traditional lip augmentation treatments, the lips can be shaped by injecting temporary hyaluronic acid (HA)-based fillers (like Juvéderm® or Restylane®) around the vermillion border. Technique varies by provider, but your practitioner will inject the product using ‘micro-droplets’ to create subtle definition.

What happens during the procedure?

As with most cosmetic procedures, your appointment will likely start with a consultation during which your board certified dermatologist or plastic surgeon will look at the anatomy of the lips and learn about your aesthetic goals. Once it's time to inject, the practitioner will then numb the area (most doctors and patients opt for topical numbing agent) before placing small amounts of filler in the top lip. There is no downtime associated with fillers, though patients may experience side effects including swelling and/or bruising for a couple of days after treatment.

Patient Perspective

We spoke to Jess, who got filler to define her cupid’s bow because she was looking for a result that wasn’t quite as ‘done’ as more traditional fillers, about her experience with the procedure.

2. Lip Threading

A newer treatment on the block, threading (not the hair removal kind) enhances the shape and volume of lips — and the cupid’s bow in particular. The procedure uses fine surgical thread to stimulate collagen production which in turn defines the vermilion border and makes lips look plumper without using fillers. The technique (which focuses more on definition than volume) is the same that is used for thread lifts on other parts of the face.

How does lip threading work?

The treatment involves the placement of a poly-L-lactic acid (PLLA) thread that the body absorbs over time. The thread is inserted via a fine, tube-like needle, ‘anchored’ at a certain point, and then placed by removing the needle. Unlike fillers, final results develop in the weeks following the treatment, as more collagen is produced and blood flow to the area increases. Like hyaluronic acid fillers, the effects last six to 12 months. Unlike HA fillers, however, thread treatments are not easily reversed and some providers shy away from using threads around the mouth.

What happens during the procedure?

After your consultation, a numbing cream is applied to the treatment area and dental blocks (the same injections you have when you go to the dentist’s office) will be administered. The provider will make incisions on either side of the mouth through which the fine tube with the string will be strung. Once it is properly placed, the tube is gently removed, leaving the thread in its place. While there is no downtime, your mouth area will likely feel numb for a little while after the procedure and swelling and/or bruising may persist for a few days.

Patient Perspective

After being unhappy with the unnatural results of filler, Jo chose a lip threading procedure to define her vermilion border.

3. Lip Lift

For those looking for long term results, surgical lip lifts are a great option defining the cupid’s bow and the philtrum columns. The procedure involves surgically removing a section of skin under your nose to lift the lip, leaving lips looking plumper, more defined, and lifted. It’s a procedure that can be performed under local anesthesia and results are permanent — save for usual signs of aging.

How does a lip lift work?

Lip lifts work by, quite literally, lifting the lip. The rejuvenation procedure removes a small amount of skin between the top lip and the nose to create contoured and youthful-looking upper lip. The surgery is best suited to patients who are happy with the appearance of their lower lip, as the procedure addresses the upper lip only. Rather than add volume (as is the case with the previous two options), a lip lift will add definition and minimize any signs of aging in the area. There are several types of lip lifts that involve different incision placements and results. Consulting with a board certified plastic surgeon will ensure you receive the best treatment for your anatomy (for example, you will need a minimum distance of about 0.7 inches between the top of your lip and your nose to be eligible).

What happens during the procedure?

During your initial consultation, your surgeon will advise on the type of lip lift that is best for you. On the day of the procedure, the surgeon will mark the incision sites and administer a local anesthetic injection to numb the area. A mild sedative may also be given to help patients relax. The hour-long procedure involves the surgeon removing the skin and securing the lower incision to the base of the nose to create an instant lift effect. Dissolvable sutures are usually used to close the wound, and there are about seven to 10 days of downtime. While the final results are immediately visible, a lip lift surgery takes three to six months to heal.

Patient Perspective

Emma had a lip lift to combat signs of aging around her mouth, including her cupid’s bow that was becoming less defined as she got older.