Lip Shape Concerns: A Guide To Uneven, Drooping, And Poorly Defined Lips

We all weren't blessed with Angelina Jolie's proportional, plush pout. Cosmetic concerns like uneven, drooping, or poorly defined lips can occur as a result of genetics or aging.

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Medically Reviewed by William A. Kennedy III, MDLast Reviewed 09.28.2020

The Skinny

In many ways, our lips act as a gateway to the world around us. Eating, drinking, speaking, and expressing emotion require repeated and complex adjustments to lip shape. With this in mind, it is no wonder our lips are one of the most prominent features of the face.

Abnormalities of lip shape — like an uneven pout, drooping, or undefined cupid’s bow — can be the result of genetics (thank your mom and dad for that one), environmental factors (think: smoking, UV exposure, and even an affinity for drinking through a straw), and/or aging and can lead to cosmetic concerns and certain medical conditions.

On the aesthetic front, a study by the American Society of Plastic Surgeons (ASPS) found a 66 percent increase in plastic surgery lip procedures between 2000 to 2018, which has led to significant advancement in procedures like lip injections, lifts, implants, and micropigmentation that have the ability to refine and perfect lip shape.

The Specifics

What is lip shape?

There is much more to the shape of the pout than just the top lip and bottom lip. The lip itself is composed of an outer layer of cells (containing hair, oil, and sweat glands), the highly sensitive red or pink area known as the vermillion, and the inner mucosal membrane. The red or pink part of the lips is separated from the skin around the mouth by a white roll known as the vermillion border, and the areas where the upper and lower lips meet are called the oral commissures. The central area of the upper lip, meanwhile, is referred to as the cupid’s bow.

What causes variations in lip shape?

Genetics, of course, determine the general appearance of the lips from birth. A quick glance around at your family, friends, and colleagues will reveal the incredible diversity of different lip shapes. Not to be confused with lip size concerns like thin lips (read our guide lip size), the shape of your lips is influenced by the curve, height, angle, and proportion of the upper and lower lips.

As we age, a multitude of natural processes cause a distinct change in lip shape. Generally, the upper lip lengthens and inverts, the lower lip thins, the corners of the mouth droop, and the curves of the lips diminish. These changes are related to the natural evolution of bone structure (especially in the jaw), dental atrophy, and collagen loss.

Premature lip aging can be caused by UV exposure (yes, an SPF-infused lip balm should be a part of your skincare/makeup routine), smoking, and even the pursing that occurs while drinking from a straw, so it is important to care for the lip and mouth area just as you would any other part of your face.

What are the main concerns related to lip shape?

As it relates to the shape of the lip, there are three distinct concerns that someone may experience as a result of their natural lip shape, aging, or trauma. (2)

  • Drooping Lips: Lip ptoisis (a.k.a. drooping lips) occur when the corners of the lips slope downward. The result is a continuously melancholy, stern, or frown-like expression — whether a person is feeling that way or not. While the downturn of the corners of the lips occurs naturally with age, some people may be born with such a lip shape.
  • Lack of Lip Definition: As described above, the white roll that separates the red or pink part of the lip from the surrounding skin is known as the vermillion border. It gives both shape and definition to the pout and is also influenced by the proportion of skin in the surrounding nose and chin area. With age, the crispness of the vermillion border begins to fade and, as the facial skin loses collagen and elasticity, the mouth area as a whole loses laxity and definition.
  • Uneven Lips: There is no such thing as perfection in the human body, but there are certain proportions and ratios dating back to ancient times that have been found to be the most aesthetically pleasing. When it comes to the lips, Angelina Jolie's famously plush pout is one such example. According to a study in JAMA Facial Plastic Surgery, one-third of the fullness should be on the top lip and two-thirds on the bottom lip-chin area, and the actress' fit the bill. While the ratios are just a guide, many individuals have lips that are uneven in terms of upper and lower proportion or skewed fullness on one side of the mouth or the other, which can be corrected.

Lip lifts, injections, and pigmenting procedures exist to augment the natural shape and definition of the upper lip, lower lip, and surrounding area.

How can someone change their lip shape?

When considering enhancements to lip shape, it is reasonable to distinguish between cosmetic enhancements to complement existing facial structure and improve the natural lip line versus procedures to correct acquired or age-related variations (think: loss of structure and definition or deformities from injury or scarring).

Fortunately, the treatment options for both are quite similar, and there are a host of surgical and non-surgical solutions that can effectively address both innate and acquired lip shape concerns. See our full guide to lip shaping solutions.

For Drooping Lips

There are both surgical and non-surgical treatments for people who wish to turn that frown upside down. Injecting botulinum toxin type A products, like Botox®, Dysport®, Jeuveau®, and Xeomin®, into the surrounding musculature can lift the corners of the mouth, with results lasting three to four months. For a longer term solution, a corner lip lift can be utilized to correct the downturning of the lip at the oral commissures. Small portions of the skin are excised, so new edges can be sutured.

For Lip Definition

Whether someone is lacking definition on their upper lip, lower lip, or both, lip lifts, fillers, and micropigmentation can all be used to optimize the lip shape. Surgical lip lifts reshape the pout by modifying the space between the lips and nostrils, resulting in youthful, fuller lips. Upper lip-defining procedures include the Italian, modified, and subnasal (a.k.a bullhorn) lip lift, while a more invasive gullwing lip lift can be used to reshape the lower lip as well.

For a non-surgical solution, lip liner can be used to define the lip line or lip filler (temporary, semi-permanent, and permanent) can be injected along the vermillion border. Additionally, micropigmentation can be used to tattoo a more defined lip line and more dramatic lip color.

For Uneven Lips

If you desire a more symmetrical appearance to your lips, there are temporary, semi-permanent, and permanent solutions. Minimally invasive hyaluronic acid-based lip fillers, like Juvederm® and Restylane®, can be used to improve lip volume and vertical lip lines for six months to a year, while more permanent solutions, like Bellafill®, offer long term results. For those looking for a natural alternative, autologen and fat transfer injections involve adding fullness to the lips with patient-derived collagen or fat cells.

Lip implants, meanwhile, are a more invasive procedure that involves placing a mold into the lips for permanent reshaping. For patients who wish to combine a lip implant with a facelift, excess tissue from the face's superficial musculoaponeurotic system (SMAS) can be removed, shaped, and positioned in the lips for added volume.

To create the illusion of a more even pout, lip liner can be used to temporarily draw a new lip line. Similarly, micropigmentation (i.e. cosmetic tattoos) can enhance lip color, shape, and definition on a semi-permanent basis.

The Takeaway

Whether someone is looking to reshape the lips they were born with or wish to correct the toll aging has taken, there are an array of temporary, semi-permanent, and permanent procedures that are noth surgical and non-surgical in mature to enhance the natural shape of the lips. There are many changes to your lips as you age, and no single treatment can address every change. It is important to take this into account when choosing your lip treatment.

Source List


(1) Maloney, BP. “Cosmetic Surgery of the Lips.” Facial Plast Surg, vol. 12, no. 3, 1996, pp. 265–278., doi:10.1055/s-0028-1082417.

(2) Luthra, A. “Shaping Lips with Fillers.” J Cutan Aesthet Surg v.8(3); Jul-Sep 2015

(3) Johnston, MC, Millicovsky G. “Normal and Abnormal Development of the Lip and Palate.” Clin Plast Surg. 1985 Oct;12(4):521-32.

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