SMAS Modifications in Subnasal Lip Lifting: Evaluation of 600 Patients.

BACKGROUND: Aging of the upper lip is characterized not only by volume loss but also by soft-tissue laxity, elongation of the cutaneous lip, and progressive deterioration of vermilion show. Skin-only subnasal lip lift techniques may inadequately address these structural changes and may be associated with unfavorable scarring when excessive tension is applied to the skin closure. The aim of this study was to evaluate the clinical outcomes and safety of SMAS-based modifications in subnasal lip lifting, with specific emphasis on scar quality, lip eversion, and complication rates in a large patient cohort. METHODS: A retrospective analysis was performed on 600 female patients who underwent SMAS based subnasal lip lifting between 2020 and 2024. Patients were treated using either SMAS plication or SMAS excision depending on lip volume and tissue characteristics. Standardized preoperative and postoperative photographs obtained at a minimum of 12 months were analyzed. Clinical outcomes, revision rates, and postoperative complications were assessed. RESULTS: The mean patient age was 36.4 years, with a mean follow-up duration of 14.6 months. Minor scar elevation occurred in 11 patients and was successfully managed with fractionated carbon dioxide laser therapy. No surgical revision procedures were required. Overall aesthetic outcomes and lip contour improvements were clinically satisfactory. CONCLUSIONS: SMAS-based modifications in subnasal lip lifting provide effective lip elevation with favorable scar outcomes and low complication rates. Tailoring SMAS plication or excision according to lip volume allows for controlled lip eversion while minimizing skin tension. This technique represents a reliable and reproducible approach to upper lip rejuvenation. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .