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Lip Shaping for trans* women

Feminization of the Mouth Area –
Lip Lift & Lip Augmentation

Medically reviewed by: Dr. med. Timo Spanholtz

The mouth area is one of the most expressive features of the face – and at the same time one of the areas where male and female facial anatomy differ particularly clearly. For many trans* women, lip shaping is an important building block of Facial Feminization Surgery (FFS), because with a comparatively small procedure it has a noticeable effect on the overall perception of the face.

At the Transgender Clinic of the Praxisklinik am Rosengarten at our locations in Cologne, Bergisch Gladbach and Hamburg, we offer lip shaping both as a standalone procedure and as part of a comprehensive facial feminization – individually planned, precisely performed and respectfully accompanied.

Why do female and
male lips differ?

From puberty onwards, in men the distance between the base of the nose and the upper edge of the upper lip – the so-called philtrum – lengthens considerably. In women, this distance remains shorter throughout life, similar to childhood. This has visible effects:

Feminine Lips

  • The upper lip is more strongly curved forward and more voluminous
  • The philtrum is shorter and more pronounced
  • The upper edge of the upper incisors is slightly visible at rest
  • The lip roll (vermilion) is overall thicker and more pronounced

Masculine Lips

  • The upper lip is flatter and less projected
  • The philtrum is longer
  • The incisors are barely visible at rest
  • The entire mouth area is narrower and less voluminous
These differences arise hormonally and cannot be changed by hormone therapy alone – this is where surgical lip shaping comes in.

What procedures are there?

Lip Lift – Surgical Philtrum Shortening

The lip lift is the central surgical procedure for feminizing the mouth area. In this procedure, a small, precisely cut spindle of skin is removed directly below the base of the nose. The shape of the removed strip of skin resembles a bull's horn – it follows exactly the natural contour of the nasal opening, so that the later scar lies inconspicuously in the fold between the nose and the upper lip.

The result:

  • The philtrum is shortened
  • The upper lip lifts slightly upwards and forwards
  • The lip roll becomes more visible and more voluminous
  • The incisors shimmer slightly through at rest – a classic feature of feminine facial aesthetics

If the lip lift is performed as a standalone procedure, general anesthesia is usually not necessary. The procedure takes about 20 to 45 minutes under local anesthesia, and with careful technique the scar heals almost invisibly.

Lip Augmentation – Volume through Fillers or Autologous Fat

If more volume in the upper or lower lip is desired after the lip lift or as a supplementary measure, two options are available:

Hyaluronic acid fillers are a temporary, non-surgical method. The results last about 6 to 18 months depending on the product and individual metabolism. Fillers are well suited to complement the result of a lip lift or to test beforehand how more lip volume looks.

Lipofilling (autologous fat injection) is a permanent solution: the body's own fat is removed from another location – for example the abdomen or the thighs – processed and injected into the lips. Since no foreign material is used, the result is particularly natural. A portion of the transplanted fat is resorbed by the body, which is why a second session can occasionally be useful.

Dermastrip (dermis transplantation) is a permanent solution: the body's own collagen tissue from the dermis, which is "borrowed" for example from the groin or the upper arm, can be drawn into the lip and ensures good volume of the upper lip, the lower lip or directly of both lips.

Combination with other FFS procedures

The lip lift is often performed as part of a more comprehensive facial feminization – for example together with a rhinoplasty (nose correction) or a forehead feminization.

Important to know: A nose correction that reduces the nose can visually increase the distance between the nose and the upper lip – the lip lift compensates for this effect and ensures a harmonious overall appearance.

If several procedures are combined, the operation is performed under general anesthesia, which reduces the overall downtime and simplifies the healing process.

Procedure & Healing

Before the procedure

Before the procedure a detailed consultation takes place in which your facial anatomy is analyzed and it is decided together with you which procedure – lip lift, augmentation or combination – suits your goals.

The procedure itself

During the procedure (as a single operation) you are locally anesthetized. The procedure usually takes 20 to 45 minutes.

After the procedure

After the procedure a temporary swelling of the upper lip is to be expected, which usually decreases significantly after 3 to 6 days. The sutures are removed after about a week. You are usually presentable in society after about 7 to 10 days. The final result shows when the swelling has completely subsided – usually after 4 to 6 weeks.

Risks & Safety

As with any surgical procedure, the lip lift also has possible risks, which we communicate to you openly and transparently:

  • Swelling and hematomas during the healing phase are normal and usually subside within a few days.
  • Scar formation directly below the nose is inherent to the procedure, but usually fades very well with good scar care and suitable skin texture.
  • In rare cases, asymmetries can occur, which can be corrected with a small revision.
  • Temporary changes in sensitivity of the upper lip are possible.

An open conversation about realistic expectations is just as important to us as the surgical precision itself.


Who is lip shaping suitable for?

Lip shaping is an option for you if you:

  • wish for a more feminine-looking mouth area
  • have a lengthened philtrum and an upper lip that appears flatter than desired
  • miss volume in the lips
  • are planning lip shaping as part of a more comprehensive facial feminization

An individual examination determines which technique is best suited to your anatomy and your goals.


Frequently asked questions about Lip Shaping for trans* Women

We are happy to answer your questions about the treatment here.

Are there visible scars after surgical lip shaping?

For lip shaping for trans* women, we position the incision extremely precisely in the natural fold at the base of the nose. As a result, after the lip shaping for trans women has fully healed, the scar is nearly invisible to outsiders, as it follows the natural contours of your face.

Does the Lip Lift leave visible scars?

The scar is located directly at the fold between the nose and the upper lip – an area that is "hidden" by the anatomy of the face itself. With careful surgical technique and good scar care, it is usually not noticeable to others after healing.

Is the procedure also possible without general anesthesia?

As a standalone procedure, yes – it is then performed under local anesthesia and takes about 20 to 45 minutes. When combined with other FFS procedures, the operation is performed under general anesthesia.

Can lip shaping be performed using autologous fat?

Yes, lip shaping for trans women using autologous fat is a very popular, permanent alternative to fillers. A small amount of fat is taken from another part of the body and prepared for lip shaping in order to create a particularly natural and soft volume.

Can I combine the Lip Lift with a rhinoplasty?

Yes, and this is even frequently recommended. A rhinoplasty can visually lengthen the philtrum – the Lip Lift compensates for this effect. Both procedures together produce a particularly harmonious result.

Can lip lift surgery be combined with other FFS procedures?

Absolutely. Lip lift surgery for trans* women is very often performed together with a rhinoplasty or a chin reduction. Combining it with other feminizing procedures ensures a particularly harmonious and coherent overall appearance of your face.

Does the health insurance cover the costs?

That depends on the individual case and the respective health insurance. We are happy to advise you on which documents you need for an application and how we can support you with it.

Why is lip shaping an important part of facial feminization for trans* women?

Lip shaping for trans* women plays a central role in passing, as masculine-read faces often exhibit a longer distance between the nose and upper lip as well as narrower vermilion portions. Through targeted lip shaping for trans* women, we shorten this distance and create fuller, curved lips that make the entire face appear immediately more feminine and softer.

Which techniques are used in lip shaping?

For lip shaping for trans* women, we primarily use two methods: the surgical lip lift (bullhorn lift) for permanent shortening of the white lip and volume building using autologous fat or hyaluronic acid. We decide which lip shaping technique for trans women is ideal for you based on your anatomy and your aesthetic goals.

How long do the results last?

The surgical lip lift is permanent. Lip augmentations with hyaluronic acid last approximately 6 to 18 months; lipofilling with autologous fat is long-lasting and in many cases permanent, although a portion of the fat may be resorbed.

How does the healing process work after a surgical lip lift as part of lip shaping for trans* women?

After a lip lift as part of lip shaping for trans* women, the first few days are characterized by mild swelling. With this form of lip shaping for trans women, the fine suture directly under the nose usually heals very quickly, so that you will be fully presentable again after about 10 to 14 days.

Arrange an appointment

Get non-binding advice on lip shaping now. We clarify all open questions and talk about your desired change.

Completely without pressure, completely non-binding and above all on an equal footing and without prejudice!