Thin upper lip and thick lower lip: assessing the proportion

The ratio between the lips is one of the most frequent concerns in a harmonization consultation. The patient looks in the mirror and says: "the top one is so thin next to the bottom one". In many faces that difference is simply the usual anatomy. It should only become a plan when it bothers the patient and when the whole face justifies it.

This page covers the ratio between the lips and the trap of treating it as an arithmetic sum. If the concern is the size of the lip relative to the face, see lip out of proportion to the face.

Is there a proportion to chase?

The esthetics literature describes a relationship in which the lower lip is a little thicker than the upper. Lip proportion is the name for that comparison. But it describes a tendency, not a rule: there are beautiful, harmonious faces with lips of similar thickness, and others with a thicker upper lip.

The risk of taking the proportion as a goal is leading the patient to a "calculated" mouth, unrelated to the personality of the face. The safest reading is: the proportion is a data point, not a verdict.

Front and profile say different things

From the front, the ratio is seen in the visible height of the vermilion. In profile, in the projection of each lip. The two can tell different stories: an upper lip that looks thin from the front may project well in profile, and vice versa.

For the profile, the labiomental angle and the presence of retrogenia help in understanding whether the lower lip is being visually pushed forward by the chin. The page recessed chin goes deeper into this reasoning.

When it makes sense to propose something

There are three scenarios in which the conversation about enlarging the upper lip usually moves forward:

1. The patient is genuinely bothered and the anatomy allows a discreet addition.
2. The upper lip lost volume with age, and the ratio changed.
3. The shape of the mouth became unbalanced from previous product in the lower lip.

In all of them, the addition tends to be small and a return visit is planned. Thinking in terms of a "perfect" ratio is the road to overdoing it. For a sense of scale: among Harmy's shortcuts, "First time" uses lips 1 ml at Moderate, and "Maintenance" uses 0.5 ml at Subtle. These are the app's references for simulating, not doses to follow.

Thick lower lip: what fits

If the lower lip is naturally full, no injectable reduces it. If there is previous product, dissolving it with hyaluronidase can be discussed, with consent and planning. If the concern is visual, the conversation goes through the balance of the whole, as described in overprojected lower lip.

The rule of little and of the return visit

With a lip ratio concern, the most frequent mistake is doing more than necessary in the first session. Hyaluronic acid causes initial swelling, and the perceived result changes over the following weeks. Planning a return visit to reassess, instead of adding product on the same day, reduces the risk of excess.

Safety

The upper and lower lips are supplied by the labial arteries. Possible complications include swelling, bruising, asymmetry, nodules and, rarely, vascular occlusion. The professional must know the anatomy, keep hyaluronidase available when using hyaluronic acid and be familiar with lip vascular occlusion and the vascular danger zones of the face. Approaches and volumes are at the discretion of the qualified professional, following the rules of their professional council in Brazil.

Using Harmy to align expectations

Harmy lets you simulate the addition at the Lips point from the frontal photo. Because the Lips point treats the area as a whole, it does not separate the upper and lower lip. That is a limit: the tool illustrates scale, not the ratio between the lips.

More support in explaining the lip to the patient, thin lips: what to do and asymmetric lips.

Common mistakes with the ratio between the lips

Chasing a number. Any proportion presented as a goal turns the consultation into a calculation exercise and pulls the professional away from the patient's real face. The reference is a conversation, not a ruler.

Correcting the difference in the first session. If the upper lip is visibly thinner, the temptation is to even it out. The change tends to look more natural when the addition is small and repeated only if needed.

Ignoring the profile. An addition to the upper lip that looks good from the front can project too much from the side, and the reverse also happens. The profile is the reality check of the plan.

Forgetting the relationship with the nose. The upper lip rests on the base of the nose. A projected nose or a drooping tip changes how the proportion reads, and the conversation can move beyond the mouth. See nose that drops when smiling as an example of this relationship.

How to talk about proportion without promising symmetry

Patients often bring the idea that lips should have an exact ratio. It helps to explain that lips have natural variations, that mild asymmetry is common and that the goal is harmony, not sameness. See explaining natural asymmetry to the patient for an approach to wording. When asymmetry between the two sides is the concern, the topic changes to asymmetric lips: assessment.

What to record

Record the photos from the front, in profile and smiling, the approximate ratio between the lips with the caveat that it is an observation and not a goal, the patient's concern in their own words and the plan discussed. For clinical photos, follow standardized photography and consent for photos.

Summary

A thin upper lip with a thick lower lip is, in most cases, natural variation. It only becomes a plan when it bothers the patient and when the whole picture, from the front and in profile, justifies it. Prefer a small addition, reassessment and the reminder that the chin and nose change the reading. Approaches, volumes and technique are at the discretion of the qualified professional, following the rules of their professional council in Brazil, with no promise of results.