There are noticeable differences in the perioral morphology of males and females; a contrast which is particularly stark in the upper lip. Specifically, the female upper red lip tends to be fuller, with a shorter vertical cutaneous component and offering more dental show at rest. Familiarity with these differences, aesthetic ideals, and underlying anatomy is critical for the optimal planning of gender-affirming facial surgery (GFS). This chapter will review the evaluation of the perioral area and discuss operative planning. Multiple surgical techniques will be described in detail, including the commonly performed lip lift via a “bullhorn” incision, and others. Non-surgical procedures, such as lip implants and injectable fillers are also explained, as in patient counseling regarding expectations, periprocedural care, indications, contraindications, and potential complications. A case study with an instructional video is included as well.