If you’ve ever considered a lip piercing, chances are you’ve heard of the philtrum and perhaps the lesser known vertical philtrum piercing. Aka the medusa and jestrum lip piercings. 

At first glance, they look somewhat similar – they both sit above the upper lip and accentuate the cupid’s bow. But these piercings have actually very different placements, piercing processes, and even healing experiences. 

If you’ve stuck choosing between the two, in this articlle we’ll break down:

• Placement differences

• Jewelry styles

• Healing processes

• Anatomy considerations

• Which piercing may fit your lifestyle and aesthetic best

What is a Philtrum Piercing?

The philtrum piercing, also known as the medusa, is placed in the center groove above the upper lip. 

• Goes through philtrum area

• Sits directly above the cupid’s bow

• Jewelry enters from inside the mouth and exits above the lip

Jewelry options:

• Flat back labret stud

• Small gem or decorative top

Overall, the traditional philtrum piercing offers a super balanced and symmetrical look that works with minimal jewelry setups to curated facial combos. It also looks amazing paired with a labret piercing for cyber bites. It’s a piercing that offers a lot of range.

Pros:

• Classic, versatile placement

• Tons of jewelry options

• Accentuates lip and cupid’s bow

• Low risk of rejection or migration

• Most anatomies can support this piercing

Risks + Considerations

Like with any oral-adjacent piercings, there are some important things to know before committing.

• Swelling during healing

• Snagging while eating or talking

• Risk of gum recession or enamel erosion from jewelry

Healing: 3-6 months

Best For:

• Classic + traditional facial piercing

• Range >> subtle to bold lip look

What is a Vertical Philtrum Piercing

The vertical philtrum piercing (or jestrum piercing) passes vertically through the upper lip tissue. 

• Enters vertically through the upper lip

• Exists through bottom of the top lip

• Both ends of the jewelry remain externally visible
  

Jewelry options:

• Curved barbell with decorative end on top, bead or disc on bottom

The jestrum is a bold upper lip option. It definitely is not as common as a medusa piercing. It’s like the older sister of a vertical labret.

Pros:

• No jewelry backing inside the mouth

• Less direct contact with the teeth and gums

• Highlights lip shape

Risks and Considerations

• Swelling and tenderness

• Anatomy dependent

• Risk of migration and rejection

Healing time: 4-6 months

Best For:

• Bold piercing

• Less gum/tooth interaction

• Unique and less common

Choose a medusa if:

• Anatomy limitations

• Subtler option

• More jewelry options (rests easier)

Choose a jestrum if: 

• Gum and tooth concerns

• More unique piercing

At the end of the day, the best piercing is the one that:

• Fits your anatomy

• Matches your aesthetic

• Feels comfortable long-term