Lip Fillers, At A Glance
- Best Results1 session
- Treatment RecoveryImmediate (swelling 2-8 d)
- Procedure Time20 minutes
- Skin SpecialistNurse Injector
- Duration of Results6 - 12+months
- AnaestheticBlocks & numbing
- Back to WorkSame day
- Cost $
Lips are pivotal when it comes to facial aesthetics. They can be enhanced in younger patients with optimal proportions, whilst more mature lips can benefit from volume replacement. Different dermal fillers and techniques are used, depending on the clinical findings.
FactsFacts on lip fillers
- Lip rejuvenation & shaping involve both volume & lip definition
- Proportions, structure & volume are important aspects to consider
- As a guide, younger patients require only 0.5 to 1ml of hyaluronic acid filler
- More mature lips can often take up to 2ml of dermal filler
- Mature lips will benefit from support to the lip area over actual lip injections
- Treatments are well tolerated as anaesthetic is used during the procedure
- Duration of results are range from 6 to 12+ months
What can we improve with lip dermal fillers?
Size; can be improved in both genetically underdeveloped lips as well as ageing lips. This is known as volumetric dermal filling.
Definition; is super important, as this highlights the margins of the lips, also known as the vermillion border. Fillers can also highlight the midline columns of the lips, known as the philtrum.
Proportion is the ratio of the upper lip height compared to the lower. Aesthetically pleasing lips have an upper to lower ratio of 1 is to 1.68, namely the lower lip is higher compared to the upper lip. This ratio is not set in stone & depends on cultural as well as racial perceptions.
Support of the upper and lower lip is essential, especially in mature patients. Over time, there is a loss of bone, fat & collagen. This results in hollowing & laxity surrounding the perioral (mouth area). Support of this region can be achieved with hyaluronic acid as well as collagen stimulating dermal fillers. Lasers, threads & skin tightening devices can reduce wrinkles & laxity in this area.
What types of dermal fillers are used for lips?
The Hyaluronic Acid family of dermal fillers are most widely used for lip rejuvenation. Within this family there are soft fillers as well as ‘structural fillers.’ The latter is used for more mature patients, whilst soft fillers are better for younger patients with good existing support. Hyaluronic acid fillers are also reversible.
For more mature patients, I also perform collagen stimulating fillers, especially for the treatment of upper lip lines & wrinkles; colloquially known as ‘smoker’s lines’ or barcode lines. This type of filler is not recommended for younger patients.
What lip shape is the most attractive?
The most important concept to grasp is ‘what is the most natural lip shape for your facial features?’ Lips should not be the most defining part of the face, & they should be age appropriate. The ideal proportion is 1:1.68, upper vs lower. This ratio is not set in stone, as some ethnicities, such as Asians, will have an ideal ratio of 1:1.
A guide as to lip rejuvenation over the ages, what filler is best?
Lips are so much more than the upper & lower volume. Lip shapes change over time, with both chronological ageing as well as trends.
As a guide; lips in the 20s to 30s: Concentrate on definition. Subtle rolled vermillion borders, good volume, but not OTT. Often 0.5 to 1.0 ml of hyaluronic acid dermal filler is advisable.
30s-40s; both volume & definition. Again, hyaluronic acid, with volumes ranging from 1.0 ml to 2.0 mls
50s+. Much more complex. Ensure underlying structures can support volume. Structural support often required for the upper lip area. This is where collagen stimulating fillers can be useful for some, but not all cases. Address wrinkles with lasers & or chemical peels. Lip borders are often blurred, hence one should work on definition. There may be underlying sun damage, especially for patients who live in Queensland. Lip filling in this age group has to match the more mature face. Never attempt to over volumize lips as this is obvious to all.
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How long do lip fillers last?
The majority of lip fillers last between 6 to 12+ months. You can get repeat treatments every six months or a top up when clinically indicated. Scientists have found that hyaluronic acid injections prompt the skin to produce more collagen, creating more natural plumpness in the lips.
Are lip fillers safe?
Dermal fillers are safe and effective in the correct hands.
Finding the right clinician to perform your dermal filler procedure is key. Side effects from dermal fillers are rare, however they do happen; see below!
- Bruising & swelling; is almost universally seen. This is NOT a side effect. Swelling can take up to 10-14 days to settle down
- Arterial-vascular compromise is the most feared side effect. This occurs when dermal fillers (including Hyaluronic Acid) are injected into a blood vessel. When this happens, the skin supplied by that vessel becomes ischemic (lack of oxygen). This can lead to ulcers & permanent scarring. There have been reported cases of vision loss (blindness) following lip injections. Careful injection technique as well as anatomical knowledge can reduce the chances of side effects.
- Infection; rarely seen. The most common infection is viral, namely activation of cold sores.
- Transient lumps & nodules occur within the first few weeks following dermal fillers. The majority of cases are due to product placement and injection technique; namely too much filler, or filler placed too superficially. These are usually self-resolving, however an enzyme can dissolve HA fillers if required.
- Delayed lumps & nodules are uncommon. They usually occur months or even years after filler injections. Most cases can be treated without dissolving the filler.
- Biofilm infection is very rare. This reaction requires treatment with antibiotics & dissolving enzymes.
How many ml / syringes are required for lips?
The average lip will require just 0.5 to 1 ml of filler to achieve both definition & volume. You are unlikely to require more than one syringe of dermal filler. In some cases, a little more filler may be used to achieve a more dramatic look, but it would rarely require more than 2ml (or 2 syringes) of filler. It is always best to go under, rather than over. Top-ups are super easy, dermal filler reversal is harder (& more expensive in the long run)!
Are lip fillers reversible?
Yes, hyaluronic acid dermal fillers are reversible. Don’t be too hasty in making that decision, especially if you are still swollen & bruised. It can take up to 2 weeks before the swelling goes down. If you still don’t like what you see after this time, a reversal enzyme injection can help.
For lip filler reversal, please book to see my clinical nurse injector @cliniccutis
Are lip fillers painful?
Fillers are more comfortable than you think. Correct injection technique, blocks & numbing agents will ensure your experience is comfortable!
Do lips go back to normal after dermal fillers?
Hyaluronic acid fillers such as Juvederm, Restylane & Belotero are temporary fillers. They typically last between 6-18 months. Once your body absorbs these fillers, your lip shape will return back to baseline.
How often are filler top-ups required?
To maintain lip definition & volume, lips are usually topped up every six months to eight months, however fillers can last up to 18 months (the usual is about one year).
Results vary from patient to patient though, so it’s best to speak to your advisor about how to keep your lips looking their best after the first injection.
Can you feel dermal filler in your lips/mouth?
Most lip fillers contain hyaluronic acid which is the building block for the dermal or deeper layer of your skin; hence the name- dermal fillers. Depending on the injection technique you may have minimal swelling in the injection area or across your lips at first, but once that subsides, you should not be able to feel the filler in your lips. It may take 2-3 weeks to get used to this. ‘It is normal to feel lumps, but it is not normal to see lumps.’
Why don’t my lip fillers last longer than 6 months?
On average, fillers are supposed to last six to nine months, but as the lips are more mobile compared to other frequently filled areas (such as the cheeks, jawline, temples). This movement, coupled with your metabolism, means that filler longevity can be less than expected. If this happens, consider changing to another brand of hyaluronic acid fillers.
Are permanent lip fillers advisable?
No. There are many reasons why permanent lip fillers are not advisable. Firstly, the shape of your lip changes over time. Secondly, filler side effects such as lumps are more common in permanent fillers. Thirdly, IF arterial injection occurs, there is no way to easily reverse the blockage. Fourth reason is that trends change with time. The ‘in-look’ now may not be the best look in the future.
Fat transfer vs dermal fillers for lips, which is better?
Pros and cons for each. Fillers have many advantages over fat grafting in the context of the lips. I used fat transfer over a decade ago, primarily in the United States. Fat gives volume, without definition. Not a great look.
|Technique||Dermal Fillers||Fat transfer|
Able to shape & define
|Finesse||Able to shape columns|
|Good for bulk only|
|Typically lasts 12 + months, enzyme can reverse filler if required.||Last much longer cf. fillers.|
Unable to reverse easily, especially if arterial injection.
Davin’s Viewpoint on Lips
I do think that the current trend of lip shaping is improving (albeit some Instagram personalities who are over the top). Dermal fillers have the ability to both VOLUMISE & DEFINE the lip. My advice is to go slow, as a guide, patients in the 20s should aim for 0.5 to 1.0 ml, namely ½ to one syringe only. As one ages, more VOLUME can be added.
For more mature lips (50s+), multiple factors come into play, namely lines and wrinkles above & below the lips as well as structural support. Laser, radiofrequency as well as collagen stimulating fillers can reduce lines in addition to providing support. Once again, it is important to pick a filler based upon the clinical presentation.
Disclaimer: My work focuses on more difficult jobs. This includes lip rejuvenation in more mature lips as this often requires a combination of surgical techniques (lip lift), ablative lasers, collagen stimulating fillers, & structural support of the oral area. For normal lip fillers, please see my nurse injectors.
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