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The Beverly Hills Guide to Lip Fillers

Having full pouty lips is all the rage, today. If you look on the internet, women want to make their lips look full, pouty, and even sexy. Lip fillers can be a safe and easy way to enhance the perioral appearance. The viewer likes a youthful lip, without wrinkles in the skin. As we age, our lips tend to thin out and develop wrinkles and creases on the white lip portion. The corners of the mouth may gradually start to turn downward. This can create the appearance of a perpetual frown, and the diminished volume of the lips themselves only adds to the fatigued-looking effect. If you’re considering lip fillers, here’s a quick guide.

What are lip fillers?

Lip fillers are injectable agents that are administered into and around the lips to make them appear attractively full and lifted. Most modern lip fillers are made from hyaluronic acid, which is found naturally in the body and is thus well-tolerated by patients. In the early days of cosmetic lip augmentation, silicone and collagen were commonly used, but these methods are now less sought-after due to a higher incidence of complications. Fat transfer lip augmentation is another option for patients who want added lip volume that lasts longer than synthetic fillers. And while botulinum toxin is not technically a filler, it is often used as an adjunct to injectable fillers, to evert or turn “up” the lip, and make it look more youthful. Using botulinum toxin, just above the red lip, a so-called “lip flip”, and this procedure has gotten very popular. The lip flip has the advantage of everting the red lip, while simultaneously diminishing the wrinkles adjacent to the lip.

While lip fillers themselves work to enlarge a person’s pout, studies have also shown that getting certain types of injectable fillers actually helps the body produce more of its own natural collagen, keeping the lips more naturally volumized and preventing further wrinkling and sagging. In our practice, we have seen cases where people need lip injections less and less over time to maintain their desired look. 

What are the different types of lip fillers?

The most common injectable fillers used in and around the lips are:

  • Juvederm
  • Restylane
  • Belotero
  • Voluma

All of these injectable fillers are composed of hyaluronic acid. The great thing about hyaluronic acid is that most of these substances draw in a little bit of water, which is great for plumping the lip. The other main advantage is that hyaluronic acid fillers can be reversed with a substance called hyaluronidase, which can eradicate a lump or bump that may be a consequence of the filler injection.

Lips can also be augmented using a person’s own fat. In fat transfer lip injections, fat is harvested from another area of the patient’s body — usually the abdomen, thighs, or buttocks — and then injected into the lips. Patients may select this option when they want increased lip volume with longer-lasting results, or when they desire augmentation in a variety of areas of the face. In this case, fat can be a great volumizing substance in many facial regions.

Many of my patients do not like needing to get frequent lip augmentation with filling agents that go away. I commonly get requests for permanent lip augmentation. There are permanent fillers that can be placed in the lip, such as Bellafil or silicone. And there are synthetic lip implants that create permanent augmentation with a small surgical procedure. I personally, do not like any permanent lip fillers or procedures with permanent lip implants. My years of experience have told me that, in the lips, permanent fillers or implants cause permanent problems. For this reason, I use only dissolvable hyaluronic acid fillers.

Will my lips be swollen after I get filler injected into them?

Yes, slightly. But most swelling and bruising should subside within a few days of the injection, and applying ice packs or cold compresses can help. Most patients find they can easily cover minor bruising with makeup or concealer, and that post-procedure soreness and swelling resolve quite speedily, without any significant discomfort. 

It’s important to note, however, that swelling may cause your lips to appear larger than desired immediately following the procedure. Don’t panic — the results will be less dramatic once the swelling goes down and the filler fully settles, which should take no more than a week or two. 

If you also have botulinum toxin injected around the lips, you may temporarily experience a little difficulty pronouncing certain letter sounds, or a little awkwardness when eating or drinking through a straw. These effects shouldn’t last more than a few days, but if they are severe or persistent, never hesitate to contact your doctor. 

Does getting lip fillers hurt?

Injectable lip fillers are slightly uncomfortable. However, when I place lip fillers, I pretreat the lips with topical anesthetic cream, which lessens the needle discomfort. Additionally, all contemporary fillers contain lidocaine, and the combination of the filler agent with lidocaine, markedly reduces discomfort. 

Occasionally, a very anxious patient will request a dental block with lidocaine. We used to do these all the time, when fillers initially came out, because the initial prep did not contain lidocaine. However, now that most filler agents are made with lidocaine, the necessity for dental blocks has gone away, in the vast majority of patients.

How long will it take for my lips to look normal after lip injections?

While it may take one to two weeks for swelling to go down entirely, most patients can expect lips to look pretty “normal” after about three days post-injection. At four to five days, any swelling is usually only noticeable to the patient themselves. Since lip fillers are non-invasive and don’t require incisions or stitches, the recovery period is negligible and no downtime is required. Your lips will likely be most swollen the day following injection, so it’s best to schedule accordingly. And just to be safe, leave a week or two between your procedure and any major events or photo sessions. Clients who are self-conscious about having any visible signs of injection may choose to have it done on a Friday after work, so that swelling and bruising is mostly gone by the following Monday. 

Will my lips look fake or too big after getting lip injections?

The size and shape of lips after lip augmentation is a combination of the patient’s desires, the injectors skill, and any limitations that the patient’s particular lip has on achieving the desired result. Many patients considering lip fillers are afraid that their results won’t look natural — and rightfully so. We’ve all seen the dreaded “trout pout” on celebrities, where the lips have been so overfilled that they become all you can focus on when you look at the person’s face. My personal bias is to not create over-inflated lips or duck lips, which I think always draw negative attention to an important part of a person’s facial appearance. However, some of my patients want a very aggressive look, and I feel that the result I get on any given patient requires me to listen to the patient’s wants — and those may make me inflate a lip more than what I think is personally attractive. 

It is important that the patient and their injector have a detailed consultation, in which the injector listens to the patient, and also tells the patient what honestly can be achieved. Augmenting the lip relates to a patient’s desire for their own personal style. It is really important that a practitioner listens to a patient, regarding what they want to achieve.

How long does lip filler last?

Most filler agents last approximately six months. Although, some augmentation can be present for up to a year. However, the frequency with which each patients get reinjected, is individual. As some patients are very aggressive and want the full lip they tended to have the first few weeks after an injection. In what I would call the aggressive patient, they are clearly going to need more frequent injections into their lip, to satisfy their personal sense of style. In patients who are a little more tolerant, as their lip deflates, their frequency of injection may be somewhat longer.

How much does it cost to get lip injections?

The cost of lip filler injections is variable, relating to the product used, and the injector’s cost to inject the product. As a general rule, the augmentation of the lip costs between $500-800 for a single syringe of iller. It can be noted that one syringe of filler is the most common abount used for a given lip filler injection.

It is really important that the patient does not shop price when considering lip augmentation, as a cosmetically poor injection can have devastating consequences on an individual’s appearance, their smile, and their self confidence. My advice to patients is to seek an injector who listens to your needs and has an artistic manner in the way they look at faces, and in the way they inject.

What if I don’t like the way my lips look after I got filler?

Unfortunately, unsightly or excessive lip injections are not as uncommon as patients might like to think. In our practice, we have fixed all kinds of “lip jobs” gone wrong, no matter what method or filler was used originally.  In patients who have had hyaluronic acid placed, careful dissolving of the unsightly fullness or irregularity in the lip often is sufficient. Sadly, some lip augmentation is done with permanent injectable material, or with permanent lip implants. In these patients, no injectable dissolver exists. They have to have a surgical procedure to remove the permanent filler or implant, and the scarring that takes place as a result of it. 

Do I need a lip injection doctor near me?

It always pays to go to the very best lip injection practitioner you can, and it behooves all patients to view before-and-after galleries and read client reviews of lip filler procedures. Those seeking an expert lip filler plastic surgeon may wish to travel in order to ensure they get the very best result. At our practice in Beverly Hills and Sacramento, it is not uncommon for us to have patients flying in for all types of lip augmentation procedures.

About Dr. Jonathan Sykes

Dr. Jonathan Sykes is a world-famous expert plastic surgeon who performs all cosmetic and functional plastic surgery procedures on the face and neck. He is a past president of The American Academy of Facial Plastic and Reconstructive Surgery, and served on their Board of Directors for over 10 years. He is also a Professor Emeritus in Facial Plastic Surgery from UC Davis Medical Center, and the former Director of Facial Plastic Surgery at that institution. He is known as the expert’s expert, and is often called to consult and advise other plastic surgeons in both Northern California and Beverly Hills. He has a special interest in eyelid and browlift surgery, facial rejuvenation surgery, including facelifts and rhinoplasty.