- Lip fillers can add volume and fullness to thin lips and treat lip lines and wrinkles.
- Lip fillers produce immediate results.
- This procedure is relatively safe, with most people experiencing only mild side effects.
- Most lip fillers last up to one year; some options last longer but may be less safe.
It is no secret that plump, full lips are widely considered to be attractive. To achieve this look, physicians and nonphysicians have experimented with various treatments for many decades. From paraffin injections in the early 1900s to synthetic and natural tissue implants, they have had varying degrees of success.
Modern lip fillers are the culmination of this experimentation that offer a safe and effective solution for lip augmentation.
What Are Lip Fillers?
Lip filler injection is a minimally invasive cosmetic procedure that is performed at a doctor’s office with minimal downtime. They are injectable treatments that can add volume and definition to the lips, improve lip symmetry and treat vertical lip lines.
Fillers are generally made from natural or biocompatible compounds such as hyaluronic acid. Due to their ease of administration and instant results, lip fillers have boomed in popularity over the past few decades.
Lip fillers vs. lip augmentation
Surgical lip augmentation is another option for improving the aesthetics of the lips. Through a small surgical incision, an implant or filling material is inserted to achieve the intended effect. Synthetic materials such as silicone and polytetrafluoroethylene, as well as dermal fat grafts (skin and fat tissue) harvested from another body area are possible options.
Compared to fillers, surgical augmentation produces longer-lasting results but is more invasive and carries a higher risk of complications. It is also generally more expensive with less predictable results.
Types of lip fillers
Most modern lip fillers are based on hyaluronic acid (HA), a natural compound that is abundantly found in body tissues. HA is used as a soft tissue filler in many areas of the body and has demonstrated safety and efficacy as a lip filler.
Collagen is a natural compound that can be used as a lip filler. However, the collagen used in soft tissue fillers is extracted from animals, which poses a risk of allergic and inflammatory reactions. An allergy test is necessary before receiving collagen injections.
Another possible option is fat transfer; using liposuction to remove some fat tissue from the thigh, abdomen or other parts of the body, then injecting it into the lips. While this produces permanent or semipermanent results, it is relatively unpredictable, more invasive, and associated with additional risks of complications.
Juvederm and Restylane are the two major brands of HA-based lip fillers currently approved for use in the United States by the Food and Drug Administration (FDA). These fillers are available in a variety of formulations to best serve your needs.
- Juvederm Ultra XC for lip augmentation.
- Juvederm Volbella XC to address fine lip lines and provide a moderate volume increase.
- Restylane for fuller lips and to correct minor lip folds.
- Restylane-L for results similar to Restylane but with an additional numbing agent for added comfort during the injection process.
What is the best lip filler?
HA is considered the best option for nonsurgical lip augmentation. The simplicity of the procedure, relatively low cost and consistently good results make it an excellent choice.
Collagen and fat transfers used to be popular options for lip augmentation; however, the more favorable safety and predictability of HA fillers have made them significantly more popular.
An experienced provider can administer HA fillers in minute quantities to make precise and symmetric adjustments. HA fillers also have a reversal agent in case the results are not satisfactory.
Juvederm and Restylane are comparable in terms of effect, safety and longevity, and can generally be used for the same indications.
Adults who are in good health, have no medical conditions and are nonsmokers are good candidates for lip injections. A realistic understanding of what fillers can and cannot do will help you define your goals with your cosmetic provider and achieve the results you are seeking.
Who should avoid lip fillers?
People with the following conditions should avoid lip filler injections:
- Active infections or cold sores
- Autoimmune conditions such as lupus or rheumatoid arthritis
- Bleeding or blood clotting problems
- Allergy to lidocaine (local anesthetic)
What to Expect During the Procedure
Lip filler injection is a simple procedure performed at a doctor’s office with almost no downtime.
Preparation involves marking the treatment area and applying a topical numbing agent such as lidocaine. Some fillers contain lidocaine premixed in the vial.
Using a very fine needle or cannula, your provider will inject the filler under your skin. You may need multiple injections during the same session to achieve the desired results. The procedure, including preparation time, should take 15 to 30 minutes.
Do lip fillers hurt?
Lip filler injections can cause some slight discomfort. Applying a topical numbing cream, using an injectable nerve-blocking medication or using a filler with a premixed numbing agent can help reduce the discomfort.
With a numbing agent, you will feel the initial needle prick and a sensation of pressure rather than pain.
The downside of using a numbing cream is that it can cause some swelling, which can make it harder for the provider to gauge the results with precision, until the swelling goes down.
Following the procedure, you may experience some swelling and bruising for up to two weeks. You should follow some simple instructions and precautions to speed up recovery and avoid any complications:
- Apply an ice pack to the lips to reduce swelling
- Avoid vigorous exercise and direct sun exposure for 48 hours
- Avoid massaging or unnecessarily touching of the injection site
- Avoid aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen, as they may cause bleeding
Lip Fillers Before and Afters
How Long Do Lip Fillers Last?
Collagen fillers are also temporary and are typically absorbed by the body after about three months.
Fat injections last years and are considered semipermanent, while surgically inserted synthetic implants made of silicone are truly permanent.
Can lip fillers be reversed?
In the event you are not satisfied with the results, a reversal agent can remove the filler. Hyaluronidase is an enzyme that is injected to degrade HA safely and effectively.
More permanent lip augmentation options such as implants or fat transfer are more difficult to reverse or correct.
Side Effects and Risks
Lip filler injections are fairly safe when performed by an experienced provider. Side effects are generally mild and self-limited; they include:
- Swelling and bruising lasting up to two weeks
- Bleeding at the injection site
More serious side effects and complications are rare. These may include:
- Reactivation of cold sores
- Skin infections
- Allergic reactions
- Asymmetry and poor aesthetic outcome
- Tissue damage causing ulceration, scarring or necrosis (tissue death)
There is no downtime following lip filler injections – you can follow your daily routine immediately, keeping in mind the aforementioned precautions.
Lip fillers at home
Some people may be tempted to try lip filler injections at home to save on professional fees. This is highly dangerous and can lead to a host of complications including infections and poor aesthetics. Only a qualified medical professional should give dermal filler injections.
The main determinant of lip filler cost is how many vials or syringes are used. Lip fillers are usually available in syringes of 1 cc (1 mL) each, and most people experience good results with one to two syringes.
On average, one vial of HA filler (Juvederm or Restylane) costs about $650–$700. Other factors that may influence the cost include geographic location and additional facility fees.
How to Pick a Lip Filler Provider
Selecting a board-certified dermatologist or plastic surgeon you feel comfortable with will go a long way towards ensuring you get your desired results. You should opt for a consultation session with your provider before deciding on treatment.
Ask your physician about their experience with this particular treatment, whether they can share any before and after pictures, and what they would recommend for you.
Lip filler injections can help you add volume, plumpness and symmetry to your lips. Most modern lip fillers are temporary and last months and will need to be repeated to maintain the results. More permanent options do exist but they come with additional downsides that make them a less attractive option.
- Glicenstein J. [The first “fillers”, vaseline and paraffin. From miracle to disaster]. Ann Chir Plast Esthet. 2007 Apr;52(2):157-61. ncbi.nlm.nih.gov/pubmed/16860452
- Donald W. Buck, Murad Alam, John Y.S. Kim. Injectable fillers for facial rejuvenation: a review. Journal of Plastic, Reconstructive & Aesthetic Surgery. Volume 62, Issue 1, 2009, Pages 11-18, ISSN 1748-6815,
- Brody, H. J. (2001), Complications of Expanded Polytetrafluoroethylene (e‐PTFE) Facial Implant. Dermatologic Surgery, 27: 792-794. doi:10.1046/j.1524-4725.2001.01014.x
- Cockerham K, Hsu VJ. Collagen-based dermal fillers: past, present, future. Facial Plast Surg. 2009 May;25(2):106-13. doi:10.1055/s-0029-1220650
- Rzany, B. , Becker‐Wegerich, P. , Bachmann, F. , Erdmann, R. and Wollina, U. (2009), Hyaluronidase in the correction of hyaluronic acid‐based fillers: a review and a recommendation for use. Journal of Cosmetic Dermatology, 8: 317-323. doi:10.1111/j.1473-2165.2009.00462.x
- Glogau, R. G., Bank, D. , Brandt, F. , Cox, S. E., Donofrio, L. , Dover, J. , Grekin, S. , Lawrence, I. , Lin, X. , Nestor, M. , Shamban, A. , Stewart, D. , Weiss, R. , Axford‐Gatley, R. A., Theisen, M. J. and Smith, S. (2012), A Randomized, Evaluator‐Blinded, Controlled Study of the Effectiveness and Safety of Small Gel Particle Hyaluronic Acid for Lip Augmentation. Dermatol Surg, 38: 1180-1192. doi:10.1111/j.1524-4725.2012.02473.x
- Geronemus, Roy G. MD; Bank, David E. MD, FAAD; Hardas, Bhushan MD, MBA; Shamban, Ava MD; Weichman, Barry M. PhD; Murphy, Diane K. MBA. Safety and Effectiveness of VYC-15L, a Hyaluronic Acid Filler for Lip and Perioral Enhancement: One-Year Results From a Randomized, Controlled Study. Dermatologic Surgery: March 2017 – Volume 43 – Issue 3 – p 396–404. doi:10.1097/DSS.0000000000001035
- Pasini, Lisa MD; Cavallini Maurizio MD; Gazzola, Riccardo MD. (2019) Herpes Virus Outbreaks After Dermal Hyaluronic Acid Filler Injections. DOI:10.1177/1090820X12452293