Pucker Up! Let's Talk About Lip Enhancement
I think of lip enhancement as restoring lost lip volume, and augmenting for someone who wants fuller lips.
The most common thing I hear is “I don’t want to be too big, I have a friend with crazy big lips”. To this I respond, “the crazy big lips are not a direct result of the lip filler, it is from the addiction to lip filler”. That is to say that 1-2 syringes of filler will enhance a lip, but the oversized lips takes multiple sessions to build to that unnatural appearance.
What are the options?
At one time we used collagen, and that was a great treatment with no swelling and instant results. But the collagen only lasted on the order of weeks, so collagen has been replaced with hyaluronic acid (HA).HA is a naturally occurring substance in our body that supports certain tissues.
The HA’s for lip filler are the same as HA fillers used in other parts of the face. They are “cross linked” meaning they have been modified to last longer than naturally occurring HA.
The filler is added to the lip with a needle or cannula (which is a device that is less likely to bruise than a needle and is safer).
The weird looing “duck lips” are from improper filler application. The unnatural appearance to the lip after fillers is most likely from only filling the upper lip which leads to over projection, or from falling outside of the natural tubercles of the lip. The lip has 3 tubercles of the upper lip, and 2 of the lower lip.
The anatomy of the lip tubercles are outside the scope of this post. Internally, when we train injectors, a crucial part of that training is the location of these tubercles and how to properly fill them.
Enhance deflated lips with 2 syringes of HA modified with sugar alcohol to make the filler softer and longer lasting:
Enhance lip with 1 syringe of sugar alcohol modified HA (also had Botox to masseters to slim jaw line):
Mild enhancement with modified HA (equivalent of 1 syringe):
Enhancement with 2 syringes of modified HA:
How much filler to use?
Depends on the lip size at baseline, and the amount of correction desired.
In a study of two brands of lip filler, the average was 1.5 syringes to get to what is called a “one grade improvement”. A small lip requires less filler to look fuller than a larger lip. So that is contradictory to what we may assume, but think of it this way. If the lip is thin, there is little surface area to fill. Whereas a fuller or wider lip requires more filler to contact the volume of the lip.
This refers to injecting Botox® (Or Xeomin®, Dysport® etc) into the upper lip.It only takes 4-6 units, and the injections are done superficially into the lip so that the deep muscles of the lip contract and turn the lip out slightly.
It is not that impressive, and doesn’t last very long (say 10 weeks or so), but it is a very inexpensive way to enhance the lips without making them bigger.
Who is a candidate for a lip flip?
Someone with an average or fuller lip who may have fine wrinkles or just wants a little more lip.Smaller, thin lips are not good candidates as the lip will further thin out over repeated treatments. A filler should be used in this case.
Lip Flip 5 units Botox® upper lip to soften wrinkles and subtle increase lip exposure:
How long does it last, can they be done together?
Lip flip can be used with lip filler. The lip flip lasts about 10 weeks and lip filler lasts 6-12 months (the first time, subsequent lip filler can last longer).
Dr Charles Mok