All Your Lip Filler Questions, Answered
Strategically placed lip liner and capsicum-laced glosses have their place in the quest for juicier lips, but at the end of the day, they can only do so much. Lip filler can offer a more transformative result, making it an increasingly popular treatment. Injectors performed over 3.4 million filler procedures last year according to data from the American Society of Plastic Surgery. And judging by the fact that #lipfiller has garnered 1.3 billion views on TikTok and nearly 2 million posts on Instagram, it seems safe to say that many of 2020's millions of treatments were lip filler procedures — especially since that's a common injection site.
While the treatment may be extremely trendy, widespread, and low-stakes compared to surgery, lip filler still isn't something you want to rush into. Results may vary, and unlike lip liner and gloss, it doesn't wear off within a matter of hours. So, if you're thinking of booking a procedure and want to learn more about it first (which, TBH, you probably should), here's your expert-backed lip filler cheat sheet.
What Is Lip Filler, and What Is It Used for?
Lip filler injections are a cosmetic procedure that involves injecting dermal fillers (gel-like substances commonly made with hyaluronic acid that can also be injected in other areas of your body) into your lips. As mentioned, they can give you plumper lips, however, that's not the only reason why people seek out lip filler. In addition to adding subtle fullness or more noticeable augmentation, filler can help with maintaining hydration, which, in turn, can reduce the appearance of fine lines, says Smita Ramanadham, M.D., a double board-certified plastic surgeon in New Jersey.
"With age, we just sort of lose that hyaluronic acid within our skin and the hydration and the moisture," she says. "Patients tend to notice just the more wrinkled, kind of dryer lip, and lip fillers are actually a great way to kind of give you that extra little hydration and plumpness. So you're not truly increasing the size of the lip, you're just giving it a little bit more of a boost." (Related: What's the Difference Between a Lip Flip Vs. Filler?)
How Is Lip Filler Injected?
Before a treatment, your provider should chat with your goals for the treatment and will typically apply numbing cream. From there, they can rely on a number of injection techniques.
Oftentimes providers will inject filler around the "white line" or "white roll" — a line just above the upper lip. The goal? Re-establishing a more crisp white line since it tends to become less defined with age, says Melissa Doft, M.D., a double board-certified plastic surgeon in New York. This technique is often turned to when a patient is striving for a more youthful look, adds Dr. Doft. And it's sometimes responsible for what's commonly known as a "duck face," which is the result if the filler is injected too high or it ends up migrating upwards, she says. (Filler has the potential to spread after it's injected.)
With that in mind, "some people will say, 'well for a young person who doesn't need that redefinition of the white line, you might want to inject just underneath the white line, which is called the vermilion border," says Dr. Doft. Another technique? Injecting from the "top-down so that they aren't injecting too high up, but they're adding vertical height to the upper lip," she explains. (Think: holding the needle upwards and shooting down for the top lip and holding the needle downwards and shooting up for the bottom lip.) "I often like to inject from the side and from across, I think that I can move the needle a little bit further along so I can do fewer injections and minimize pain," says Dr. Doft.
Dr. Doft has also noticed an increased interest among her patients in injecting the philtrum columns, which are those two projections that are like vertical columns between your nose and top lip. Similar to the white roll, they can become less pronounced with age, and filler can help plump them back up, she says.
What Are the Best Lip Filler Options?
Various types of fillers exist, but, by and large, injectors go with hyaluronic acid fillers when it comes to the lips, according to experts. Hyaluronic acid is a sugar that occurs naturally in your body and is known for its ability to draw moisture and hold onto it like a sponge. (That's why lip filler can result in the aforementioned hydration boost.) The HA eventually absorbs into your bloodstream, so hyaluronic acid lip filler is temporary (versus, say, a surgical lip lift, which is permanent).
Lip filler tends to last between 12 to 15 months, and people often book a lip filler appointment every six to 12 months to maintain their results rather than letting them fully wear off each time, she says. Injectors typically charge per half or full vial; so if you opt to book appointments more frequently but receive less filler each time (closer to half vial), you may pay less per appointment than were you to go longer in between treatments and receive a greater amount of filler (closer to full vial).
If you want to get more granular, there are particular hyaluronic acid fillers that injectors typically rely on for lip treatments. "Hyaluronic acid filler is really the go-to I think for all plastic surgeons and dermatologists and people who are doing this, but the hyaluronic acid comes in different-sized particles," says Dr. Doft. "So for the lip, you want to use a small particle because then it's going to be a little bit more flexible. In addition, you won't be able to feel bumps. The lips are so sensitive that you can appreciate any little bump because there are so many nerve endings in the lips." Examples of hyaluronic acid fillers with smaller hyaluronic acid molecules include Juvéderm Volbella, Restylane Kysse, Belotero, and Teoxane Teosyal RHA 2, she says. (Related: A Complete Guide to Filler Injections)
Are There Downsides to Lip Filler?
With lip filler, immediate side effects are pretty much a given, according to Dr. Doft. "The most common complication would be a bruise or a little bump," she says, adding that massage the bump can help get rid of it quicker. "[Your lips always become] swollen for at least one day, sometimes up to a week," says Dr. Doft. Both the swelling and bruising typically last anywhere from a few hours to a few days, according to the ASPS.
Ice can speed up the lip filler swelling timeline, while arnica (an herb) or bromelain (an enzyme found in pineapple) can help with bruising, she says. You can use these natural substances in topical or supplement forms (although best to consult your doc before trying any homeopathic remedies).
Lip filler treatments can potentially create lumpy or asymmetrical results (due to poor injection technique). Although rare, the procedure can also cause necrosis (the death of body tissue) if the filler is mistakenly injected into an artery or vein, which can block blood flow to the lip, says Dr. Doft. This can appear as small white and purple dots on top of skin that looks unusually inflamed or red, she says. If anything seems out of the ordinary, call your doctor ASAP.
And then there's always the chance that your results won't be exactly what you hoped to achieve — a disappointing outcome when you've already shelled out on filler. The good news? An advantage of hyaluronic acid fillers is that they can be reversed via a hyaluronidase injection at any point after you've received the filler. Hyaluronidase is an enzyme that breaks down the bonds between hyaluronic acid molecules.
Some filler skeptics have questioned whether the prolonged use of filler, in general, can stretch out your skin, ultimately leading to a deflated look. It's tough to say whether that's a possibility, says Dr. Doft. "Often you're putting in fillers because you're seeing aging," she says. "[And] the aging process continues," even post-treatment. Meaning, it's hard to know whether looser skin at the end of a long bout of using filler had anything to do with the filler itself, or if it resulted solely from the natural aging process, she says. If you're concerned but still want to get filler, you can make a point to stress to your injector that you want to stay more on the natural, conservative side. "As long as you're not putting in many vials, I don't think you're at a risk of really stretching," she adds.
On that note, there's not a hard and fast rule as to how many vials you should get during a given treatment. "In my practice, we don't go over one vial and usually use between half a vial and one vial," says Dr. Doft. "I have a few patients who have less than half a vial, but most people are between half a vial and one vial."
What Else You Should Know Before Booking an Appointment
A few more logistics on lip fillers: Hyaluronic acid filler typically costs anywhere from $700 to $1,200 per vial and can take around 30 minutes. Since you're fully awake during the treatment and results are immediate, you have the ability to weigh in throughout, notes Dr. Ramanadham.
"The best thing about lip filler is it's very individualized," she says. "There's such a range of what a lip can look like as far as volume. The good thing about this is you can put in a little bit and you can stop if you're happy. If you want a little bit more, you can add a little bit more. So there's a lot of flexibility and you're seeing it in real-time."
This can be especially comforting to first-timers, she notes. "I'll discuss with the patient what they're looking for beforehand, then once the filler is in I'll show them. I'll stop and they'll look at the mirror and, most of the time they're like, 'okay, that looks great, stop.'" (Related: I Got Lip Injections and It Helped Me Take a Kinder Look In the Mirror)
If you're sold on lip filler, finding a qualified injector and communicating throughout the process can make or break your experience. When looking for someone, "the first place to start is to really go to the three core specialties within cosmetic medicine," suggests Dr. Ramanadham. "That includes doctors or nurses in plastic surgery, dermatology, and facial plastics [who] will understand the anatomy of where they were trained." As for a clinician at an injectable bar or med spa? Make sure they're well-educated in the anatomy and trained — filler might be easy compared to other options (see: surgery), but it, like everything in life, can still come with risks.