Lip Enhancement

Quick Facts About Lip Enhancement

Procedure Time: 1-3 hours
In/Outpatient: Usually outpatient
Anesthesia: General or local with sedation
Recovery Time: 10-14 days; strenuous activity in 3-6 weeks
Duration of Results: Long-lasting
Treatment Cost: Starting at $500
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What you should know

What Is A Lip Enhancement

The secret to a younger, pouty lip may lie in looking to cosmetic lip enhancement to restore a fuller shape to your lips. Due to age and other factors, our lips show signs of aging like loss of volume, wrinkling around the lips and a blurry lip line. 

The following are some of the more common ways to address lip enhancement:

  • Lip implants
  • Fat transfer
  • Fillers such as Restylane (FDA approved), Juvéderm or Perlane (off-label uses)
  • Or Laser lip procedures

Each has its own pros and cons, risks and post-treatment care that you should discuss with your doctor.

Lip Implants

Lip implants may have recently taken a backseat to less invasive enhancing procedures, like fillers, but there are still women who desire even more long-lasting results when it comes to achieving fuller lips.

One reason permanent lip implants fell to the wayside is the unnatural look they can create. A new type of implant, called PermaLip, is more anatomically correct than other implants. It requires only minimally invasive surgery. “Although permanent implants are often considered, they seem to be prone to less-than-optimal outcomes and pose the potential for future removal,” says Dr. Mark Jewell. Implants can pose a greater risk of complications, some of which cannot be corrected.

Saline Lip Implants

The FulFil implant is a saline implant approved for use in the nasolabial folds and is being used off-label to augment both upper and lower lips. It is inserted into the lips through a small incision, and then filled with saline, and it can be adjusted for volume during insertion.

Patients have reported natural-looking results and minimal recovery time but plan to be home for approximately one week.  No infections, deflations or firm scarring have been reported in short-term follow-ups, although only time will tell whether patients will experience the long-term complications seen with some previous lip implants.

Silicone Lip Implants

September 2007 marked FDA approval of the Perma Facial Implant. Used for the enhancement of thin, aging lips, the Perma Facial Implant is made of contoured, pliable silicone. The implant is inserted through incisions at the corners and/or top of the lips and molded manually, similar to injectable fillers, which provide only temporary filling of the lips. The Perma Facial Implant does not require replacement or repeated treatments unless there is a complication, and it is designed to not rupture or leak.

Various sizes are available and the implant procedure takes approximately half an hour under local anesthesia. As with any facial implant, there is risk of infection, as well as shifting and hardening of the implant, and you may experience swelling or bruising for up to a week or more.

Fat Transfer

For long-lasting lip fullness, a human fat transfer (or fat grafting) can be use to enhance and augment lips. Fat transfer to the lips involves using a syringe to extract fat from the buttocks, or other fatty areas of the body, then washing it with saline and reinjecting it into the lips with local anesthesia to maximize comfort.

Cosmetic lip enhancement using fat transfer provides long-lasting results, so it may be the best option for you if you don’t want constant upkeep. “In order to achieve the results you desire, you may need a secondary procedure performed six months or more after the initial procedure. There are theoretical reasons why more of the fat stays the second time around,” says La Jolla, CA, plastic surgeon Robert Singer, MD, who often performs two smaller procedures as opposed to significantly overcorrecting the lips the first time around.

Because the body can absorb some of the fat, some doctors prefer to use lip implants instead, although they do pose some risks like hardening, infection and distortion or asymmetry. “Both fat transfer and lip implants require a small surgical procedure to be performed, and both have a low potential for risk,” says Eugene, OR, plastic surgeon Mark Jewell, MD.

Lip Lift

A lip lift is a surgical lip procedure that can permanently tighten saggy skin and lift the natural curve of your lips to fix droopy lips or to redefine a blurry lip line due to age and other factors. 

Lip Lifts for Droopy Lips

Reston, VA, plastic surgeon George Weston, MD, explains that with natural aging, the upper lip elongates and starts to cover more of the upper teeth while young people have “short, pouty, curled-up lips that show their teeth.” In an older person, more of the bottom teeth are visible and the mouth corners tend to turn down, producing an unhappy expression.

New York City plastic surgeon Lawrence Reed, MD, notes that a nostril-sill excision can lift the lip. In this surgical procedure, an incision is made in the crease at the lower edge of the nose where it joins the lip. This lifts the skin and exposes more of the lip’s pink vermillion. Deeply downturned lips can be improved with tiny incisions at the corners of the mouth, but too much correction and you may end up looking like the Joker’s wife. There is about 10 days swelling and downtime involved.

Surgical lip enhancement is most commonly performed in conjunction with a facelift, rather than as a stand-alone procedure.

Redefine a lost lip border

For a longer-lasting solution, your doctor may recommend a lip lift to redefine a lost border. Once an incision is made, a small piece of skin and tissue is removed, and the upper lip is elevated to a higher position. “By making an external incision at the base of the nose, the lip is lifted. An incision can also be made on the inside of the lip to make them appear plumper and correct a gummy smile,” says Eugene, OR, plastic surgeon Mark Jewell, MD.

Your plastic surgeon may also use lip fillers or fat transfer in conjunction with your lip lift procedure to augment the size of your lips. A lip lift can also be performed to correct an upper lip that is too long. Unlike other surgeries, the recovery for a lip lift may be short—about three to seven days in many cases.

Lip Injectables and Fillers

Lip injections using products like hyaluronic acid-based fillers such as Restylane are a quick and easy way to augment the lips that has become popular because of its many benefits.


Fillers are used at varying depths to fill creases and create more youthful contours. Treatment can take as little as 30 minutes, depending on the number of injection sites and the injectables used.

Hyaluronic Acid Fillers: Restylane, Juvéderm

Injecting the lips with hyaluronic acid fillers like Restylane (which is FDA-approved for use in the lips) can create fuller, plumper lips in a matter of minutes. “There are two different types of candidates that benefit from lip injections,” explains Greenwood Village, CO, facial plastic surgeon Michael Menachof, MD. “One needs volume; the other needs to balance their features.” But, in some, injecting Botox, which reduces movement of the muscles that cause lines and wrinkles, around the mouth can help create a more youthful appearance all-around. “For those with a lot of lines around the mouth, adding just volume to the lips will not be enough,” explains Palm Beach Gardens, FL, facial plastic surgeon Mark Murphy, MD. “You also need to treat the area with Botox to minimize the lines.”

“Creating a beautiful lip is about more than just filling it with volume. Shape needs to be taken into consideration, otherwise you can end up with sausage-looking lips,” explains Pasadena, CA, plastic surgeon John Gross, MD, who advises that only hyaluronic acid or your own fat should be used.

Hyaluronic Acids Stimulate Collagen

Studies have also revealed that these fillers may stimulate surrounding fibroblasts to produce more collagen, resulting in a longer-lasting fill. After the anesthesia wears off, expect your lips to feel full and a little tight, and you’ll probably want to keep your improved pout under wraps for the first few days. Swelling or redness should dissipate within a week.

Who It Is For

Kiss small lips goodbye

There are many reasons why you would want lip enhancement including:

  • Restoring lost volume and shape
  • Correcting downturned lips
  • Replacing lost moisture, to hydrate lips
  • Filling in upper lip lines
  • Redefining the lip border

You are a good candidate for lip augmentation or lip enhancement if you have one or more of the above concerns.  See below for more about each problem area.

At your consultation appointment, your physician will discuss the various techniques used to achieve a good outcome. Typically, cosmetic lip procedures are relatively simple but there are known risks and you may have some medical issues that might prevent you from having lip surgery or a lip procedure.

You want fuller, more luscious lips

By injecting filler directly into the lips, volume is instantly increased (though some of the instant gratification is swelling that will go down in a matter of days). Depending on the filler used, results can last from about 10 weeks to six months.

“The lips are the most likely to look injected,” says Barrington, IL, dermatologist David Van Dam, MD. “It’s easy to achieve fullness. However to look natural, the lips should be shaped, not just filled. Shaping takes into account the current lip shape and border, along with the fullness of the upper and lower lip, and the proportion of the lips in relation to other facial features. A true master will do more than simply make the lips fuller; a master will make the lips look better.”

In the past, many doctors were reluctant to use Botox or Dysport for lip enhancement around the mouth because of the frequent movement of the lips. But many physicians are more comfortable using Botox around the mouth to treat expression-related creases and to increase the longevity of filler treatments.

Boca Raton, FL, oculoplastic surgeon Steven Fagien, MD, says, “Botox used alone can work well for wrinkles around the mouth that are seen mostly when expressions are made. Used alone, however, it won’t have nearly as dramatic an effect on the creases that are visible when the face is at rest. When Botox is used in combination with various fillers around the mouth and lips, one can achieve the most impressive results.”

You have downturned lips

Some women complain that the corners of their lips turn down, especially the upper lip, which is just one of the effects of the aging process. Once the lips begin to droop, tiny lines known as oral commissure lines can develop and extend out. By injecting just the corners with hyaluronic acid, the lips take on more of a lifted effect—any lines are filled in—and return to a more centered position. Your doctor may also choose to inject the area around the lines with tiny amounts of Botox or Dysport to help lift the area and prevent new lines from forming.

You have lost volume

Hyaluronic acid-based fillers, like Restylane, can be injected into the lips to add volume since they attract water to the area and swell the lips internally. “They work great to define the lips and lip line, but, sometimes, they can look overdone if too much filler is used,” says Eugene, OR, plastic surgeon Mark Jewell, MD.

Going to a board-certified injector is one of the best ways to avoid lips that look obviously injected.

Since the lips are one of the more delicate parts of the face, your dermatologist or plastic surgeon may first inject a dental block to numb the area or use a topical anesthetic agent. Even though hyaluronic acid fillers contain lidocaine, to make the procedure more comfortable, your doctor may still choose to use a block for added comfort. Keep in mind that the results are not permanent—you can expect your new lips to stay full for about six to nine months. Unlike other parts of the face, hyaluronic acid absorbs quicker from the lips because “the lips move more than nonmoving facial features,” says Dr. Mark Jewell. But the nice thing about them is that the body naturally absorbs the filler in a way that usually leaves behind no bumps or unevenness. Most times, you can’t even tell when the lips start to return back to their normal size.

You need to fill upper lip lines

Fillers and aging lips go hand in hand, and when it comes to treating vertical lip lines, fillers are usually the go-to solution. Your dermatologist or plastic surgeon may inject just the thin lines (as opposed to the whole lip) that extend out from the top of the lip line up toward the bottom of the nose with hyaluronic acid.

You have a blurry lip line

Injectables like Restylane and Juvéderm, are the easiest ways to restore definition to the lip line. “Fillers do a nice job of this since the borders of the lips can be ‘traced’ in a natural-looking way,” says New York City dermatologist Cameron Rokhsar, MD. Another plus to injecting the vermillion border with fillers is that there’s less of a chance that your lipstick will bleed. It’s important that your doctor injects the rest of the lip, or at least the lower lip, if it meets your specific goals.

Who It Is Not For

Who It Is Not For

Anyone who is not willing to undergo a procedure to attain fuller lips.

What To Expect

With lip augmentation procedures on the rise, it’s clear that women are seeking an effective solution to volume loss and visible aging in the lips. The aging process plays a major role.

And as collagen is lost, the lips begin to deflate and sag, making lines around the mouth appear worse as well.  Genetics can also come into play.  If your parents have thin lips, it’s more than likely yours will also thin over time.

Lip Enhancement Results: Temporary Results vs. Permanent

Hyaluronic acid fillers: Can offer dramatic results, but what you’ll see will only be temporary improvement. “You definitely want to stay away from the thicker injectables that last longer when it comes to the lips. Some are white in color, and can be seen through thin skin, and they don’t spread as evenly as hyaluronic acid fillers, possibly leading to lumps and bumps,” says Madison, WI, facial plastic surgeon Richard Parfitt, MD. Those who regularly have injections know that there is some pain associated with them. In fact, some patients report the lips to be one of the more painful areas to have injected because the area is sensitive, leaving the lips swollen and feeling almost hard for the first few days post-injection.

A concern among women who augment their lips is that they’ll be overfilled.  Where your doctor injects you determines your result. “If too much is injected in the white roll, your lips will look like a shelf,” he says.

“Your doctor should also avoid overcorrecting the philtrum—the two lines that come down from your nose to your lip—which can make your lips look duck-like,” says New York City dermatologist Cameron Rokhsar, MD. If your lips are too full, they can be injected with hyaluronidase, which breaks up hyaluronic acid. The fact that hyaluronic acid fillers are reversible (which rarely has to be done) is a significant advantage over other types of fillers.

Steer Clear of Silicone and Permanent Injections! Even though it’s FDA-approved for use in implants and micro-droplet injections for correcting deep-pitted acne scars, silicone is one product that is not FDA-approved for use in the lips and should not be injected into your lips no matter what. “Many women are drawn to the idea of having silicone used because it’s permanent. But the results may be disastrous, even though you may not see any problems for a few years,” says La Jolla, CA, plastic surgeon Robert Singer, MD. If complications arise, it can cost you much more than your initial injections to have your lips surgically corrected.

Permanent fillers: Using permanent fillers in the lips poses the potential for lumps, bumps, unevenness and granulomas, which, at best, can only be partially removed with surgical excision that leaves behind a scar and potential distortion.

The major issue with permanent fillers is that the product doesn’t change and ages over time like the lips do. Plus, there’s more of a chance for infections and complications. “Harder fillers like Radiesse are not recommended for the lips either because the product can clump up,” says Dr. Cameron Rokhsar.

Inside Tips

Since swelling and bruising are normal, yet unpredictable side effects of injectables, it’s best to avoid taking vitamin E, aspirin and any anti-inflammatory for a few days before treatment to minimize your risk. 

To prevent lip lines from forming, ask your doctor about having the area above the mouth injected with tiny amounts of Botox or Dysport. “This works well because it decreases muscle movement and slows down the progression of upper lip lines,” says New York City dermatologist Cameron Rokhsar, MD. When injected properly, you’ll have full movement in your mouth and lips and still be able to smile. The combination of Botox or Dysport and filler may be more beneficial than either one alone.

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