Question

Hi Dr. Peter,

I am a 29 years old part-time model. I have very thin upper and lower lips. I hate it when I smile as my lips look like a thin, fine line. This makes my profile photos look less appealing.

I would like to explore lip filler augmentation but I am unsure if it’s the right lip augmentation procedure for me. Could you tell me more about the process and how long do lip fillers last? What are the possible complications from getting lip filler enhancements? Thank you.

Katherine

Answer

Lip filler augmentation is a common aesthetic procedure that is much sought after in my practice. Most of the time, patients with genetically thin lips, thinning lips or lined-lips due to aging request to have their lips plumped up.

While it takes only minutes to get the procedure done, selecting the right injector is akin to choosing the right painter for your portrait. Let me address all your queries regarding lip filler injection so that you can decide what’s best for you.

What is lip filler made of?

The lip filler that we use is made of hyaluronic acid. Hyaluronic fillers (HA) are the only FDA-approved temporary lip fillers in the market today.

We use two types of filler depending on the area of injection. To plump up areas that require a deeper injection, a “firmer” or more cross-linked hyaluronic filler is used. To enhance the vermillion border which fades with age, we use a very soft filler just to highlight that area.

By using hyaluronic acid fillers, we have better control over the lip volume and shape. If the patient desires more volume, it can be performed in the next sitting and during different appointments. The gradual pace of treatment makes this HA lip fillers a safe treatment with high patient satisfaction.

What can lip fillers correct?

One of the main reasons why patients request for lip augmentation is to correct volume loss due to aging. As we age, our lips tend to thin out. To address volume loss at the vermillion border on the upper lip, we inject lip fillers to highlight the vermilion border. This will also re-create the definition that is lost over time.

Volume loss can also happen at the lower lip. To create a poutier lower lip, the lip filler is injected deeper around the center of the lower lip.

Lip fillers can also be used to correct vertical lip lines caused by aging.

Moreover, with advancing age, the frenulum denoted by the 2 vertical lines connecting the nose to the lips can become less obvious. By enhancing the lips, we can boost volume at lip area, and rejuvenate one’s appearance to look years younger.

Can you share the process of getting lip fillers?

Getting your lips injected can be sometimes uncomfortable or painful. This is why I would normally administer one regional anesthesia on each side of the cheek, and one on the chin. The injection on the cheek is to numb the upper lips, while the injection on the chin is to numb the lower lip. Only one injection point is created per area.

Once these areas are numb, we will insert a blunt cannula into the lips depending on where the volume deficit is apparent. I prefer using a cannula as it minimizes bruising. Because injecting with a cannula is better tolerated as opposed to a needle, we see a higher percentage of patients returning for repeat lip augmentations.

Our lips are very vessel-dense, and we must inject into the place that has lesser vessels. Simply because puncturing the vessels can cause necrosis.

Apart from building volume, fillers can also be used to hydrate the lips. This is effective when the patient presents with lips filled with lines. Once the hyaluronic filler is injected into the lines, the area plumps up to resemble luscious, youthful young lips.

To correct the lips, we look at the entire region holistically. This includes the mouth, nasolabial fold, chin, and jawline.

For example, by softening the appearance of the nasolabial fold, we can make the lips look better. In fact, we need to consider the appearance of the chin too. So don’t be surprised that making subtle corrections to the chin can enhance the look of the lips.

How long do lip fillers last?

Lip fillers can last anywhere between 6 to 12 months. Fillers that are injected deeper into the lip can last longer and up to one year.

Fillers to enhance the vermilion border can last 6 months. The same soft fillers can be injected into the lips but it does not last beyond 6 months.

Essentially, how long your lips stay full depends on how fast your body metabolizes the filler.

Will I see immediate results after lip filler augmentation?

You will see immediate results after the lip filler treatment. There will be some mild swelling immediately. So the best results can be seen 1 to 2 days after the treatment.

Is getting lip fillers painful? Will I bleed or bruise from getting lip fillers?

There will be some mild bleeding at the puncture holds where the syringe penetrates the lip. To stop the bleeding, we would immediately apply pressure at bleeding points.

Rest assured that bruising is minimum. Plus, this is a zero-downtime procedure.

I do not like the lip fillers. Can it be removed?

Yes – we will inject hyaluronidase to remove the filler. Hyaluronidase works by breaking down the particles in the filler. This will accelerate the rate in which the body disposes of the filler.

So the beauty of lip fillers is that it is not permanent, unlike lip implants of other permanent fillers in the market.

Are there any dos and dont's after getting my lips reshaped with filler?

I tell my patients not to apply unnecessary pressure on the lips on the day of treatment.

Nevertheless, you can smoke, exercise or purse your lips. These actions will not affect the shape or outcome of your lip filler augmentation. It would be best not to apply any lipstick or synthetic products on your lip on the day of treatment to aggravate skin sensitivity.

Will my lips feel natural? Can it be felt when kissing?

If you are a virgin lip-filler patient, then you will feel as if there is something present in your lips. After a couple of days, that feeling will disappear.

From this point onwards, lips that have been augmented with fillers feel natural, just like non-augmented lips!

Will my lips be overstretched once I have lip filler? Will it go out-of-shape?

The purpose of lip filler augmentation is to restore lost volume, and not to inflate lips out of proportion. By plumping lips to look natural, you can be assured that your lips will not be overstretched. So do not worry about having “duck lips”.  And do not be bothered about having two “inflated bags” post-treatment, as lip filler treatment will not make your lips any saggier.

What are the possible complications or side effects of getting lip filler?

Just with any filler injection, injecting into a vessel can cause lip necrosis. Lip necrosis means part of the skin on the lips dies. And when this happens, there is a chance of scarring on the lip. So as an injector, we must know the lip anatomy well as this will help us avoid the vessels in the lip area.

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