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Lip Filler: A beauty staple for all ages

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Thursday, February 24th, 2022

by Terri Harper, FNP-C

Individual facial features and proportions-eyelashes, eyebrows, chin, tip of nose, and LIPS- create a beautiful face. Lips are a very important facial feature, often determining first impressions of overall appearance, as well as personal confidence. People who spend more time at home on social media and work with tools like ZOOM® have increased awareness of personal appearance, including the size and shape of lips. Lip filler has been a significant part of my practice since I started my career in aesthetic medicine 20 years ago. Dermal filler injections have increased every year, including approximately 500 patients each year desiring lip filler.

I consistently hear 3 primary reasons that patients desire lip filler.

To restore natural lip definition and size that diminishes with age
To enhance natural lip shape and volume
To create asymmetry

Over the past 20 years, dermal filler for lips has become increasingly popular for all ages. Older women, over the age of 50, may experience thinning lips caused by the skin above the upper lip beginning to elongate and sag, turning the upper lip inward. This age group also complains of the lip border becoming “fuzzy” and losing definition, creating lipstick lines. When injected correctly to achieve the desired outcome whether adding overall volume or simply creating definition or outline of the lips, filler for lips has proven to be not only efficacious in treating these complaints but also very satisfying to the patients. The group of patients between 40-50 years old, often come in wanting a slight enhancement but are fearful of looking unnatural. They often present telling me who they DON’T want to look like, or they don’t want their husbands to notice. Achieving these kinds of results may actually be more difficult to please the patient. They want to get their money’s worth but really don’t want anyone to notice. With younger women desiring lip filler, the main reasons given may be very different than other ages and peer pressure becomes a significant factor. The younger patients typically just want overall bigger lips. Easy. They come showing a collection of pictures, usually of famous people, they want to look like.

Lip injection with dermal filler is a medical art. The perfect lips are achieved by attention to proportion. Consideration of the proportion of the facial features to each other and proportion of the upper lip to the lower lip. An injector can apply the golden ratio 1.618—known as Φ (phi)—to identify the proper points for injection. On each side of the upper lip, 3- 4 points for injection in each upper half of the lip are identified using a phi caliber. Approximately 0.01–0.05 ml of an HA filler is injected into each area, from the vermillion border into the vermillion. On the lower lip, the caliper is used to identify proper injection points. Since this technique is the most natural and pleasing to the eye, there was a 92.4% exceptional satisfaction rate reported in a study involving 833 patients who were injected using this technique. Proportion matters.

Other injection techniques continue to be published and tested. Some of these include the ‘Russian technique’ which accentuates the cupid’s bow by lifting it with Botox and injecting additional volume in the cupid’s bow only instead of overall volume, creating a heart-shaped lip. The ‘Instagram Face’ includes overall full lips from corner to corner, upper and lower lip. Social media’s ability to create delusion has even made the cyborgian, mechanical face, including lips, popular.

All faces have asymmetry. As we interact with each other, most of the differences on the right and left sides of faces are not recorded in our brains. We notice asymmetry on our own faces, but others do not. Asymmetry of the lips can sometimes be corrected with dermal filler if one quadrant of the lips lacks volume. However, asymmetry due to the different shapes of the lips from side to side may be very difficult to completely correct. In fact, sometimes lip filler can actually exacerbate such asymmetries. An experienced injector can determine when an asymmetry can be corrected with filler and when it’s best to use other modalities or simply leave it alone.

Lip augmentation with HA dermal filler continues to be a staple in non-surgical cosmetic offices. It is a relatively safe, rewarding procedure that marries medical science and art enhancing the beauty and boosting the confidence of patients of all ages.

Lip Filler FAQs

1. Does it hurt?

Most patients have heard from friends or read about the discomfort associated with lip filler. Lips are rich with nerves and are very sensitive. That is why it feels good to kiss, but that is why it also hurts to get filler. We have 4 ways to successfully mitigate the pain involved.

Topical anesthetic- We have a compounded product that works great! You sit for about 12-15 mins with a very effective ointment on your lips prior to injection. Most patients will state that their pain level is about a 3-4 on a scale of 10, with 10 being a kidney stone!
Ice- I have a stainless-steel roller that I freeze and roll on the lips prior to injecting. This actually decreases 2 factors: pain and bruising.
Pronox- A device that delivers nitrous oxide to inhale for a few ‘don’t-care’ minutes. Studies prove the gases are completely out of your system within 10 minutes, leaving you safe to drive home.
Nerve block- We can do a nerve block injecting lidocaine into specific areas inside the mouth that deaden sensation. This is overkill for most people after using the topical anesthetic.

2. How much does it cost?

Cost may vary from location to location, value-added to the treatment, longevity, and size of syringe chosen to inject. Metropolitan markets are likely to charge more to cover expensive overhead. Added value to the procedure includes the experience of the injector, customer service, office environment, and staff. Some fillers come in ½ syringe and start around $350 and other full syringes may be as much as $700. The latter may yield a few more months of longevity.

3. How long does it last?

Different fillers may lend varying longevities, according to their manufacturer. Regardless, most hyaluronic acid (HA) filler used in lips will last approximately 6-9 months. There are outliers who may get over 12 months, but that is rare.

4. How do you know which filler to choose?

Our experienced injectors will talk to you regarding your goals and expectations. Filler choice will depend on what area is being treated, just the border or the volume of the lip to increase size. Some fillers provide more structure in order to create symmetry or lift or staying volume. Other fillers may simply smooth vertical lines by hydrating while adding a small amount of volume.

5. What are possible complications?

Most complications that occur are considered mild and include bruising, swelling for a couple of days, tenderness at the injection site, and the subjectivity of the patient, meaning they just don’t like it. Additional complications are less frequent such as fever blister and lumps or bumps. There are rare complications that can be more serious and include compression of a blood vessel that may lead to lack of oxygenation to lip tissue creating a sore in the area or lack of blood to the skin that the affected vessel supplies to the face. This rare complication can cause, “bruising” or a dusky shade of skin to slowly appear in the skin surrounding the affected lip, the cheek, or even tip of the nose. This is extremely rare as I have seen this one time in my 20 years injecting lips. All of these complications, no matter their severity, can be treated. The latter, rare vascular complications, must be recognized and treated early for the most favorable outcome.

6. How do I choose an injector?

There are injectors showing up everywhere these days- doctor’s offices, (dermatology, plastic surgery, internal medicine, OB/GYN), medical spas, dental offices, hair salons, and even home parties. But it is important that your injector should be experienced not only in anatomy and injection techniques to give you your desired results but also in being able to recognize and treat any complication. Though rare, because there are some emergent complications, the American Society of Aesthetic Plastic Surgery (ASAPS) advises against injections of any kind being performed outside of a medical facility. They site reasons of cleanliness of the environment, sterility of the product, and privacy.

So, while it is important to know have good expectations going into your lip filler treatment. It is equally as important to choose the RIGHT injector for your treatment. The right injector will help educate you, provide you with a customized treatment plan, give you the best results, and be available to you when you have questions.

Call (478) 743-2299 or click “Make an Appointment” to get started.

Spa Medical® is located in downtown Macon, Georgia, and offers surgical and non-surgical anti-aging procedures to help you look as young as you feel.