The assessment carried out before a lip filler treatment, the topics covered in the physician consultation and why planning around facial proportions matters.
In this article we look at what lip filler is, whether it hurts and how the treatment is planned, and clarify from a medical standpoint whether lip filler can be done at home.
Lip filler consists of injections that add volume to the lips and is a type of dermal filler. The lip fillers on the market are made of synthetic hyaluronic acid (HA), a substance that occurs naturally in our bodies. There are many different lip filler brands, including Juvederm, Restylane and Renee.
Who Is Lip Filler For?
Having lip filler is a personal choice. The points to consider are:
- Having had a preliminary check regarding your physical condition
- Having realistic expectations
- Having no active oral infection, including mouth ulcers or cold sores
Many people who have lip filler want to add volume to their lips. The main reasons are:
Restoring previous lip size: As you age your lips may thin, your philtrum (the groove between your upper lip and septum) may lengthen and flatten, and the distance between the corners of your mouth (intercommissural distance) may increase.
Correcting the shape of the lips: Lips of different sizes or shapes are common and sometimes call for intervention.
Softening wrinkles: Wrinkles can form at the corners of your mouth when you laugh.
Building confidence: Lip fillers can help you regain self-esteem and improve your image.
Why Is Lip Filler Used?
You may lose lip volume over time as a result of factors such as genetics, tobacco use and sun damage. In 2018 alone, close to 3 million lip filler procedures were carried out worldwide.
Lip fillers add volume to the lips. It must be underlined that lip filler does not stop the ageing process; more invasive surgical options such as lip implants or a lip lift address different needs.
How Long Does Lip Filler Last?
Like botox, lip filler is temporary and generally lasts 12 to 18 months. The duration also depends on your age and how fast your metabolism works. In younger people, whose metabolism works faster, filler may not last as long.
Before the Procedure
The US Food and Drug Administration (FDA) has not approved lip filler for anyone under 21. You should review the laws of your country before booking an appointment.
You will meet your physician before the procedure. Many factors, including your health status, are assessed. Your physician may ask:
- Why do you want lip filler?
- What are your expectations?
- How concerned are you about your appearance?
- Is your spouse, partner or friend encouraging you to have the procedure?
Your physician will examine and measure your face before the procedure and, with your permission, take photographs of your face and lips for your medical record.
Being able to convey how you want your lips to look is important. It is similar to showing your hairdresser a photograph of a new haircut: your hairdresser may tell you the result cannot look exactly like the photograph because of your hair's texture, hairline or length. In the same way, you may want your lips to look like someone else's, but because your face shape and structure are unique the result may not be identical. Ask your physician whether working from a photograph is helpful, and be ready to describe the look you want in words too.
What Happens During the Procedure?
During lip filler your physician may apply topical anaesthesia to your lips. This numbs your lips for a while so the procedure is comfortable. The numbing creams used generally consist of benzocaine, lidocaine and tetracaine (BLT); your lips should be numb after about 15-30 minutes. If you have a BLT allergy, your physician may use an injection to numb your lips.
Your physician then uses a fine needle to inject filler into part or all of your lips, including the lip borders (the vermilion border) and the curve in the middle of your upper lip.
You will not feel significant pain; you may feel some pressure and your eyes may water. On average 1 millilitre (mL) of filler is added to the lips, roughly a fifth of a teaspoon. The needle does not go deeper than 2.5 millimetres into your skin.
Your physician may apply an ice pack to your lips throughout the procedure to minimise swelling and bruising. The whole procedure can take between 30 minutes and two hours.
What Happens Afterwards?
Once the procedure is complete your physician may gently massage your lips to settle the filler if necessary, and may continue to apply ice.
You are observed for about 15 minutes to make sure you have no side effects such as dizziness, nausea or bleeding. Local anaesthesia does not usually leave you drowsy, so you can travel home on your own; you may nevertheless want someone to accompany you.
Your lips may be swollen, tender and bruised. Swelling usually resolves within 24-48 hours, though in some cases it may last a week.
Your physician will plan a check-up appointment about two weeks after the procedure to assess your lips. They may ask for a second photograph for your medical record so that the before and after can be compared.
What to Do During Recovery
- Apply ice for about 10 minutes to reduce inflammation, pain and swelling.
- Do not apply lipstick or any other product to your lips for at least 24 hours.
- Avoid touching or pursing your lips, including kissing and drinking through a straw.
- Take care when brushing your teeth.
- Drink plenty of water.
- Avoid exercise for at least 24 hours.
What Are the Advantages?
- Applied under appropriate conditions, they are safe, with a low risk of complications and side effects.
- They can improve self-esteem.
- They are reversible: if you are not happy with the result your physician can inject an enzyme (hyaluronidase) to dissolve the filler.
What Are the Risks?
If lip filler is not applied by a specialist physician under sterile conditions, it can pose the following risks:
- Bleeding and pain at the injection sites
- Reactivation of cold sores
- Discolouration or tenderness
- Infection
- Tissue death (vascular compromise), which can occur when filler is injected into or around an artery
- Lips of different sizes (asymmetry)
- Migration of filler to other parts of the face, usually towards the nose
Is Lip Filler Harmful?
Lip filler is a medical treatment and the complication rate is low. It is safe when carried out by an experienced physician in a healthcare facility. Avoid having the procedure in places that are not healthcare facilities, such as beauty salons or spas.
Can Lip Filler Ruin Your Lips?
If you do not proceed with an experienced healthcare provider or physician you risk harm: your lips may stretch and sag permanently, the tissues around the lips may be damaged, the filler may harden or the injection sites may become infected.
Does Lip Filler Hurt?
You may feel very mild pain at the injection sites. The pain should disappear after 12 to 24 hours.
Is Lip Filler Permanent?
As with botox, lip filler is not permanent. Depending on your metabolism it generally wears off after 12 to 18 months. You may need routine touch-up treatments to maintain the volume you want.
Can Lip Filler Be Used During Pregnancy?
There is insufficient research on the safety of lip filler during pregnancy, so its use in pregnancy is not approved.
What Is the Recovery Time?
Your pain should ease after 12-24 hours and your swelling should subside after 24-48 hours. If you want lip filler before an important occasion such as a wedding, plan the procedure at least two weeks in advance to be sure you have fully recovered.
When Can I Eat and Drink Afterwards?
It is best to wait until the effect of the topical anaesthetic or nerve block wears off so that you do not accidentally bite your lips and disturb the filler. Avoid foods that can smear on your lips for at least 24 hours.
Do not use a straw or smoke for at least 24 hours; pursing your lips can also disturb the filler. Alcohol thins the blood and can worsen bruising, so avoid it for at least 24 hours too.
When Should I See My Physician?
Plan a check-up appointment with your physician two weeks after the procedure. At this visit you will review the results together, including whether you want more volume.
What Questions Should I Ask?
- How many times have you performed lip filler?
- Which brand of lip filler do you use?
- Which brand would you recommend?
- Are there alternatives to lip filler?
- How long will my lips take to heal?
- Which painkillers can I take while healing?
- What is the full list of risks and complications?
- How often should I plan follow-up appointments to maintain volume?
A Final Note From Dr. Murat Irmak
Having lip filler is a personal decision. If you want to add volume to your lips, consult a healthcare provider or physician experienced in the procedure to discuss your options.
Lip filler can improve your confidence, but you should also be aware that the result is temporary. On average the treatment may need to be repeated every 12 to 18 months.
