All too often these days we see people with over-filled, unnatural looking lips: the dreaded “duck-face”. Its’s amazing how often people tell me that, “I’d never get lip filler injections because it looks so unnatural”.
When we see people with over-filled lips, it’s often because the injector doesn’t understand the underlying anatomy of the lips. The lips aren’t an expandable balloon, which we pump full of as much filler as we can: we just need to understand a few key points of the lip, and subtly add volume with filler to plump your lips.
In this fashion, we can enhance the lip in a way that looks natural, and with much smaller amounts of filler. It’s always been my philosophy that the best cosmetic treatments are the ones that aren’t noticed, and it’s no different for the lips. Less is more, especially when done properly.
Firstly, we need to decide which type of filler we want to use. Fillers can either be thicker and harder, or thinner and softer, and the type of filler that we use depends on which part of the face we are going to inject it.
If we are aiming to replace lost volume in the cheeks or temples, we want to use a thicker filler with more structure. In the lips, an area which is used for kissing and eating, we need a softer, more malleable filler which will feel and look natural. You can expect your lip filler enhancement to last for approximately twelve months on average.
The Cupid’s Bow
The first key point to inject is the Cupid’s Bow. This is the enlargement just to either side the middle of the upper lips and adding just a small amount of filler here can really enhance the appearance of the upper lip. I like to inject slowly while withdrawing the needle, and in a “fanning” motion to spread the filler out evenly, instead of in a lump.
The lower lip
The second important lip injection site is in the lower lips, again just off to the side of the midline; it’s essentially the lower lip version of the “Cupid’s Bow”. The lower lip is typically slightly thicker than the upper lip, so it’s important to inject the correct amount of filler to both the upper and lower lips to keep the proportions natural looking. Again, only a small amount of filler is required, and the “fanning motion” is used here to ensure an even spread.
The vermilion border is the “edge of the lip”, or where the red or pink of the lip meets the skin. Injections along this line, if done correctly, will cause the lip to roll slightly outwards, showing more of the pink and accentuating the look of the lips without adding excessive volume. It’s almost like an optical illusion.
We don’t need to inject the entire length of the vermilion border though. I start with the upper lip and inject from the point where the philtral columns meet with the vermilion border. We only need to inject along a short length of the upper vermillion border on either side to achieve the desired look. Once again, only a small amount of filler is required.
A pattern is starting to form here: small amounts injected in key points add up to subtle enhancements that don’t add excessive volume, leading to beautiful, natural looking lips.
The oral commisures are the edges of the lips, where the upper and lower lips meet. You may wonder why we bother adding filler to this region. The answer is simple: a small deposit of filler just underneath the corners of the lips acts as a support, which slightly elevates the corners of the lips.
Instead of a “down-turned frown”, we achieve an “upturned” happier appearance. I also like to inject a small amount of filler along the vermillion borders of the lower lips on either side, just next to the commisures, once again to cause a rolling out of the lips and letting more pink lip show.
The last key point, and the most often overlooked, is the philtrum. The philtrum is the shallow groove that runs up the middle of the face between the top lip and the bottom of the nose. The philtral columns are the two small ridges that run along either side of this grove up to the bottoms of the nostrils.
A small amount of filler injected along the line of the philtral columns can really add definition to the top lip, enhancing the appearance of the whole face.
And that’s it! Five key points on both sides of the lip, and we’ve achieved a natural looking enhancement without adding huge amounts of volume. To give that natural look, we really want to avoid any lumps or unevenness in the lips, so a proper massage is essential to really spread the filler around.
What should I expect during filler injections to the lips?
It’s important to choose an experienced lip filler injector who understands the anatomy of the lips, and who understand that filling with small amounts can enhance the lips naturally.
An experienced injector also knows how to avoid the important structures around the lips, especially the veins and arteries which should be avoided. Not everyone has lips that are perfectly symmetrical, so your injector will have to decide how much volume to add to each side to obtain the perfect result.
Do lip fillers hurt?
The lips can sometimes be a sensitive area to inject, as they are an area with lots of blood vessels and nerve endings: the lips are after all the part of the body that we use for activities such as kissing and eating. You may want to have some numbing cream on your lips prior to your treatment, and your injector can do this for you beforehand.
Your injector will assess your face and lips for volume required, as well as for any underlying asymmetry. Photos will be taken so you can compare your “before and after” pictures. After thoroughly cleaning the skin with antiseptic, ice is used to numb the lips and help constrict any small veins to minimise the chance of bruising. Remember too that the filler contains a local anaesthetic, so discomfort will be minimised.
What should I expect after filler injections to the lips?
Because the lips are quite a sensitive area, some people experience bruising and swelling for the first twenty-four hours or so. This is very normal, and nothing to be concerned about. I’ve also written an extensive lip filler aftercare guide that will give tips on before and after lip fillers.
You may wish to have your procedure when you have a free day following, so you don’t need to worry about the swelling! That said, there are several tips that can help to minimise the swelling experienced: Ice to the area may help for the first evening, as well as mild painkillers such as paracetamol.
Aspirin and ibuprofen should be avoided as they thin the blood. An anti-histamine tablet also helps some to minimise swelling. I advise clients to spend the first night sleeping on an extra pillow or two can minimise the swelling experienced when they wake up the next morning. If you do have any small bruises, arnica cream can also be helpful. Any bruises and swelling should resolve in a day or two. In general, lip filler injections are very well tolerated. Your injector will contact you over the next few days to check up on you.
How much filler do I need in the lips? How much do lip fillers cost?
To begin with, I recommend that just one ml should be injected to the lips for a noticeable, although subtle and natural difference to be seen. Remember that filler expands over the first few weeks as the molecules naturally attract water. That’s one of the reasons why I like to see my clients for a review two or three week after their treatment.
At that review we can decide if more filler is required and what the lip injections will cost. At the time of your review appointment, we also love to offer our clients a complimentary skin assessment and mild facial peel with one of dermal clinicians at our Melbourne skin clinic.
Are lip fillers permanent? How long will my filler last for?
There are some filler types that are permanent, but we discourage using them for multiple reasons. Firstly, they are much thicker and therefore unable to be used in the lips where we need to use a more subtle, softer filler that looks and feels natural; thicker fillers are better for replacing volume and structure in the cheeks and temples.
Secondly, and most importantly, permanent fillers are unable to be dissolved if you are unhappy with the result or in the very rare case of any complications.
That said, your lip fillers will last for quite a while. As a general rule, fillers last for an average of approximately twelve months. The thicker filler types, more commonly used in the cheeks and temples, last longer than the softer types used in the lips.
There are some people who break down their filler slightly quicker than others, and a continued lip filler treatment may be needed sooner. On the other hand, some lucky people find that their filler lasts longer than in others. Everyone is different, and everyone breaks down filler at a different rate.