Priorities
Thin or uneven lips
Thin lips, an upper lip that disappears when you smile, or uneven lip shape.
Lip concerns usually fall into two groups. In some people, the upper lip looks full enough at rest but rolls inward and nearly disappears when they smile. In others, the lips are thin at rest or uneven, with one side smaller or sitting higher than the other. These are different concerns, and each has its own treatment.
Lip filler isn’t always the first step. A few minutes with a mirror at your consult usually shows which approach fits.
What we'd want you to know
The amount of filler depends on your anatomy and goals
If your upper lip disappears when you smile but looks fine at rest, a lip flip is often the right first step. A few units of Botox along the upper lip border let it roll out slightly. It adds no volume and wears off in a few months, which makes it an affordable way to find out whether you want filler at all.
If your lips are thin at rest, or one side is smaller than the other, a lip flip won’t be enough. That’s when we’d suggest hyaluronic acid filler from our nurse practitioner with a check-in at two weeks.
How we decide
We’ll ask you to smile, then relax, then say “eee.” If your upper lip curls under when you smile and there’s plenty of pink at rest, the muscle is the issue, and a lip flip can help. A lip flip is an off-label use of Botox, since no toxin is approved for the lip muscle. A prospective study of 17 women measured a modest but significant increase in upper lip height at 15 days with no change in lip volume, per Aesthetic Plastic Surgery.
If your lips are thin at rest, a lip flip won’t add the volume you’re looking for. That’s where lip filler comes in: Restylane Kysse, Restylane Silk, or RHA 3, all approved by the FDA for lip augmentation in adults over 21 (RHA 3 says 22). The amount of filler used depends on your anatomy and goals. Your provider will recommend the appropriate amount during your appointment. In the Restylane Silk trial, lip swelling lasted a mean of 7.3 days and bruising 8.4 days, per the FDA summary, so we’d suggest planning it two weeks before any big event.
For uneven lips, we’ll look at the cause. If one side is smaller, we place filler asymmetrically on purpose. A side that moves less is a muscle issue, and toxin can help balance it.
Your questions, answered
Lip flip or lip filler, which should I get?
If your lip looks fine at rest but thin when you smile, a lip flip. If it’s thin at rest, filler. Many people end up with both. If you’re unsure, start with the flip, since it wears off on its own and costs the least.
How long does lip filler last?
Typically 6 to 12 months, depending on the product and how much movement your lips get. Restylane Kysse’s maker says up to a year, though lips are the fastest-metabolizing filler site on the face. A lip flip lasts about two to five months, per Cleveland Clinic, often toward the shorter end. Individual results vary.
Can I get lip filler if I'm under 21?
No. Every lip filler’s label says over 21, and RHA 3 says 22. We follow the label for every patient.
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