Priorities
Thin or uneven lips
Thin lips, an upper lip that disappears when you smile, or uneven lip shape.
Treatments from $100
The short version
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.
Why it happens
Why lips change shape
Lips change for a few different reasons, and the reason decides the treatment. Sometimes it's the muscle, sometimes it's volume, and sometimes one side was simply made a little differently.
The muscle rolls the lip in
The ring of muscle around your mouth can pull your upper lip inward when you smile, so a lip that looks full at rest seems to disappear.
Volume thins with time
In an MRI study of 200 adults, upper lips in people aged 65 to 80 were longer and thinner than in people in their 20s, with soft tissue up to 41 percent thinner in women.
No two sides match
Most faces aren't perfectly symmetrical, and lips are no exception. One side can be smaller, sit higher or move less than the other.
Sources: American Society of Plastic Surgeons, upper lip aging study
Your options
How we'd approach it
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Step 1We'd start with
Lip flip
From $100
About Lip flipIf 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.
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Step 2If you need a little more
Lip filler
From $650
About Lip fillerIf 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.
Side by side
Lip flip or lip filler
Both are quick visits with our nurse practitioner. The difference is what they change: a lip flip changes how your lip moves, and filler changes its shape and volume.
We'd start with
Lip flip
From $100
- Best for
- An upper lip that disappears when you smile
- Appointment
- About 10 minutes
- Downtime
- None
- First results
- About a week
- Sessions
- One visit, lasting about 2 to 5 months
If you need a little more
Lip filler
From $650
- Best for
- Lips that are thin at rest, or uneven
- Appointment
- 30 to 45 minutes
- Downtime
- Swelling and bruising for about a week
- First results
- Right away, settled by two weeks
- Sessions
- One visit, with a check at two weeks
Prices are starting prices from our menu. Your provider will confirm the plan and total cost at your consult. Individual results vary.
What to expect
The first two weeks, and beyond
Filler shows the same day and settles by two weeks. A lip flip takes about a week to show and lasts a few months.
Day 0
Filler swells fast
Filler swelling starts within minutes. A lip flip shows nothing yet.
Days 1 to 2
Peak swelling
Lips look bigger and lumpier than the result, and any bruises show. This is all normal.
Week 2
Judge the result
Filler result is settled and the lip flip is at full effect. We see you for your filler follow-up.
Months 2 to 12
Gradual fade
Lip flip fades at 2 to 5 months; filler softens at 6 to 12. Repeat either when you’re ready.
Timeline for lip filler and the lip flip, from our treatment page. Individual results vary.
Our reasoning
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). 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.
Why is one side of my lip bigger?
Most faces are a little asymmetrical, so it's common for one side of the lip to be smaller or sit higher. If it's volume, we can place filler on the smaller side to balance it. If one side moves less when you smile, a little toxin can help even out the movement.
Do lips get thinner with age?
Yes. Lips lose volume and the upper lip gets a little longer over time, which can make it look thinner. Filler can restore some of that volume, and we keep it in proportion with the rest of your face.
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