When someone thinks about the most beautiful parts of their face, eyes and lips seem to come first to mind. As you get older, lip volume decreases, making your lips look like a fraction of their previous height. Plus, wrinkles around the lips, including deep creases that run from the chin to the lips, are two aging signs that are hard to stop.

There are other reasons for wanting beautiful lips. It could be that you simply weren't given beautiful plump lips from your genetics. Born with thin lips or one lip larger than the other or one side of the lips shaped differently than the other are all reasons to utilize the latest in lip technology and rejuvenate your lips, making you feel a sense of pride about them that you never did before.

Technology’s answer is lip fillers that are either temporary or permanent. Lip fillers increase soft tissue bulk, produce beautiful aesthetic contours and flatten wrinkles.

Identifying the Different Lip Fillers and Their Makeup

Restylane

Medium depth filler: Hyaluronate

Restylane Silk, Lyft

Temporary filler: Hyaluronate

Restylane Refyne

Temporary filler: Hyaluronate

Restylane Defyne

Temporary filler: Hyaluronate

Vollure, Voluma

Temporary filler: Hyaluronate

Volbella

Temporary filler: Hyaluronate

Bellaill

Permanent filler: Polymethylmethacrylate

Belotera Banace

Temporary filler: Hyaluronate

Juvederm Ultra

Medium depth filler: Hyaluronate

Juvederm Ultra Plus

Medium depth filler: Hyaluronate

Silicone

Deep filler: Silicone

Zyplast

Natural filler: Collagen bovine

Zyderm

Natural filler: Collagen bovine

Radiance

Deep permanent filler: Hydroxyapatite

Radiesse

Deep permanent filler: Hydroxyapatite

Sculptra

Deep permanent filler: Poly-L-lactic acid

Identifying Where to Use Fillers on Our Faces

Fillers are chosen also for what facial part they do best at filling. Below is a chart on exactly this topic.

Lips

Juvederm, Ultra, Volbella, Fat injections

Reduce vertical lip lines

Restylane Silk, Volbella, Belotero

Lift and enhance cheeks

Voluma, Restyalane Lyft

Reduce marionette lines

Juvederm, Belotero, Restylane Refyne, Restylane Defyne

Reduce chin wrinkles

Belotero, Radiesse, Juvederm, Restylane

Soften nasolabial folds

Vollure, Sculptra, Bellafill

What Are Lip Filler Compositions?

The two top lip filler compositions are hyaluronic acid and polyacrylamide. Polyacrylamide lip fillers are typically avoided because of granulomas. In an Australian medical report published in 2014 that chronicled 10 years of experience with this type of lip filler, researchers reported 11 lip infections of 166, or a 6.6% point. Granulomas weren’t reported, but seven lip asymmetries were reported.

Hyaluronic acid is naturally found within the skin and is for the purpose of plumping the skin. Because it's more natural than polyacrylamide, this may be why it has less chance of granulomas. (Learn more about hyaluronic acid with Considering Juvederm? Here's What You Need to Know.)

Another lip filler is calcium hydroxylapatite, which is a type of calcium found in our bones. It’s lasts much longer than other temporary lip fillers, lasting 12 months instead of the usual 6 months. Calcium hydroxylapatite fillers stimulate collagen production and may be chosen by your doctor to fill in deep wrinkles and lines.

Poly-L-Lactic Acid is a biodegradable synthetic substance that has been used in recent years for dissolvable stitches. They also help your skin rebuild collagen. It’s used for deep facial wrinkles and lasts for about two years.

What Type of Treatment You Need Depends on What Your Lips Look Like Now

Board-certified plastic surgeons carefully examine the lips of their patients, looking for:

  • Drooping mouth corners.
  • Thin lip or lips.
  • Poorly defined Cupid’s bow.
  • Which part of the lips has good lip volume.
  • Whether or not a pouty look will work.

The edge of the lip is called the vermillion. It’s the part that you would use a lip liner on to outline the lips. To enhance the lips filler will be placed superficially in the vermillion area to enhance its structure. For thin lips, filler is placed deeper and then an additional superficial filler corrects the volume.

Because the hyaluronic acid is mixed with lidocaine, there is no pain with the procedure.

Are There Any Known Side Effects to Using Lip Fillers?

Eventually, the natural/biologic lip filler is resorbed into the lip tissues if the fillers are only temporary. Synthetic polymers aren't easily resorbed and they can remain in place for many years. Most patients tolerate these materials without complications; however, some will develop what’s called an ugly granuloma or bump in the lips. If this happens, patients return to the plastic surgeon’s office to reverse the injection.

Granulomas are a lot more common with the permanent lip filler than the temporary ones. However, they are still not that common.

The granulomas may migrate up to 3 cm away from the initial injection site and masquerade themselves as a tooth infection, a cancer of the mouth or a minor salivary tumor. They are usually without symptoms. They may also be accompanied with inflammation.

You should also know that from more than 100,00 cases of lip injections per year, the medical literature has yet to provide a high incidence of these granulomas. For example, one 2017 report that reviewed the literature only found 17 cases of the granulomas.

In 2005, a Miami study of liquid silicone lip fillers in 608 patients found that 2% of patients developed small palpable granulomas that responded to steroid injections or were removed. The researchers concluded that liquid silicone was still an effective method of lip augmentation.

What Happens After the Lip Filler Procedure?

Some side effects can be expected from using lip fillers, but they are temporary:

  • Swelling.
  • Bruising.
  • Possible reactivation of herpes cold sores on the lip.
  • Down time of 2 days to 2 weeks.
  • Possible anxiety due to the swelling and bruising.

The side effects are less if the doctor uses a cannula instead of a needle for the procedure. With a cannula, only two points of entry are made – one at either side of the lips. Swelling and bruising resolve easily when cold packs are used but sometimes non-steroidal anti-inflammatory agents will be prescribed.

Acyclovir or famciclovir – antiherpes drugs – may be administered before the procedure if the patient has a history of herpes cold sores.

Choice of a highly trained board-certified plastic surgeon is a strong preventative measure against side effects. They understand the inherent properties of the products used and won’t make inappropriate decisions about its delivery or dilution. They also can be expected to get controlled and predictable results. Overaggressive injection of fillers may lead to lumpy lips or beading if it’s placed too superficially.

Sometimes plastic surgeons will also add neurotoxin to the procedure for best results.

How Do I Get Started?

If you wish to get lip augmentation, the first step is to schedule a consultation with your plastic surgeon. They will ask you questions on why you feel it is necessary, examine your lips, take a medical history, and then give you options.

You may be scheduled for the actual lip filler injections immediately after your consultation, or they'll ask you to come back for another appointment. The doctor will monitor your progress during the healing and be there for you if something goes wrong.