Lip Fillers: The Ultimate Guide

Somewhere in my thirties, I had to give up my matte lipstick. That’s because my lips had noticeably begun to lose volume and matte shades showed every last unforgiving line. But given the many pairs of badly done fish lips (often paired, it seems, with a completely unmoving brow) I’d seen, I put the idea of fillers aside for years. Chalk it up to the Kylie Jenner effect, but I’ve lately been reconsidering my stance and here’s why: a few years and a baby happened and my lip lines are only getting worse. Plus, I ran in to a friend who confessed she had just a bit of filler done and the results were Drew Barrymore of the ‘90s — that is, bee-stung in the very best way. But lest I end up looking like a tragic case (“Mommy, did somebody punch you in the lips?”), I did some research first. See this lip filler guide below to get a lay of the land.

Collagen

Imagine this as dial-up internet: way, way back, it was pretty good stuff. But today, this category has been replaced by hyaluronic acid-based fillers, which “last longer and has less allergy risk,” says Kenneth Mark, MD, a dermatologist in Manhattan.

Juvéderm and Restylane

The gold standard of today’s options — “they have the best record for safety and results,” Mark says — these hyaluronic acid-based fillers are nearly interchangeable. The effect can last about 7-9 months. If you’re looking for an even lighter formula (a.k.a. less commitment), ask for Juvéderm XC.

Belotero

Another hyaluronic acid filler, it’s far subtler than Juvederm or Restylane, says Barry Weintraub, MD, a plastic surgeon in Manhattan who uses it to plump fine vertical lip lines. Mark suggests that Belotero, which lasts about 3-6 months, can be a good option for a patient who’s young or very thin.

Voluma

This option is also composed of hyaluronic acid, but it’s inappropriate for lips, says Weintraub, because it’s much heavier and thicker. “Lips should be fluffy and soft,” he adds. “Voluma is made for the cheekbones.”

Radiesse

Similarly, Radiesse, which is actually composed of tiny mineral particles, can be effective on the cheekbone but disastrous for the lips. “There were ‘cowboys’ who really jumped on Radiesse when it first came out and would inject it into the lip,” Mark recalls. “The patients would end up with nodules in their lips — they had to be cut out.”

Fat Injections

In theory this route sounds like an enticing one to take: remove your own fat from an unwanted area and inject it in an area where you don’t mind a little plumpness. But in fact, doctors are divided on whether it’s the best solution. “Done well, the advantage here is that it lasts a very long time,” Weintraub says. But Mark thinks that’s also the problem. “Your face may change, or styles may change,” Mark says. “What was considered the perfect lip 10 years ago may not be what is the perfect lip today. And I’ve seen it done wrong and then you’re stuck with a fish look for a very long time.” Mark also warns that it’s a more invasive procedure than it looks from the onset. The lip area may be small, but you have to assume that maybe 50% of the fat that’s injected is going to die, so you have to take enough fat to correct that, he says.

Proportions

Both Mark and Weintraub agree: Less is more. “The lips are a relatively small area and it’s also a fixed compartment,” says Mark. “It’s not like your cheek where if you put too much in you have an area that will absorb it.” Balance between the top and bottom lip are paradigm, plus pay attention to where volume is actually supposed to be. “The goal is to get a gentle sexy pout,” Weintraub says. “The upper lip should be two-thirds as big as the lower lip. The upper lip is more complex because of the Cupid’s bow. There are two columns and a dimple and you want to make sure there is volume is in the middle. You don’t want to look like a duck.”

Recovery

For your typical filler, downtime is minimal but there’s always the risk of bruising. To minimize bruising, Mark recommends avoiding blood thinners (which include Advil, Motrin, aspirin, and even flax seed and omega oils) a week in advance.

Be conservative

Weintraub actually does a light first round of injections (three on the top lip and three on the bottom lip) and requests the patient to come in a week later to assess the results. “If you overshoot, you’ll look terrible,” he says. “And the thing with fillers is you can always put more in.”

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