Do you have issues with thin lips? In our society plump, pouty lips are definitely looked on as a youthful feature, but unfortunately as we get older our lips definitely lose volume and they get thinner.
The great thing is that there are a number of options for you to get those lips back and to plump them up.
Let’s go over first how we look at lips.
The one thing that we don’t want and that we’ve all seen in Hollywood celebrities are overly plumped up lips. They don’t look natural, they look stiff, they look weird and people even called them a trout pout or duck lips.
What are the normal proportions of a lip?
The lower lip should ideally be about 50% thicker than the upper lip. If you look at this picture, you can see a younger woman with nice full lips:
These are the normal lip proportions, where that lower lip is about 50% thicker than the upper lip. However, as we get older and like you see in the next picture, those are a pair of lips that have gotten quite a bit thinner with age, where it’s hard to even see what the proportions are.
This is very common as we get older where those proportions decrease.
Where people go wrong is when they plump the lips up, they overly plump up the upper lip and you get those proportions off and sometimes I’ll even see that the upper lip looks bigger than the lower lip and that’s why people look like they have duck lips or trout pout.
What you want to do if you are considering refilling up your lips and plumping your lips up, you want to keep those normal proportions that lower lip should be 50% thicker than the upper lip.
All injector specialists should be knowledgeable about these natural lip proportions.
The easiest way to plump up the lips is to do it in the office.
We use injectable fillers and typically these are all hyaluronic acid fillers. I don’t recommend any non hyaluronic acid fillers for the lips.
The ones that we use most commonly are Juvederm Ultra and Ultra Plus. It’s a nice filler for the lips. It lasts anywhere from six to twelve months.
It’s nice and soft, injects real smoothly and we use that very commonly in the lips.
Another option is Restylane Silk. It’s a little bit thinner than the traditional Restylane but has good longevity, around six months, sometimes longer. It can also be used for some of the vertical lip lines that we typically don’t use Juvederm for.
Restylane Defyne and Refyne are also great options for the lips I would use Defyine to help plump the lips up. Refyne could be great for some of the fine lines around the lips as well. That lasts up to a year.
Regular Restylane is something that we occasionally use in the lips. It used to be the gold standard until some of the newer ones have come around. But that’s a reasonable option as well.
Once again, I don’t recommend non hyaluronic acid fillers in the lips. I don’t recommend Sculptra in the lips, definitely don’t recommend Radiesse or injectable silicone. Not good ideas. Stick with hyaluronic acid fillers.
How we do the treatment?
Pretty straightforward. You come in, you fill out the paperwork and then at that point typically we’ll give you an ice pack to numb your lips up. Also we can apply some numbing cream to lips as well.
The majority of time we combine using a cannula with a needle to inject the filler. What I typically do, I will make a tiny little poke in the corner of the mouth, then use the cannula, which is a long blunt needle that glides under the surface to inject that filler.
Then we’ll make a little poke in the upper corners of the mouth and inject it with a cannula and then we switch the needle to inject that Cupid’s bow, which is a part of your lip, to keep that nice and curved as naturally it is.
By using a cannula it’s typically a bit less painful for most patients. Some patients disagree but in general I think it’s less painful. You have less swelling and less bruising because you have less injections of it and I do think overall you can get a smoother result with the cannula.
Most importantly there’s a lower risk of the accidental injection of that filler into a blood vessel. The big risk with injection of any filler is injecting into a blood vessel. Using a cannula that risk is definitely lower.
After the procedure you’ll put some ice over the lips. It will look a bit swollen. The lips swell up more than any other part of our face and that’s why if somebody gets popped in the face they never end up with a swollen jaw or a swollen cheek. It’s always their lips, they get lips puffy.
The lips will swell up very quickly but the great thing about lips is you ice them up for a while and that swelling does typically come down very quickly.
So you may have a little bruising, definitely little bit of swelling. Within an hour or two of leaving the office, it will come down.
I’ve had patients who have had their lips injected, they walk out the door the office going “oh my gosh what did I do my lips, they look way too big” and then they call us an hour layer, saying it’s perfect, the swelling has come down.
It’s very common, don’t be afraid if you have it injected and you feel the lips are a little puffy initially. Most likely that’s just due to swelling.
Let me show you an example of a photo of somebody who’s had Juvederm Ultra.
You can see a real nice change. Those natural lip proportions in this patient are retained and they look
The most common choice to plump up the lips is an injectable filler. You know what you’re going to get, you can see it, by using a cannula it can be done very safely and effectively in the office. The goal is to keep those natural lip proportions.
What if you are looking for a longer lasting result?
We do have the option of fat.
When we inject fat, we take fat from the tummy or the thighs, purify it, make a little incision in each corner of the mouth and then inject it into the lips.
This is typically done under a general anaesthetic. You’re completely asleep, the procedure takes a half an hour to 45 minutes. That’s it. There’s no stitches involved but initially your lips are big, they look puffy, because not only is there a good amount of fat injected into them, but they swell up a lot.
As far as a recovery, there’s very little pain with it, your lips going to feel a bit tight, they’re going to feel plumped up and they’re not going to move quite as naturally for a while because they’re so plump.
But usually you give it about two to three weeks and the vast majority of swelling is gone. In about six to eight weeks, you’ll see pretty much what you’re going to see long-term.
The negative about fat grafting in the lips, and the reason why this is not my top choice and we go more with the fillers is that a good percentage of that fat that we inject into lips will go away.
Upwards of 80% to 90% of the fat that we inject will disappear. That’s a lot of fat that goes away. Because of that, we will over correct the lips, knowing that almost all of that fat is going to go away.
But because we over correct so much, things are quite puffy afterwards. We inject anywhere from 1 to 4 cc of fat into each lip. You compare that to the average patient who has one syringe or one cc total. When you combine the upper and lower lip, those lips are quite big with fat grafting initially. And then almost all of it goes away.
But what does stay will stay long-term. It can stay 5 to 10 years, even longer.
If you’re undergoing another surgery, like a facelift, and you always want a big lips, by all means do the fat, because whatever sticks around, sticks around. You’re going to be recovering from the other surgery anyway.
But if you’re just in the office and you’re working and you don’t want to take time off, fat grafting is probably not the best option, because you will look quite puffy for a while.
Just do a filler because then you’re going to have much less downtime than you would with fat grafting.
Her are a couple of examples of very nice but pretty subtle changes with the fat grafting:
You can see with the last patient, a bit of an older patient, very thin lips. I injected 3 cc’s of fat into each lip and a nice change but still fairly modest.
If you’ve got issues with thin lips, start off considering the filler. If you’re looking for a more permanent result, fat grafting can definitely do that for you, but it takes a bit longer and you may need more than one treatment.