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    Lip injections with fillers

    Well-shaped plump lips look sexy and youthful with every mouth. With age, subcutaneous fat tissue and bone density decrease. The corners of the mouth may droop and the lips become narrower. With decreased skin tone, wrinkles form under the action of facial muscles and gravity. As a result, upper lip wrinkles, mouth wrinkles (marionette wrinkles) and wrinkles between the wing of the nose and the corner of the mouth (nasolabial fold) can form.

    Fillers emphasize the harmonious and sensual contours of the lips. After hyaluronic acid treatment of the mouth area, the subjective well-being of patients is rated higher (Dayan S.H., 2019, Dermatol Surg.). Filler injections of the lips is a safe treatment and is characterized by high patient satisfaction (Stojanovič L, et al., 2019, J Cosmet Dermatol). The following treatments of the lips with fillers increase attractiveness:

    1. Emphasizing the upper lip tubercles (tuberculum labii superioris).
    2. Volumizing the red of the lips (lip tubercle)
    3. Restoration of a youthful proportion of the upper lip to the lower lip
    4. Definition of the elevation immediately above the border of the labial tubercle (white roll)
    5. Raising the corners of the mouth
    6. Emphasizing the cupid’s bow
    7. Embellishment of the vertical hollow between the lip and nose (philtrum) to correct flat lips
    8. Reduction of lip wrinkles (pleated wrinkles, smoker’s wrinkles, perioral wrinkles).

    In which cases does lip injections make sense?

    Often a certain dissatisfaction with the facial expression is attributed to the lips. A certain predisposition or changes in age can cause women as well as men to inquire about a correction. During an examination at CenterPlast, your facial features, skin elasticity and volume distribution will be examined. Any misalignment of the teeth or jaw must also be considered, as they can affect the proportions of the lips. Occasionally, it may be helpful if you bring pictures to illustrate your desired change. During the examination, Dr. Santos Stahl will show you which features of the lips will help create a more youthful, attractive, outgoing or friendly expression. A filler treatment helps to achieve more volume and a more beautiful contour. To achieve a harmonious result, drooping corners of the mouth or wrinkles around the lips are also taken into account. A supplementary treatment with a muscle relaxant can be useful to slightly emphasize the edge of the lips (lip flip technique), or to treat a gummy smile. Thanks to her many years of extensive experience, Dr. Santos Stahl is able to provide you with comprehensive information about non-invasive and surgical treatment methods.

    What alternatives exist?

    As an alternative to hyaluronic acid treatment, autologous fat treatment can be performed to beautify the lips. The technique of nanofat is used for the lips. The advantage of this treatment method is that the results are permanent. In addition, the precursor cells have a positive effect on the skin properties. The skin elasticity and collagen content improve. Since these are the body’s own cells, there is no need to fear allergic reactions. Nanofat treatment can be performed on an outpatient basis under local anesthesia or in twilight sleep. A so-called permanent make-up is not an alternative, as it does not give the lips more fullness or volume.

    What products are used for lip injections?

    Only high-quality certified products are used for lip injections at CenterPlast. Since the administration of hyaluronic acid in Germany is hardly regulated by law, semi-skilled practitioners repeatedly offer hyaluronic acid from countries without any quality control. The best-known certified products that have been in use for many years include fillers from Merz, Allergan and Galderma. The precise application of small amounts of a muscle relaxant to the outer edge of the upper lip, causes the upper lip to curl outward. This creates a sensual pout. The technique is also commonly referred to as a lip flip. A muscle relaxant can also be used on the corners of the mouth. For drooping corners of the mouth, relaxant helps to create a friendly and open-minded facial expression. Nanofat treatment is a good and permanent alternative to the application of hyaluronic acid. You can read more about other treatment methods here.

    Tips for natural sensual lips with hyaluron

    The right filler should be selected for the individual needs of your lips. For volume building, a filler with a low modulus of elasticity should be selected. Treatment of upper lip wrinkles requires a hyaluronic acid gel with a low cohesiveness. Lifting the corners of the mouth requires the use of a firmer hyaluronic acid gel.

    Other possibly effective options of treatment should not be withheld from you. In the case of drooping corners of the mouth and increased muscular tension (mouth corner depressor, lat. Musculus depressor anguli oris), the application of a small amount of muscle relaxant may be useful. Upper lip wrinkles can be treated additionally with a small amount of relaxant. In older patients with a thin upper lip and a wide upper lip line, a minimally invasive lifting operation ( bullhorn lip lift ) may be more effective.

    We always strive for natural results that also suit you visually. During and after the hyaluron injection, there is occasionally a temporary swelling. Many patients would like to know in advance what quantities should be used the first time they have their lips injected, in order to avoid unwanted swelling and to achieve the best possible results: It is advisable to limit the injected volume to one milliliter and to inject a little more after one to two weeks if necessary.

    We use different techniques to achieve the best possible effect. The hyaluronic acid is injected selectively, for example, to emphasize the upper lip bump (tuberculum labii superioris) or to raise the corners of the mouth. For more volume of the red of the lips, the fan technique is used. The linear technique is used, among other things, to define the transition to the lip red line, the cupid’s bow and the vertical hollow between the lip and nose (philtrum).

    What you should know before lip injections

    Lip injections are in themselves a safe treatment with few side effects. Temporary swelling and small bruises may occur after any injections. Inflammation and allergies are rare. In rare cases, hyaluronic acid may cause vascular occlusion and affect blood flow. Thus, we ensure safety and satisfaction:

    • Dr. Santos Stahl is proficient in all techniques of injections and, after years of specialization in the field of facial surgery, is intimately familiar with the anatomy
    • Due to her training and experience, Dr. Santos can also offer you alternative treatment methods and provide you with comprehensive advice
    • During the examination and consultation, an optimal treatment plan will be worked out together with you
    • We use only high quality hyaluronic acid products
    • We select the hyaluronic acid with the best properties, taking into account your skin conditions and the region of your face.
    • CenterPlast doctors are technically and professionally prepared for the treatment of complications.
    • After the treatment, Dr. Santos Stahl can be reached by phone at any time in case of emergency.
    • By video consultation or personally on site, we would like to make sure that you are satisfied after the injection.

    Additional information about general precautions to be taken before treatment with fillers can be found on the page Filler – everything you need to know.

    What should be considered after lip injections?

    The lips are slightly numb after the treatment, but this wears off in a short time. You should not do any sports during the rest of the treatment. Also sauna and swimming pool are taboo during this time. This is possible again from the next day. During the conversation with the doctor, it will be explained to you that an occasional light massage of the lips after the treatment is beneficial in order to promote the even action of the active ingredient and to achieve an optimal treatment result.

    After lip correction, you should refrain from smoking for at least 24 hours or reduce it to a minimum. In addition, you should avoid mouth movements as much as possible (talking, kissing, etc.) in order not to affect the result. To reduce the amount of chewing, it is advisable to consume preferably strained foods, such as soups. Avoid overly hot foods and extremely cold foods such as ice cream.

    What are the costs for lip injections?

    Before the first injectable is performed, it is essential to have an examination, education and the creation of a treatment plan. You can find more information about the consultation here.

    The cost of the treatment is calculated from the effort and the amount of hyaluronic acid injected. You can find an order of magnitude of the prices for orientation on our cost page..

    Fillers and lip herpes

    Hyaluronic acid injections are very effective and particularly low in side effects when performed by experienced plastic surgeons. Nevertheless, cold sores can break out in less than 1.45 percent of cases 24 to 48 hours after filler injections (Gazzola R, et al., 2012, Aesthet Surg J). Cold sores are a sign of herpes simplex virus 1 inflammation. Over two-thirds of the population carries the virus. If the body’s defense mechanisms are temporarily disrupted, herpes inflammation can be triggered. Initially, small painful nodules appear on the lip. In the further course, vesicles and small crusts develop with reddening of the border area. An experienced plastic surgeon can distinguish the skin changes from an allergic reaction. Allergies are very rare and occur in the first 48 hours after the injection. If you suffer from herpes infections at least three times a year, we recommend preventive treatment with a virus-inhibiting medication.

    What are the risks of lip injections?

    Temporary swelling and small bruises may occur after each injection. Inflammations and allergies are rare. Lip injections are in themselves a safe treatment with few side effects. The following conditions must be met:

    • The hyaluronic acid treatment in consideration of your findings and your goals appropriate.
    • The respective hyaluronic acid is appropriate for the treated region
    • A high quality hyaluronic acid is used
    • Your surgeon is proficient in injectable techniques
    • The surgeon is familiar with the anatomy
    • The practitioner has experience with alternative surgical procedures
    • The surgeon is professionally and technically prepared to handle complications
    • Your surgeon can be reached after treatment if needed.

    Nodules after filler

    Unlike irregularities, which are visible immediately after the injection and disappear on their own, indurations develop after a few days and can be palpable for many months. Hardening may be the sign of a reaction of the immune system. When the immune defense is directed against germs, a painful induration, redness, hyperthermia, and possibly wound secretions develop on the second or third day. Examination of the wound secretion can help clarify the cause. Redness and induration may occur two to three days after injection in 0.8 percent of patients. Nodulation that appears 21 to 28 days after injection may have several causes. Late appearance of nodules is caused by unusual germs or intolerance of components of the filler. If nodules are very pronounced, a tissue sample should be examined. In the case of mild nodules, an allergy test is informative. If the nodules are an expression of hypersensitivity to the filler, they usually disappear quickly after injection of hyaluronidase and cortisone. Hypersensitivity after injection affects an estimated 0.04 percent of patients (Chung KL, et al. 2019 Aesthet Surg J). Unusual or atypical germs are additionally treated with antibiotics.

    Too much hyaluronic acid, now what?

    Hyaluronic acid products bind water in varying strengths. A perfect lip correction with filler therefore requires a lot of experience to inject the right hyaluronic acid, in the right amount and at the right place. Since we attach great importance to natural and harmonious results, we dose the hyaluronic acid very carefully. If desired, a second injection (so-called “touch-up”) is performed at a follow-up appointment after one week.

    The result of an unskilled and inexpert treatment are disfigured lips, which are a recurring motif in the tabloids as inflatable lips. Injections that are too superficial can lead to a Tyndall effect, or a blue discoloration of the skin. Over or incorrect corrections can be treated with the antidote hyaluronidase. Anyone offering filler treatments should also have sufficient hyaluronidase in stock for emergencies. Hyaluronidase is marketed as a drug under the name Hylase® and may therefore only be administered by physicians. Hyaluronic acid, on the other hand, is classified as a medical device and is therefore injected by medical laypersons without the necessary training and experience. Those who seek non-medical treatment for lip injections therefore run the risk of not being helped in time in the event of a complication.

    The more time has passed since the injection, the less effective hyaluronidase is. Hyaluronidase is dosed in units. The amount of hyaluronidase required depends on the amount, concentration and degree of cross-linking of the injected hyaluronic acid, as well as the region of the body. Overall, Restylane® fillers are better dissolved by a Hylase® than Juvéderm® and Surgiderm® hyaluronic acid (Sall I, et al., 2007, Polymer Degradation and Stability). If the injection was performed no more than four days ago, we use 15 to 30 units of hyaluronidase. If necessary, the treatment can be repeated after one week. An allergic reaction to hyaluronidase is rare (0.05 percent; Landau M. 2015, Dermatol Surg). Bee and wasp venom contains hyaluronidase. Therefore, in case of bee or wasp sting allergy, an allergy test for hyaluronidase should be performed (Keller AC, et al., 2014, Dermatol Surg).

    Other common questions about lip injections

    Many patients wonder if a natural result is even possible with lip injections, as they have seen many negative examples in the media. This is the result of treatment by unqualified and inexperienced, often self-proclaimed experts. You can find out how to identify the right doctor and specialist on our page Filler – everything you need to know

    There you can also read in detail:

    • how fillers for wrinkle treatment work
    • how long lip injections last
    • when lip injections should be repeated
    • when the swelling subsides
    • which product lasts the longest
    • when to expect the final result
    • whether it is allowed to have lip injections during pregnancy or while breastfeeding
    • whether minors are allowed to have lip injections
    • what to consider before lip injections

    Testimonials for lip injections

    Before patients decide to have lip injections and choose a suitable experienced expert for the treatment, they usually look for testimonials on the Internet. People who have already used the treatment at the corresponding practice explain in such reports whether they were satisfied with the service, the consultation and, of course, with the treatment and the result. Patient testimonials can be quite helpful. Reviews additionally provide an average overall picture of patient satisfaction. Therefore, visit our corresponding page, which bundles all this.

    Before and after pictures of lip injections

    Before patients decide to have lip injections, they often want to see before-and-after pictures of treatments that the practice has performed. Centerplast also offers the possibility to see the results of the treatment. You can find more information about it on our corresponding page.

    Author’s statement

    Author: Stéphane Stahl, MD, PhD. There are no financial relationships with the pharmaceutical or medical device industries that could have influenced the above text. Any reproduction, even partial, is permitted for personal use only. All texts used on this website are protected by copyright.

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