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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, some dissatisfaction with the facial expression is attributed to the lips. A certain predisposition or changes in age can cause both women and men to inquire about lip correction due to narrow lips. During an examination at CenterPlast, your facial features, skin elasticity and volume distribution are examined. Misalignment of the teeth or jaw must also be taken into account, as they can affect the proportions of the lips. This allows the doctors treating you to weigh up the different methods in your case and choose the most suitable tissue fillers. Occasionally, it can be helpful to bring pictures that illustrate your desire for change and the look you hope to achieve with beautiful lips. During the examination, Dr. Santos Stahl, a specialist in aesthetic medicine, will show you which features of the lips will help you achieve a more youthful, attractive, open-minded or friendly expression. A lip filler treatment helps to create more volume and a more beautiful contour. To achieve a harmonious result, drooping corners of the mouth or wrinkles around the mouth are also taken into account. A supplementary injection with a neuromodulator substance can be useful in order to emphasise the edge of the lips somewhat (Lipflip technique). The use of such a preparation is also suitable for lip correction in the case of the so-called gummy smiles. Through her many years of extensive experience, Dr. Santos Stahl can fully educate you on both non-invasive and permanent surgical treatment methods.

    What alternatives exist?

    An alternative to injections with hyaluronic acid is the use of autologous fat. The advantage of this method of lip correction with nanofat is that the results are permanent. Thus, the lips remain full and completely without surgery. In addition, the precursor cells have a positive effect on the skin properties. The elasticity and collagen content of the skin improve. Since the cells are the body’s own material, allergic reactions need not be feared. The body doesn’t reject it. An autologous fat treatment can be performed on an outpatient basis and under local anaesthesia or in twilight sleep. A so-called permanent make-up is not an alternative, because it does not give the lips more fullness or volume.

    What products are used for lip injections?

    Only high-quality certified products are used at CenterPlast for lip injections. Since the administration of hyaluronic acid is hardly regulated by law in Germany, semi-skilled practitioners repeatedly offer hyaluronic fillers from countries without any quality control. Among the best known certified products, which have been in use for many years, are the fillers from Merz, Allergan and Galderma. Precise application of small amounts of a neuromodulator substance to the outer edge of the upper lip, causes the upper lip to curl outward. This creates a sensual pout with full lips. This method of lip augmentation with a special effect is also commonly known as lip flip. A neuromodulator substance can also be used on the corners of the mouth. If the corners of the mouth are drooping, the active ingredient helps to create a friendly and open-minded facial expression. The use of autologous fat is a good and permanent alternative to the use of hyaluron. Thus, it offers you a permanent lip enhancement. 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 treatment options that may be effective should not be withheld from you. In the case of a drooping corner of the mouth and an increased muscle tension (mouth corner depressor, lat. Musculus depressor anguli oris), the application of a small amount of neuromodulator substance may be useful. Wrinkles on the upper lip can be treated with a small amount of a neuromodulator substance. In older patients with a thin upper lip and a wide upper lip line, a minimally invasive surgical procedure (minimally invasive surgical lip augmentation) may be more effective for tightening. This is known by the technical term bullhorn lip lift. On this page you will also find detailed information about the pre- and aftercare as well as details such as the surgery duration of this operation.

    We always strive for natural results of a lip correction that also visually suit you. With Centerplast, you do not have to worry about over-injected lips, so-called inflatable lips. During and after the hyaluron injection, there is occasionally a slight swelling, but this is only temporary. Many patients want to know in advance what quantities should be used for the first time lip injections to avoid unwanted swelling in the first few days and to achieve an optimal result: It is advisable to limit the injected volume to one milliliter and, if necessary, inject a little more after one to two weeks for lip correction.

    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. Inflammations 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.

    For additional information on what general precautions to take before lip corrution with fillers, see the Filler – Everything You Need to Knowpage.

    What should be considered after lip injections?

    After lip augmentation, the lips are somewhat numb, but this wears off in a short time. You should not exercise for the rest of the day of the procedure. Allow your body to rest and recover. Also saunas and the swimming pool are taboo during this time. From the next day this is possible again. During the consultation with the treating physician, it will be explained to you that an occasional light massage of the lips after the lip correction is beneficial in order to promote the even action of the active substance and to achieve an optimal treatment result with smooth lips.

    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 a first lip augmentation with filler, it is essential to have an examination, to inform the patient and to draw up a treatment plan. You can find more information about the consultation here. The cost of the service 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. During an individual consultation you will receive a detailed offer for lip augmentation. In addition, we will gladly inform you about the possibilities of financing interventions. You will also find information on this in advance on our corresponding 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, as inflatable lips, are a recurring motif in beauty trends in the tabloids. Injections that are too superficial can lead to a Tyndall effect, or a blue discoloration of the skin. Overcorrections or incorrect corrections can be treated with the antidote hyaluronidase. Anyone offering filler treatments should also have enough hyaluronidase on hand 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 product and is therefore injected by medical laypersons without the necessary training and experience. Those who seek non-medical treatment for lip augmentation therefore run the risk of not being helped in time if a complication arises. So it is best to entrust yourself to a specialist in aesthetic surgery/plastic surgery (plastic aesthetic surgeon).

    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 search the internet for testimonials. People who have already used the treatment at the respective 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. Ratings 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 photos of treatments the practice has performed. Centerplast also offers the opportunity to see before and after results. You can find more information about this on our corresponding page.

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    The author

    Dr. Adelana Santos Stahl

    “Our goal is to provide the best, most discreet and precise treatment based on our extensive expertise in plastic surgery. „

    Dr. Adelana Santos Stahl is distinguished by a unique international perspective with a feminine view of plastic surgery. Her personalized and detailed approach is key to the beautiful and natural results she achieves. Having trained in Brazil, one of the largest and most well-known countries for aesthetic and reconstructive plastic surgery, she understands her patients’ desire to look and feel their best.She completed her medical studies and her training as a specialist for plastic and aesthetic surgery in Brazil. In 2009, she also successfully passed the German equivalence examinations for the medical state examination. Two years later, in 2011 she received the German and in 2012 the EU specialist recognition (EBOPRAS) for plastic surgery.From 2009 to 2013, she deepened her knowledge of aesthetic and reconstructive facial surgery with world-renowned representatives of plastic surgery such as Professor Gubisch at the Marienhospital and Madame Firmin in Paris.A VDÄPC Fellowship (continuing fellowship for graduate students) in Switzerland, France and the USA has further enriched her professional experience.Dr. Santos Stahl is active in several prestigious professional societies. Besides the DGPRÄC and DGBT, she is also a member of the Brazilian Society of Plastic Surgery – SBCP.She is also the author of several scientific articles and, together with her husband, is dedicated to research and clinical studies in the field of plastic surgery.

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