Lip Fillers

What it is

Lip filler is a gel-like material injected into or around the lips to add moderate volume, define their outline or improve their balance. The most commonly used type is based on hyaluronic acid, a substance found naturally in the body. The effect is temporary, because the product breaks down gradually over time, and the doctor decides after an assessment whether the procedure is suitable.

Who may benefit, and why people ask about it

• Wanting to add moderate volume to the lips.
• Wanting to define the outline of the lips or bring out their shape.
• Mild imbalance between the upper and lower lip, or between the two sides of the lip.
• Fine lines around the mouth in some cases, after a careful assessment.
• Some loss of lip volume with age.

Lip fillers can help some people, but they are not suitable for everyone, and the doctor usually aims for a result in balance with the rest of the face rather than an exaggerated change.

What the consultation covers

• A review of your health history, including autoimmune conditions, bleeding disorders, blood thinners and any known allergies, including allergy to local anaesthetics.
• Questions about any previous fillers or procedures in or around the lips, and what type they were if known.
• Questions about any history of cold sores.
• An assessment of the shape of the lips, their balance with the rest of the face, and the quality of the skin around the mouth.
• A discussion of realistic expectations; the doctor may suggest a different option or advise against injections.
• An explanation of the risks — including rare and serious ones — and the aftercare, followed by informed consent.

Questions you may want to ask the doctor:

• What type of material will be used, and can it be dissolved if needed?
• What is a realistic result for my lips?
• Which signs mean I should contact the clinic immediately after the procedure?
• Is there a follow-up appointment to review the result once the swelling has settled?

What a visit looks like

1. Registration, and review of the health-history and consent forms.
2. Clinical photos may be taken with your consent; they are kept in your medical file only and never published.
3. The skin is cleaned with an antiseptic, and the doctor may mark the injection points.
4. A topical numbing cream may be used in some cases, and some products contain a local anaesthetic.
5. The injections are given with a fine needle or a blunt-tipped cannula, depending on the area and the doctor's judgement.
6. The result is reviewed, aftercare instructions are given, and a follow-up appointment is booked if the doctor considers it necessary.

The number of sessions, their length and the interval between them vary from person to person and are set by the doctor based on the assessment.

Preparation

• Please tell the doctor about all medicines and supplements, especially blood thinners and supplements that may make bruising more likely.
• Do not stop any prescribed medicine without speaking to the doctor who prescribed it.
• Please tell the doctor if you are pregnant, breastfeeding or planning a pregnancy; lip fillers are usually postponed in these situations as a precaution.
• If you have a history of cold sores, the doctor may discuss a preventive measure before the injections.
• Please tell the doctor about any recent or planned dental treatment, and any recent or upcoming vaccination, as the doctor may suggest different timing for the injections.
• If you have an important event coming up, mention the date during the consultation, to allow enough time for swelling and bruising to settle.
• It helps to arrive without lipstick or make-up around the mouth.

After the session and possible side effects

Common effects, usually temporary:

• Swelling of the lips, which may be more noticeable in the days straight after the injections.
• Redness or tenderness at the injection site.
• Bruising.
• Small lumps or slight unevenness, which often improve as the swelling settles.

Less common effects:

• Infection or inflammation at the injection site.
• A cold sore flare in people with a previous history of them.
• An allergic reaction.
• Nodules or swelling that appear some time after the injections.

Rare but serious effects:

• Blockage of a blood vessel by the injected material, which can damage the skin and, very rarely, affect vision.

Contact the clinic immediately, or seek urgent medical care, if you feel severe or increasing pain, notice a change in skin colour in or around the lips (pale, bluish or dusky), or notice any change in your vision.

Aftercare instructions may include not pressing on or massaging the lips unless the doctor advises it, and avoiding strenuous exercise, intense heat and make-up on the area for a period the doctor specifies.

The doctor explains the full list of risks during the consultation.

Limitations

• Results vary from person to person and cannot be predicted precisely in advance.
• The effect is temporary; the product breaks down at a rate that varies with the person and the type of material, and filler in the lips may break down at a different pace from other areas because the lips move so much.
• Filler cannot change the underlying structure of the lips, teeth or jaw, and the result depends on each person's natural shape.
• In some cases the doctor can dissolve hyaluronic acid filler; that procedure has its own risks, and it does not apply to every type of filler.
• The doctor may advise against injections in situations including: infection, an active cold sore or inflammation in the area, pregnancy or breastfeeding, some autoimmune conditions, an allergy to the product's components, previous injected material of unknown type in the lips, or expectations the procedure cannot meet.