Types of Lip Fillers

Author

Dr. Stephen Cosentino

PRESIDENT OF EMPIRE MEDICAL TRAINING Lip augmentation is among the most common and affordable cosmetic procedures because lip fillers themselves are so common and affordable. The most widely used temporary types of lip injection (hyaluronic acid) enables millions of successful lip volume enhancement procedures each year for everyday people, not just the rich and famous. Needless to say, this is welcome news for patients seeking fuller, more natural-looking lips — and clinicians eager to add this popular procedure in practice. Any comprehensive dermal filler training program should include detailed instruction in lip fillers (a type of dermal filler) and injection techniques. This guide is merely an overview for plastic surgeons and other board-certified clinicians interested in adding temporary or permanent lip augmentation to their practice.

Guide to Lip Filler Types

The following sections cover:

• Hyaluronic acid, the most common type of lip plumping filler
• Lip filler brand names, such as Restylane® and Juvederm®
• The outcomes, benefits, and possible downsides of lip filler treatments
• The possible side effects of lip fillers
• Alternatives to temporary lip fillers, including lip implants and grafts

Lip Filler Compounds and Brand Names: Outcomes, Benefits & Downsides

The most common compound used in temporary lip fillers is hyaluronic acid (HA). Fillers containing calcium hydroxylapatite are more commonly used in peri-lip wrinkles and naso-labial fold treatments but can be used in lip filler treatments. Hyaluronic acid occurs naturally in the body, reducing the risk of serious allergic reaction. Results may be visible immediately, allowing clinicians to adjust dosing and injection placement in real-time to achieve desired results, though certain brands of hyaluronic acid-based fillers can take several days to show results. In any case, the relative safety and ease of injection of hyaluronic acid lip fillers allows for incremental treatment spanning several office visits in a period of weeks. HA fillers produce natural-looking volume enhancement. Any post-treatment bumps or irregularities should dissolve on their own without further intervention. The most notable downside to HA fillers is their impermanence — results last no more than two years, and often not that long, even with follow-on touch-up treatments. Restylane and Juvederm are the best-known HA lip filler brands on the U.S. market. Both are formulated to durably but temporarily produce fuller, smoother lips.

• Restylane®: Restylane Silk is approved by the FDA for lip augmentation procedures and other cosmetic indications around the mouth. Its gel is smoother than other Restylane variants, making it ideal for fine work in the lips and mouth, and contains the local anesthetic lidocaine. Its lip-enhancing effects generally last for 6 to 12 months, possibly longer for patients who receive in-office touch-ups at 6 to 9 months. The initial procedure should take no longer than one hour.
• Juvederm®: Two Juvederm products are FDA-approved for lip augmentation: Juvederm Ultra XC and Juvederm Volbella XC. Like Restylane Silk, both formulations contain lidocaine. Results are comparable in appearance and duration to Restylane Silk, with visible enhancements persisting for as long as 18 to 24 months with post-treatment touch-ups.

Though popular in the past and appreciated for more durable (if still temporary) results, collagen lip fillers are much less common today than HA lip fillers. This is partly because HA fillers hydrate the lips while adding volume, creating a more natural appearance of fullness than collagen (which doesn’t draw water into the lips).

Filler Types and Possible Side Effects

Temporary lip or face filler injection is an outpatient procedure that does not require general anesthesia or internal surgery. It is widely regarded as a safe, effective cosmetic procedure. That said, no cosmetic procedure is completely without risk. All clinicians and patients should be aware of the possible side effects of face fillers and lip fillers. These effects can vary by filler type and tend to be mild and transient, lasting no more than three to four days:

• Swelling or bruising around the injection site
• Redness or itching at or around the injection site
• Bleeding at the injection site
• Cold sores

More serious side effects are rare but may require medical attention if they persist:

• Lumpy, irregular, or asymmetric lips (developing after injection)
• Severe swelling or bruising that persists for longer than a week
• Infection accompanied by fever (requires prompt medical attention)
• Stiffening of the lip
• Scarring or chronic bleeding
• Severe swelling or extreme itching around the lips (requires prompt medical attention)

Lip Implants and Grafting: Alternatives to Temporary Lip Fillers

Temporary lip fillers like Restylane and Juvederm are not the only lip augmentation options available in outpatient settings. Patients seeking fuller lips and clinicians eager to expand their aesthetic practices should consider longer-lasting alternatives like lip implants and fat or tissue grafts. Like temporary lip fillers, lip implants and grafts are nonsurgical options that do not require general anesthesia. However, as they are effectively permanent and do involve changes to the body that can result in scarring, clinicians need to thoroughly apprise candidates of their risks and implications before proceeding. Lip implant and graft procedures are considerably costlier than temporary lip filler injections, although the cumulative cost of temporary lip filler injections can exceed the one-time cost of implants or grafts over a lifetime of treatment.

Lip Implants

Permanent lip implants are not marketed as lip fillers, but they do increase the volume and full appearance of treated lips. Permalip, a popular choice, is a smooth silicone implant that is FDA-approved for use in the nose, chin, and jaw, though importantly not the lips themselves. Lip implants last for years and need only be removed in the event of serious complications from the implantation procedure or degradation of the implant itself (both of which are rare). However, they are not appropriate for people with very thin lips and are subjectively less natural-looking than temporary fillers.

Lip Tissue Grafts

A lip tissue graft transfers the lower layer of skin (dermis) from another part of the body, most often the abdomen, to the lips, creating a fuller and more lifelike appearance. A lip tissue graft may also be performed as part of a surgical facelift that results in some skin being removed from the face. The dermis is used as a cylindrical filler inside the lips, similar in shape to a silicone implant, rather than a flat layer on top of the existing lip tissue.

Lip Fat Grafts

A lip fat graft transfers fat from the abdomen into the lips, achieving similar results as a lip tissue graft with less scarring at the site where the fat was removed. Because the fat needs to be processed before insertion into the lips, this procedure can take longer than a tissue graft, but is still performed as a same-day in-office procedure.