Lip augmentation: Compare practices from our network

Lip augmentation adds volume, shape or definition to the lips, most often with an injectable hyaluronic acid filler. It can also soften the fine vertical lines around the mouth that many people notice with age.

Hyaluronic acid occurs naturally in the body, and the fillers made for lips are softer than those used to build up cheeks or a jawline. Because they are hyaluronic acid based, they can be dissolved with an enzyme called hyaluronidase if a problem arises or you don't like the result. Some practices also offer fat transfer to the lips, which lasts longer but involves a small procedure to collect the fat.

Lip filler is used to:

• Add volume to thin lips or lips that have thinned with age
• Define the lip border and Cupid's bow
• Balance the upper and lower lip, or soften a mild asymmetry
• Smooth fine vertical lines around the mouth

Lip filler adds volume and definition. It does not:

• Last permanently, so keeping the result means repeat treatments.
• Relax the muscles behind expression lines, which is what anti-wrinkle injections do.
• Guarantee symmetry, since few lips are perfectly symmetrical to begin with.

Consultation. Your injector looks at your lips in proportion to the rest of your face, asks what you would like to change, checks your medical history and allergies, and photographs your starting point. In Sweden, the law requires spoken and written information about the treatment and a reflection period of at least two days before it can go ahead.

Preparation. Avoiding alcohol and blood-thinning supplements beforehand reduces bruising. Mention any previous lip filler, including where it was done and which product was used.

Numbing. A numbing cream is applied, and most lip fillers contain lidocaine, a local anesthetic. Lips are sensitive, so some clinics also use a quick local anesthetic on the inside of the lip.

Injection. Small amounts of filler are placed with a fine needle or a blunt cannula, checking shape and symmetry along the way. The injecting usually takes 15 to 30 minutes; allow up to an hour at the clinic in total.

Lips often feel firm, swollen or tender at first. Swelling usually peaks in the first 48 hours and settles within about a week; a cold pack and sleeping with your head raised can help. Bruising is common and temporary. Most people go back to work and normal activities straight away.

• Avoid strenuous exercise for 24 to 48 hours
• Wait about 24 hours before wearing lipstick or gloss
• Avoid saunas, sunbathing and extreme cold until swelling and redness have gone
• Don't massage or press your lips unless your injector asks you to

Review. A follow-up at around two weeks, once swelling has settled, is the fair point to judge the result and make small adjustments.

Results are visible straight away, but early swelling makes the lips look fuller than they will settle. Most people can judge the result after one to two weeks.

Hyaluronic acid lip filler is temporary. The practices in our network quote about six to twelve months, depending on the product, the amount used and the person. Lips move all day, so filler there tends not to last as long as in the cheeks or jaw. Keeping the result means repeat treatments, and filler placed conservatively should not permanently stretch the lips.

Most side effects are mild and short-lived, but lip filler carries one rare and serious risk that everyone should understand before treatment:

• Swelling and bruising, common, peaking in the first two days and usually settling within about a week.
• Lumps or unevenness, small lumps or asymmetry can occur. Hyaluronic acid filler can be adjusted or dissolved.
• Migration, filler can move beyond the intended area, such as above the lip border.
• Vascular occlusion, rare but serious, when filler blocks a blood vessel. It can damage the skin and, very rarely, affect vision, and needs treatment straight away, usually with hyaluronidase.
• Infection, uncommon, and treated promptly by the clinic.
• Delayed reactions, occasionally, swelling or firm lumps appear weeks or months later, sometimes after an illness, a vaccination or dental work.
• Allergic reaction, rare. Tell your injector about any allergies, including to lidocaine.