Thin Lips

A lip flip uses Botox to relax the orbicularis oris so the upper lip turns outward and shows more of its own pink, while lip filler uses hyaluronic acid gel to put back an edge and a substance that are no longer there. The difference is position against material. In a study of seventeen women given a standard four-unit lip flip, upper lip height had increased at fifteen days and the volume of the lip had not changed at all, which is the whole mechanism in one line: the same lip, sitting differently. Filler does the opposite. It adds gel along the vermilion border to rebuild the edge, or through the body of the lip to replace what thinned, and the lip afterward holds material it did not hold before. The two suit different starting points. A lip flip helps an upper lip that is short or that rolls inward on a smile, because what is hiding the pink is the position of the muscle. Filler helps a lip whose border has softened, or a lip that was built with a narrow band of colour and needs more than a change of position. A systematic review of the lip flip found the technique settled on four to six units into the orbicularis oris, with mild and short-lived effects such as difficulty whistling or drinking through a straw. Neither is permanent, and which one fits is a judgement made by looking at one particular lip at rest and on a smile.

The overdone look comes from ignoring the proportions of the lip being treated, not from the filler itself. It happens when volume is added through the body of the lip without re-establishing the vermilion border, so the lip pushes outward with no defined edge, or when a fixed amount of filler is used regardless of the width and curve of the mouth it is going into. A lip that already has good proportions and needs only its border restored looks nothing like a lip that has had volume added without regard for its own shape. Timing contributes too. Hyaluronic acid filler swells for the first few days after injection, and a photograph taken in that window shows something fuller than the settled result at two weeks. A measured, border-first approach matched to the shape of the lip is what keeps a corrected lip looking like a lip, and that is a judgement made at consultation on the specific lip involved rather than a fixed technique applied the same way to everyone. It is also why two people who both ask for a natural result can end up with genuinely different amounts of filler. Two things make the outcome less final than it looks. Hyaluronic acid can be dissolved with an injection of hyaluronidase, so an overfilled lip is not a permanent state, and a lip can be built in stages, with a smaller amount placed and looked at before any more is added.

Hyaluronic acid filler runs six to eighteen months across the face and sits toward the shorter end of that in the lips, and as the gel breaks down the lip goes back to the shape it had before. Published reviews put the range at four to eighteen months depending on the product, the technique and the person. The reason lips sit low in the range is movement: talking, eating and smiling work the orbicularis oris constantly, and the same gel placed in a cheek or along a jawline, which move far less, holds longer. Nothing about the fade is abrupt. Filler integrates with the tissue around it and breaks down gradually, so a lip softens over months rather than deflating on a particular day, and a repeat treatment booked before the previous one has fully gone keeps the look steadier than letting it wear off completely each time. The result also does not arrive all at once. The change is visible as soon as the appointment is over, lips swell more than any other area filler is placed in, and the shape you keep shows at about two weeks once the swelling has resolved and the gel has settled. If you decide you do not want it before then, hyaluronidase dissolves hyaluronic acid filler, and the effect of that enzyme is visible within a day or two. Nothing about the lip is worse for having been treated when the filler has gone.

Because the vermilion border has softened, and that raised edge is what held the colour in place. Outlining the coloured lip is a pale ridge two to three millimetres wide called the white roll, formed by the orbicularis oris bulging underneath it. When researchers compared young and old upper lips under the microscope, they found the angle of that muscle at the vermilion border widened with age, alongside thinner skin and broken-down collagen and elastic fibres. The ridge flattens, the line between lip and skin blurs, and colour that used to stop at the edge travels into the fine vertical lines in the skin of the upper lip. Those lines come from the same two sources as everything else here: the orbicularis oris folding the skin in the same places every time the mouth purses, and ultraviolet light breaking down the collagen and elastin that let the skin spring back. Lip liner drawn on or very slightly outside the natural border is the answer that costs nothing, and it works for exactly as long as it stays on. Filler placed along the border itself is the treatment that answers the same thing, because it rebuilds the edge rather than drawing one. A lip in this position may need nothing placed through the body at all, and the border on its own may be the whole treatment.

What it costs depends on which treatment the lip needs and how much of it, so a figure quoted before anyone has looked at your face would be a guess. The cost of a lip flip follows the number of Botox units used, which follows how much the muscle needs to relax; the published technique sits at four to six units, and it is a small treatment. The cost of filler follows how much border and how much body the lip needs. Someone correcting an edge that has gone soft is in a different position from someone replacing substance across the whole lip, and someone whose lip was built with a narrow band of colour is in a third position again. Some people have both, a lip flip for the roll of the upper lip and filler for the border, which changes the arithmetic once more. Duration belongs in that arithmetic. Botox holds for roughly three months before the nerve endings regrow, while hyaluronic acid filler in the lips runs toward the shorter end of a six to eighteen month range, so the two do not come round for repeating on the same schedule and comparing them on the price of one appointment misses what actually adds up across a year. Consultations are complimentary at both Lucie Mé clinics, in Yorkville and at Fairview Mall.