Despite the media's scandalized reaction when Kylie Jenner finally admitted to having lip fillers last May, lip augmentation procedures have exploded in popularity over the past few years — especially for people in the 20- to 30-year-old age range. The tools and methods of lip enhancement have advanced to the point where almost everything is reversible and the risk of allergic reaction, especially for injectables, is almost zero. We spoke to a dermatologist and a surgeon to get all the details on lip augmentation for those considering it. Temporary lip fillers are the best option for those new to the plumping process, so we have focused our explainer exclusively on that approach unless noted otherwise.
Read on for everything you'll need to know before, during and after lip augmentation treatments.
FIND AN EXCELLENT DOCTOR
"It's science and art when it comes to lip injections," says Dr. Marina Peredo, a board-certified dermatologist who has offices in Manhattan and Long Island. "My expression is: it's not what's in the needle, it's who is behind the needle." The lips are one of the most delicate parts of the face and require the attention of a doctor with many years of experience. Dr. Peredo advises to do research online, listen to recommendations from friends and avoid Groupon deals or anything shady. Dr. Jeffrey B. Wise, a board-certified facial plastic and reconstructive surgeon with offices in Manhattan at JTAV Clinical Skincare and New Jersey, agrees. "It's important to ensure that the doctor is board-certified. I think someone who concentrates exclusively on facial aesthetics is probably a plus." Check online reviews, too. "It's not a guarantee, but it's certainly an indication that that doctor does generally good work."
WHAT'S IN THE NEEDLE?
"Generally speaking in 2016, most people inject the hyaluronic acid compound and those consist of brand names like Juvederm, Restylane, Restylane Silk or Belotero — there are tons out there but those are the big ones right now," says Dr. Wise. He favors Juvederm Ultra Plus because it's smooth and predictable, while Dr. Peredo likes to use Juvederm and/or Restylane Silk, depending on the patient's goals. Hyaluronic acids have a gel-like quality to them and fill in deficient volume in the lips. They are natural and very safe — Dr. Wise says out of the 25,000 to 50,00 people that he's injected, no one has had an allergic reaction. The brand names are essentially all the same, so Dr. Peredo says they have different personalities. She uses Juvederm for volume and Restylane Silk to add structure, especially for older patients who want more definition on the lining of the lip or vermilion border. "I call it a lipstick in a syringe, so when it's injected into the lip itself it will not necessarily make the lips fuller, but it will make the lips very, very smooth," she says.
The body breaks down the acids slowly over time. Dr. Wise says patients usually come back to see him five or six months after their last treatment, but it can be as early as three depending on your body. Dr. Peredo puts the timeline at six to nine months. She says injectables in the lining last longer over time because the body is spurred to increase collagen production, while volume injections in the body of the lip don't have a cumulative affect.
YOUR LIPS WILL RETURN TO NORMAL IF YOU WANT TO STOP
If you want the lip filler removed faster for whatever reason — say you don't like the look — a doctor can inject a compound called hyaluronidase, which immediately reverses the effects.
And, if you decide to discontinue using lip fillers, your lips won't look like deflated sausages. "Generally speaking, [after] whatever augmentation you might get from a lip filler, the lip and the lining of the lip retracts back to its normal shape," says Dr. Wise. It just depends on how long it takes for your body to break down the hyaluronic acid.
HOW PAINFUL WILL IT BE?
Not that painful. Most doctors apply a topical anesthetic beforehand and there is often a bit of anesthetic in the needle itself. Dr. Peredo says she might only need to do four to six injections if a patient just wants volume, while attention to the lining of the lip could require more pricks — somewhere around 20.
The procedure depends completely on the doctor, and Dr. Wise uses a different approach. "We actually don't use needles: we use something called canulas," he says. A canula is a blunt device or tube that looks like a needle but isn't sharp. After inserting two tiny needle sticks into the corners of the mouth, he introduces micro-canulas that glide through a special plane of lip. It sounds complicated but Dr. Wise says "it's quite comfortable" and results in less swelling and bruising.
No matter the technique doctors use, there is a degree of swelling and sometimes bruising. But it should only last a few days, a week at the very most. Dr. Peredo says it's not a good idea to get lip fillers a week before a big event; give the lips time to settle. She recommends no alcohol, exercise or kissing for 48 hours. Dr. Wise recommends sleeping slightly elevated for a few days and always prescribes homeopathic preparations like arnica montana to help the bruising and swelling resolve faster. Both said cold compresses help, too.
RETAIN THE PROPORTIONS OF THE LIP
The best way to avoid looking like a Real Housewife of Sausage-Lip City is to ease into lip filling and always maintain proportion and balance. This is why it's key you find an experienced injector: Dr. Wise says that naturally, the bottom lip is two-thirds bigger than the top lip and that ratio needs to be maintained as you add fullness. Symmetry is also important. "The sides of the face could be sisters, but the sides of the lips have to be twins — if you are a little bit off it's really noticeable," says Dr. Peredo, who has turned away patients who have wanted too much filler.
Both doctors also recommended conservative doses in early visits, advising patients to come back a few weeks after their first session to confirm they like the look and understand how much amplification they actually want.
IT'S NOT CHEAP
The cost of each treatment varies by doctor, geographical location and complexity of the procedure. In Manhattan, where prices are always higher, the doctors estimate the cost to run anywhere between $600 to $2,000 per treatment. (A single treatment could constitute multiple sessions, especially in those earlier visits, says Dr. Peredo.) Regardless, it's a pricey habit.
PERMANENT LIP AUGMENTATION
For those committed to lip enhancement for the long term, a permanent solution is both more economical and less time-consuming. Patients would need to see a surgeon like Dr. Wise, who favors solid silicone lip implants from the brand PermaLip. The implants come in three volume sizes that can be adjusted for the length of the mouth and he inserts them through a two-millimeter incision in each corner of the mouth. Dr. Wise uses local anesthesia and patients can expect more swelling and bruising than with temporary fillers. The silicone can last a lifetime but a full removal isn't a big production because unlike silicone or fat injections, it's a solid piece that can be removed the same way it was inserted and in a matter of minutes. "[The implants are] a lot more popular than they used to be because they are so fully reversible," says Dr. Wise. Lip implant prices range from $3,000 to $5,000.
In conclusion: if you have the money and are more than a little bit curious about how your lips would look fuller or more defined, now's a pretty good time to try lip augmentation. Odds are, more than a few people you know already have.