21 Sep 2023 | by Leonard Miller, MD, FACS, FRCS

Your lips are an integral component to a vibrant, rejuvenated look. They help anchor the lower third of your face, and provide a critical counterpoint to your forehead and brow. Some people are born with lips that are too thin and out of proportion. But the size of your lips can also be affected by lifestyle choices such as whether or not you smoke as well as age. Just like the skin and tissues on the rest of the body, your lips lose volume as the number of birthday candles on your cake increase. Restoring some of this volume with an appropriate, and properly placed, filler is one of the best ways to achieve fuller, natural looking lips. However, there are other issues that may be affecting your smile which is why your first step should always be to schedule an in-person consultation.

Your lips are an integral component of a vibrant, rejuvenated look.

Lip Fillers Consultation

If you spend any time on social media then you know that a fuller pout is very en vogue. I love the fact that the web allows people to educate themselves about aesthetic procedures. The problem is that there is no nuance. The lip augmentation with fillers procedure is talked about so much online that many think that it is the go-to for achieving fuller lips. While it can be the ideal option if loss of volume is your issue, every patient is unique.

This is why it is really important to not make assumptions and to be assessed in-person, preferably by a Board-Certified dermatologist such as myself, or a Board-Certified Plastic Surgeon like my colleagues here at the Boston Center for Plastic Surgery. During your lip augmentation consultation, I will listen closely to what is bothering you about your mouth. Patients will often think that they need more volume in their lips when, instead, the issue is actually with their smile.

Ideal Candidate for Lip Augmentation

The ideal candidate for an aesthetic lip procedure is anyone in good overall health who is bothered by a:

  • Loss of volume in the upper and/or lower lip
  • Upper lip seems to disappear when smiling
  • Has a “gummy” smile

While lip procedures may be more popular with women, many men come in to see me to discuss their lips. Furthermore, this is a procedure for patients of all ages. Typically, 20 something patients are mostly concerned about increasing volume, sometimes to the point where it no longer looks natural, while my older patients are more about restoring harmony.

Lip Augmentation with Fillers 101

No face exhibits perfect symmetry. Furthermore, the upper and lower lip are never equal in size. While there used to be talk of the “golden ratio” in terms of facial proportion, there really is no longer a standard when it comes to the lips. The appropriate ratio of your upper lip to lower lip is going to depend on both your ethnicity and preference. As discussed, some patients are simply born with lips that are out-of-proportion. For others, it comes down to aesthetics. The problem with the latter, of course, is that tastes change so one of the nice things about a lip augmentation with fillers procedure is that the results are not permanent. And if for any reason you don’t like what you see, this procedure is also reversible.

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The key to a safe, naturally looking result with filler in the lips is threefold:

  • Choosing the right filler or fillers
  • Not injecting too much product
  • Proper placement 

I use a range of fillers in my lip augmentation procedures. The ones with more structure are ideal for the vermillion border or edge of your lips while ones that are softer are better for the pillows of your lips.

Botox® for Improving Your Smile

However, your dissatisfaction with the appearance of your mouth may not be about your lips at all. When a patient doesn’t like his or her smile, it is often due to the fact that the:

  • Upper lip seems to disappear when smiling
  • Gums are overly prominent, referred to as a “gummy smile”

A neurotoxin such as Botox® is my procedure of choice for addressing both of these issues. For a disappearing upper lip, I will perform a lip flip procedure in which I place an appropriate amount of neurotoxin into the upper lip to relax the muscles. This causes the lip to flip upwards, making it appear fuller.

To improve the appearance of a “gummy smile”, Botox® is injected into the muscle between your upper lip and nose. This prevents the upper lip from rising as high when you smile thus exposing less of your gums. Both of these simple fixes can have a profoundly positive effect on your self-esteem. Smiling not only brings joy to others, but also to yourself. Being able to help a patient smile again is one of the many reasons that I love my job.

To find out more about a lip augmentation at the Boston Center for Plastic Surgery, contact us today or call (617) 735- 8735 to schedule a consultation.


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