Lip implants add volume and definition to one or both lips. This cosmetic surgery is a permanent alternative to injectable fillers, like Juvéderm and Restylane. It also offers more predictable results than fat transfer and more plumping than a lip lift.
Solid silicone lip implants like PermaLip (the go-to silicone implant) are soft to the touch, so they feel more natural than implants made with Gore-Tex, a type of Teflon.
All lip implants are available in different sizes. Their size and shape can also be customized to your anatomy and desired results.
While implants of the past were intended to create large lips, they now provide a more understated, natural-looking volumization, says Atlanta-based facial plastic surgeon Dr. Mike Majmundar. “We’ve learned that people don’t want large lips—they want lips to have more volume and plumpness than they do now, but also look natural.”
With all the advantages of lip implants, they’re not without risks and drawbacks. Read on to learn more about their benefits and potential complications.
Pros
Cons
Injectable lip fillers are a more popular lip augmentation option than implants, but it’s worth comparing the two. These are the key differences to consider:
The price you pay for lip implants will depend on your surgeon’s level of experience, their practice location, and a few other key factors.
The lip implant photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.
According to Dr. Majmundar, the patients he sees most often for lip implants have had lip augmentation with injectable dermal fillers in the past and are now:
“We used to see people over 50 as the most common demographic for lip implants, because they were tired of the expense and years of recurrent injections, but now—with the boom of social media sites like Instagram and improved awareness of lip implants—most of the people seeking out lip implants are in their 20s to 40s,” says Dr. Majmundar.
Another advantage of PermaLip implants is that lip filler can be injected over the implant, to give people even fuller lips, if they desire, or create more precise shaping.
“I would say very few people do that, because they’re happy with their natural-looking implants,” says Dr. Majmundar.
“PermaLip implants are soft, flexible silicone tubes, tapered at each end, that augment without shaping,” explains Dr. Steve Laverson, a San Diego plastic surgeon.
As the name implies, PermaLip implant results can be permanent, though “they’re easily removed if you don’t like them or if you have a problem such as migration, asymmetry, capsular contracture [a hardened capsule of tissue that can form around an implant] with immobility of lips, or a disappointing result.”
If you're considering PermaLip implants, it's important to be aware that they’re not approved by the U.S. Food & Drug Administration (FDA) for use in the lips.
Surgisil, the company that manufactures PermaLip, has FDA clearance for the Perma Facial Implant, with an indication for it to be implanted in the chin, jaw, and nose.
According to a warning letter the FDA sent to the company in April 2019, “use of the Perma Facial Implant for augmentation of the lips constitutes a major change/modification to its intended use for which you lack approval.”
The specific concern is that the physiological and anatomical differences between the lips and the nose, chin, and cheeks (lack of bone structure, for instance) allow the implant to “free float," which “may cause migration or protrusion of the implant.”
Indeed, some RealSelf members have reported that their lip implants have migrated or protruded.
Another issue, according to the FDA: “Since the lips are very actively used, the free-floating nature of implanted devices exacerbates risks such as device extrusions, which, when they occur, may require surgical removal and extensive dermal repair. Migration and protrusion also increase other risks to the patient, such as infection and chronic pain.”
Because the PermaLip implant is not cleared or approved by the FDA for marketing in the U.S., the FDA requested in its warning letter that Surgisil immediately stop distributing the device for use in the lip.
A disclaimer on the company website says that “the intended use of the PermaLip Product is not approved for distribution within the United States,” but it’s still featured on the company website and sold to plastic surgeons, many of whom mistakenly say on their websites that PermaLip is FDA-approved.
“The vast majority of plastic surgeons rely on PermaLip as the go-to implant material,” says Dr. Majmundar. While Gore-Tex can be used, results are less reversible and lips usually feel firmer.
“If a patient with Gore-Tex is referred to my practice for implant removal, I usually turn them away—or I have a long discussion with them prior, to help them understand that the scar tissue induced by Gore-Tex will bind to the implant. This makes the implant much harder to remove and increases the chances that the lips will look deformed afterward.”
According to Dr. Majmundar, silicone implants are easily placed and easily removed, making the procedure completely reversible, without any lasting deformity to the lip.
A lip implant procedure usually takes less than an hour. Here’s what to expect:
RealSelf Tip: Your surgeon will recommend an implant size based on the thickness of your lip skin and desired result. “While most older patients with thin lip skin do well with the three millimeter implant, the majority of my patients have the four millimeter implant inserted,” says Dr. Kevin Ende, an Englewood, New Jersey, facial plastic surgeon.
“Four millimeters is the largest size recommended to put in the first time, since some lips may not be able to accommodate anything larger," says Dr. Ende. "Once full healing has taken place, the implant can be easily upsized to a five millimeter implant, if the patient desires fuller lips."
You'll need up to three days of downtime before you'll feel and look enough like your usual self to resume your normal activities.
One RealSelf member says that her lips “were super-swollen the first two days—I’m talking Scarlett Johansson having an allergic reaction kind of swollen.” Talking, smiling, and drinking were a struggle for a few days as well, she says.
The most common side effects of this surgical procedure are swelling, bruising, or asymmetry, which can persist for up to a week. You can also expect significant soreness, especially the first day.
Your surgeon may prescribe pain medication for the first day or two; over-the-counter options may be enough to keep you comfortable after that. Gently icing your lips and elevating your head can also help reduce swelling.
After the first week, you’ll still have noticeably fuller lips, but the bruising will have faded and your lip shape may look more even.
Most of the swelling should be resolved within a month, and you should start to see your final results.
Your surgeon will give you postoperative care instructions, to promote healing and reduce the risk of complications.
Doctors usually recommend:
After two months, one RealSelf member reported that she loved the result. “My friends think I look younger. For the first time in my life, I enjoy putting on lipstick!”
Others, however, have been disappointed with the subtle change in their lips after the swelling went down.
During your consultation, be sure to discuss your “wish lips” with your provider so that your final result is sufficiently full and voluptuous. Photos can help ensure that your expectations are realistic and you’re on the same page as your surgeon.
Implants can be felt the most during the first three to six weeks of recovery time, when your body is forming a protective collagen capsule around the implant, Dr. Majmundar explains. “Once that forms, the lip continues to get softer and more natural feeling over a period of four to six months.”
According to RealSelf member jesicat, “After about a month, it feels completely normal. You can feel the implant in there, but it kinda becomes a part of you.”
Patients who start with very thin lips might not have enough soft lip tissue in their lips to provide a cushion over the implant, so they may feel the implant for much longer.
Dr. Majmundar believes that lip implants are safe. Like many other plastic surgeons, he was using PermaLip implants well before the FDA warning and continues to do so. “It seems to be very safe in my practice,” he says.
Still, they do come with risks, side effects, and potential complications. These include:
PermaLip implants are designed to be permanent, with no need to be replaced—though they can be removed in the event of a complication or if you want to return to your natural lip size.
Updated July 19, 2023