Overfilling During Lip Augmentation?

I remember several friends in the early ‘90s getting Collagen injections (one had lips done, the other cheeks). biggest complaint: overfilling. Over 10 years later is this still an issue with new dermal fillers like Restylane? I want a lip aumentation but can't afford to hide away as things shrink back to normal-looking.

Doctor Answers (13)

Lip augmentation and plumping lips with fillers


Lip augmentation is a very popular procedure these days, and can really brighten up a face when done well. The hyaluronic acid fillers such as Restylane, Juvederm, and Prevelle do not require overfilling. You pretty much walk out knowing what your lips will look like. You will have swelling for the first 2-3 days, but not to the degree where you look abnormal or obvious. Depending on the injection technique, you can also get some bruising (more common when injection is into the "pulp" of the lip rather than the "white roll" or the border of the lip).

I think the key to natural looking results is really analyzing the natural shape of your lips and tailoring the lip augmentation to a shape that fits your face. There are some key technical points in avoiding the "duck bill" look, or the "wormy" look. A lot of well done lips are the ones you don't recognize as augmented. Also, if you are tight on money and not sure you will like the results, you can always try a filler like Prevelle, which is cheaper but doesn't last as long.

Good luck!

Beverly Hills Plastic Surgeon
4.5 out of 5 stars 10 reviews

Overfilling and lip augmentation


 Overfilling happens because of a misreading of what the real problem is.

The upper lip has the inner layer attached to your gums. The outer skin layer slides down with the rest of the skin as the skin ages. The skin then acts like a descending curtain that progressively hides the red layer of skin. 

If you plump up the red layer the lip then gets longer. As you close your mouth it runs into the lower lip and has nowhere to go but forward. Thus you get fish mouth or duck lips. Check out the video below for more details, and follow the link below for some results pictures

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 39 reviews

Overfilling lips with filler


This is a common issue and I totally understand what you are saying. My patients want to look normal and good at all times; no ups and downs. Our motto is "did she or didn't she". Therefore, I do not overfill the lips when using fillers. I make it look perfect in the office; the patient comes back to touch it up just when the fullness starts to decrease. This approach requires more office visits for the patient but they look great all the time. Also, I use Juvederm, which seems to last the longest. Hope this helps.

Tracy M. Pfeifer, MD

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
5.0 out of 5 stars 15 reviews

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Avoiding Overfilling During A Lip Augmentation



With the dermal fillers that are currently available, patients can decide exactly how they want their lips to look. But keep in mind that the outcome of lip augmentation or any other cosmetic procedure really depends on the skill of the doctor. If you are worried about people noticing a drastic change when the injection wears off, it would be best to choose the most natural looking lip enhancement options. This not only includes your choice of filler, but also requesting that your doctor does not overinject. Dermal fillers like hyaluronic acid (e.g. Juvederm and Restylane) give natural looking results. Hyaluronic acid is a natural compound that is already in your body. It provides volume and hydration because the molecules can hold a lot of water. Juvederm will disperse into your lips, while Restylane will need the doctor to manually shape the gel once it is injected. Here is a patient who also did not want an overly filled look. She had Juvederm injected which gave very natural looking results.



Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
4.5 out of 5 stars 15 reviews

Over filling is no longer done in lip augmentations


Years ago collagen had to be overfilled but the hyaluronic acid fillers such as restylane and juvederm do not require overfilling and run about $550 per syringe to give a natural soft lip.

David Hansen, MD
Beverly Hills Dermatologic Surgeon
5.0 out of 5 stars 24 reviews

Avoiding overfilling during lip augmentation


The fillers used for lip augmentation now are Hyaluronic Acid gels - mostly Juvederm and some Restylane.

Most people have some initial post injection swelling because hyaluronic gels are "hydrophilic" and work by absorbing and holding onto water. When Hyaluronic Acid gels are first injected, they seek a balance between the water in the gel and the water in your own tissue.

This is one reason some people tend to have more swelling and others less or none.

The nice thing about the gels is that it is fairly easy for an experienced dermatologist or surgeon to estimate how much will give a natural-looking lip --- without overfilling.

Overfilling with collagens in the "old days" was done mostly to give a longer duration since the bovine collagens broke down so quickly. We've all come a long way in learning how to use fillers in the best way.

I'm forever teaching that the entire mouth area needs to be considered when planning a lip augmentation. If the surrounding areas are too off-proportioned to the new fuller lip, then it all can look odd.

Surrounding and adjoining areas to pay attention to when considering lip augmentation:

  • Area above upper lip
  • Lip border
  • Philtral columns
  • Mouth corners
  • Chin (sometimes)
  • Naso labial folds

Rebecca Fitzgerald, MD
Los Angeles Dermatologist
4.0 out of 5 stars 17 reviews

Precision in lip augmentation with new fillers


Great question. In general most lip augmentations are being performed in the office under local anesthesia using a hyaluronic acid based gel. I utilize Juvederm which I find is more form stable than others. The fill volume is basically one to one so I do not overfill, though there is a period of swelling which lasts for 4 to 14 days. I emphasize the use of ice after to help decrease this, as well injection technique helps as well.

There are different regions in the lips for injections, including the upper "roll" and lower red mucosa which can be addressed separately depending on the deficiencies and desires of the patient. Good luck and I hope this helps.

Andrew P. Trussler, MD
Austin Plastic Surgeon
4.5 out of 5 stars 11 reviews

Hyaluronic acid fillers have options for great results


Hyaluronic acid fillers like Restylane, Juvederm, Perlane, etc. are a great for augmenting the lips. They allow accurate filling and you always have the options of using enzymes to dissolve the fillers for accurate touch ups. I have an approach that allows me to manipulate the fillers based on how long the fillers were injected. So poor results should be a thing of the past. Also, a knowledge of facial aesthetics is indispensable.

Philip Young, MD
Bellevue Facial Plastic Surgeon
3.5 out of 5 stars 29 reviews

Less is better with lip augmentation


The most skilled physician injector is one that would aim to achieve natural and subtle rejuvenation of the lips. Less is better with lip augmentatoin. Fantastic cosmetic results can be achieved simply by accentuating vermilion lip lines/contours utilizing hyaluronic acid filler such as Restylane or Juvederm. Subsequent augmentation of the 'meat' of the vermilion may be pursued as needed.

William Ting, MD
Bay Area Dermatologic Surgeon
5.0 out of 5 stars 7 reviews

Overfilled Lip Augmentation with Restylane, Juvederm, Collagen


Overfilling can occur with any type of lip augmentation. The real key is not necessarily overfilling, but filling to a volume that is not harmonious with the face. Since facial characteristics vary, it is important to discuss your aesthetic concerns and goals with your plastic surgeon prior to injection.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 46 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.