Thin Lips

If you’ve never had lip augmentation before, go with the temporary option first: lip injections. “You don’t know if you’re going to like the look,” says Dr. Tornambe. “I’ve even used saline water—which goes away in a few hours—first, just to show a patient what they can expect.” 

If you like the look and want a more permanent solution, talk to a facial plastic surgeon about fat transfer, lip implants, or a lip lift. The best procedure for you (all of them are listed below) will depend on your unique anatomy and the result you want to achieve.

	Botox nonsurgical	Dermal Fillers nonsurgical	Lip Lift surgical	Facial Fat Transfer surgical	Lip Implants surgical
Worth It Rating	97%	90%	90%	86%	78%
Average Cost	$555	$1518	$4514	$6758	$3065
Downtime	No downtime	Minimal or no downtime	1 week of downtime	1 week of downtime	Up to 3 days of downtime
Anesthesia	No anesthesia	Topical or no anesthesia	Local anesthesia	Local anesthesia	Local anesthesia

• A Botox lip flip is an option for those hoping to avoid fillers. Some people opt for an injection of a neuromodulator, like Botox or Dysport, into the muscle just above the top lip (the orbicularis oris muscle)—which, studies have found, can give the top lip a plumper appearance. “The lip flip injection is given just above the lip line. It relaxes the muscle in that area, letting the lip rotate up and out slightly,” explains Dr. David Gay, an oculoplastic surgeon in Austin, Texas. This gives the illusion of a subtly fuller top lip and defined Cupid’s bow, but it doesn’t actually create more volume, the way fillers do. You can expect your lip flip to last about four months. Find doctors who offer Botox lip flips

Related: Can Botox Lip Flips Be a Better Option Than Filler? 

• Injectable fillers are the most common and, arguably, the easiest way to achieve full lips. If you go the filler route, the injecting is done right in your doctor’s office. You’ll likely be prepped with local or topical anesthesia, to numb your top and bottom lips. Then your doctor will use a fine needle or thin cannula to inject the filler into the targeted area. “It should be injected right into the lip line, just above the lip, and massaged in,” says Dr. Tornambe. “That’s where it looks best. If you get too much inside the lip, it begins to resemble a stuffed sausage—it doesn’t look natural,” he says. You should be numb enough that it won’t be painful, though you may feel a slight twinge. Additionally, many hyaluronic acid fillers are formulated with lidocaine in them, for pain management.  Especially with a first-time patient, Dr. Tornambe will start with one syringe of lip filler for both the top and lower lip and then save some, asking the patient to come back three to four days later, for a touch-up. Hyaluronic acid “fillers, such as Juvéderm, attract water from your cells, so your lips are even bigger for the first 48 hours,” he says. You’ll also have some mild swelling. After a few days, you’ll see the final results of your lip shape and size, then you can decide whether you want more.|| Side effects typically include swelling, redness, and bleeding at the injection site for a day or two. You can ice the area, to help the swelling dissipate sooner. Hyaluronic acid–based fillers can also be dissolved with hyaluronidase injections, to reverse a bad result or avert a potential complication.  Find doctors who offer injectable fillers
• A lip lift removes a thin strip of skin under your nose in order to raise your top lip and roll it slightly, making it look larger, fuller, more symmetrical, and more defined. By shortening the philtrum—the space between the base of the nose and the upper lip, which elongates with age—a lip lift gives the face a more youthful appearance overall. This hour-long procedure, done under local anesthesia, leaves a small scar that heals in a few months. Results are permanent and can look more natural than lip fillers, especially in older patients. Find doctors who offer lip lifts
• A fat transfer is a more invasive plastic surgery procedure, but it can provide very natural-looking, permanent results: whatever fat survives is there for good. The downside is that fat transfer results are less predictable, since your doctor won’t know in advance how much fat will survive. And whatever fat is left over can’t be saved for use in a touch-up procedure. Your doctor will first harvest fat via liposuction, usually from your lower belly, but you won’t need much—5cc (about a teaspoon) is usually enough. The fat is sucked out with a cannula, purified, and put into a syringe or cannula. Your lips will then be numbed with local anesthesia or a nerve block, similar to what you’d get for a dental procedure. Once you’re numb, your doctor will inject the fat using a similar technique as with other injectable fillers. The whole procedure takes about an hour.  With a fat transfer, you can expect three to seven days of potentially significant swelling and bruising post-procedure. Many people take at least a week off work to recover. Bruising usually resolves by the second week.   Also, fat transfer to the lips isn’t as long-lasting as in other areas, says Dr. Tornambe. “At least 30–60% of fat transferred to the face is permanent, but in lips, it’s a little less because of all the movement,” he says.  Find doctors who offer facial fat transfer
• Getting lip implants requires a minimally invasive surgery that produces a permanently fuller pout (though the implants can be removed down the line, if you decide you don’t want them). Their size and shape can be customized for you, and they can be less expensive than fat transfer. Before the procedure, you’ll be given local anesthesia as well as an oral sedative or pain reliever. Once you’re numb, your surgeon will make tiny incisions at the corners of your lips and use a thin surgical instrument to create tunnels. They’ll thread the implants through the tunnels and trim away any excess material before closing the incisions with tiny stitches. You should be numb enough that you won’t feel it.  After a lip implant procedure, your lips may look swollen, bruised, or irregularly shaped for up to a week. If you’d rather not explain your new look, plan for some time away from work.  Find doctors who offer lip implants

RealSelf Tip: Silicone injections (not to be confused with implants) in the lips are not FDA-approved and can carry risks. “Back in the day, doctors were injecting microdroplets of silicone into the lips. Unfortunately, silicone migrates—and you can end up with lumps and bumps,” says Dr. Robert Tornambe, a plastic surgeon in New York City. Removing free silicone can be extremely tricky, if not impossible. In 2017, the FDA issued a warning against using injectable silicone for cosmetic use, stating that “The only FDA-approved injectable silicone is silicone oil, for specific intraocular ophthalmic [inside the eye] use.”

Related: The Ultimate Guide to Fuller Lips—From Plumping Glosses to Silicone Implants