This story has been medically reviewed for accuracy by Plano, TX board-certified facial plastic surgeon Dr. Vu Ho on September 30, 2020.
Lip filler needs no introduction. But we will say this: lip augmentation has become such a popular, universally beloved cosmetic treatment, that it currently boasts a 97% Worth It Rating.
As far as plastic surgery goes, lip filler injections tend to be straightforward: They’re tolerable with a topical anesthetic, their side effects include swelling at the injection site (which can be eased with an ice pack), their downtime is negligible, and no follow-up filler appointment is usually needed if you’ve gotten the desired results.
While there are multiple treatment options, hyaluronic acid (HA), the primary ingredient in both Restylane and Juvéderm fillers, is the unanimous favorite type of dermal filler for contouring the lips; it can help with plumping lip volume, enhancing lip shape, and even smoothing fine lines around the mouth. It’s produced naturally within the skin, offers hydration in skin-care products, and works well as a lip filler because it attracts and retains water, keeping the lips plump and soft to the touch. Hyaluronic acid fillers are also temporary and reversible with the enzyme hyaluronidase, giving injectors and patients peace of mind.
Do lip fillers go away?
While the bulk of lip-filling formulas share HA as a common denominator, their individual cross-linking (how the HA molecules are strung together) and chemical characteristics (density, flow, elasticity) are far too nuanced to allow for any sweeping lip-filler generalizations—well, except for one: happy patients always wish their plump lips lasted longer. Or, at least, as long as advertised, because despite what some products promise, that one-year dream isn’t always realized. This is largely due to the fact that our lips are constantly moving, which speeds up the breakdown of product.
The same bodily mechanism that regulates how quickly you metabolize calories determines how fast your filler will break down. In short: if you have a fast metabolism, your lip filler will likely break down more quickly.
It’s similar to what happens with other injectables, such as Botox. “We see this with neurotoxins as well,” says Dr. Dhaval Bhanusali, a board-certified dermatologist in New York City. “Just like with food, some people have quicker metabolisms than others, and [therefore injectables] last [for] shorter amounts of time.”
That said, different brands or specific variations of hyaluronic acid-based lip filler might work better with your biology. If you notice your lip filler is fading too fast, your doctor can experiment with alternatives, to boost longevity.
“Constant movement can cause HA to break down via simple physical shearing forces,” explains Dr. Gary Goldenberg, a board-certified dermatologist in New York City. “Since it’s a gel held together by bonds, constant movement will cause these [bonds] to eventually break down and the product to be absorbed.”
In other words, there is a direct correlation between how much you move your lips—talking, chewing, kissing—and how quickly your lip filler will break down, though the strength of this correlation is difficult to quantify because it depends on the individual as well as the type of filler used.
How long does lip filler last?
While a filler may claim to last for up to one year, that does not mean that the amount of filler injected on day one will match what is left on day 365. There may, however, be traces of gel still detectable in the lips close to one year later—or even longer—after your lip-filler procedure.
The Kysse clinical trial, for instance, ran for 48 weeks. And, according to Dr. Palm, “the efficacy standard set up in the study protocol was a one-point increase in the Medicis Lip Fullness Scale, [as determined] by both treating investigators and a blinded investigator.” This single point signifies “clinically meaningful differences in lip fullness.”
Regardless of the product used, lip-filler patients tend to come in just once, or maybe twice, a year for touch-ups and “usually notice a subtle, gradual decrease in [lip] size over the last few months,” says Dr. Bhanusali.
“The products lose volume over time,” adds Dr. Jennifer Levine, a board-certified plastic surgeon in New York City. “How long they last also has to do with the amount that needs to be corrected.” If more filler is injected in the first place, then it will generally last longer—simply because there is a greater amount of filler for the body to break down.
Your frequency of lip-filler injections can also impact how long it lasts. “First-time use leads to the quickest breakdown, [while] repeat use of fillers does lead to longer-lasting effect of the filler,” says Dr. Goldberg. “This is probably because the repeat use leads to a patient’s forming more protective collagen around the filler.” So over time, you’re getting both the temporary swell from the HA gel plus the long-term plump of new collagen growth.
The flip side of this, per Dr. Goldberg, is that our body’s natural ability to produce collagen declines with age—therefore, a lip filler treatment tends to last longer in younger people than in older individuals.
There’s also something to be said for the cumulative effect of filler. When you go in for a touch-up every 6 to 12 months, you’re hardly back to baseline. Rather, you’re building on residual gel from previous injections, which lends durability to your final result.
Which lip filler lasts the longest?
If you’re looking for the longest-lasting lip filler, the answer isn’t so straightforward. In the Restylane lineup, the brand’s original formula (referred to by providers as Restylane, Restylane classic, or Restylane legacy), Restylane Silk, and Restylane Kysse are the most widely used for enhancement of the lip area—the latter just gained FDA approval earlier this year. Clinical trials for Kysse, which is formulated specifically for the lips, highlight the gel’s flexibility—it moves naturally, without turning stiff or bumpy—and its durability (it purportedly lasts up to one year).
“The hyaluronic acid in Restylane Kysse is bound to itself,” explains Dr. Melanie Palm, a board-certified dermatologist in San Diego and principal investigator in the clinical trials for the filler. “Because of this property, the filler stretches, once injected, to integrate and mold directly into your lip tissue.”
In the Juvéderm family of fillers, Volbella and Ultra XC are commonly used for the lip area, and both claim to last up to one year.
Another HA option is Belotero, which is “a wonderful starter filler,” according to New York City board-certified dermatologist Dr. David Goldberg, because “it lasts the shortest period of time.” Its use in the lips is considered off-label, since it’s FDA-approved only for facial wrinkles such as the nasolabial folds. With so many types of filler options, how do you choose? In short: you don’t. The final decision on which filler should be injected into your lips should be left to a board-certified dermatologist or plastic surgeon, who will base their pick on “patient goals, the age of the individual, the genetic influences on their lips, and matching their lips to their face,” says Dr. Goldberg.
