Botox, filler, or lift - how can I improve my lips? (Photos)

Question

I have been unhappy with my lips for years because they get too thin when I smile and the upper gums are more visible on the left side of my mouth when I smile. I tried a lip flip but did not like the results because I felt it pulled my lip down over my upper teeth too much. I also can't really define my cupids bow because when I smile the middle of the bow gets pulled to the left. Is there anything to help address these concerns? I figured Botox, lip filler, or a lip lift were good places to start when looking for solutions.

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. Based on your concerns—thin lips when smiling, asymmetrical gum show, and difficulty defining your Cupid’s bow—I recommend lip filler as a solution. Lip filler can add volume to the lips, helping them maintain a fuller appearance even when you smile, and can be strategically placed to balance asymmetry and enhance definition in areas like the Cupid’s bow. Unlike a lip flip, which works by relaxing muscles, filler provides structure and support, which may help prevent the center of your upper lip from pulling too far to one side when you smile. I hope this helps and best of luck!

Ran Y. Rubinstein, MD · Answer

Hello and thank you for your question. Botox and filler are great noninvasive ways that can improve the appearance of the upper lip when smiling. Botox injected into the LLSAN muscle will relax the upward pull on the upper lip when smiling to minimize gum show. You mentioned you have tried the lip flip but that caused too much coverage of the upper teeth. You can also try the lip flip at a lower dose to minimize that effect. Dermal filler provides hydration and volume to the lip and in combination with Botox for muscle relaxation can attribute to a fuller lip when smiling. Hope this helps! Esther Litenatsky AGACNP-BC on behalf of Dr. Ran Y. Rubinstein, facial plastic surgeon in Newburgh, NY and Montvale, NJ.

Anna Chacon, MD, FAAD · Answer

To address your concerns about lip appearance, it's important to consider the specific issues you want to improve—such as lip volume, symmetry, and gum visibility. Here are some options that might help:

Lip Fillers: Dermal fillers can add volume to the lips, enhancing their fullness and potentially improving symmetry. Fillers can also help redefine the cupid's bow and balance the overall appearance of the lips when smiling. If your main concern is thin lips or lack of definition, fillers could be a suitable option.

Botox: While you mentioned trying a lip flip with Botox and not liking the result, Botox can still be useful in addressing specific muscle movements that affect the lips. It can help reduce the appearance of a "gummy smile" by relaxing the muscles that elevate the upper lip, though careful application is required to avoid pulling the lip down too much.

Lip Lift: A lip lift is a surgical procedure that shortens the space between the nose and the top of the lip, increasing the visible height of the lip and enhancing the cupid's bow. This procedure can create a more permanent enhancement compared to fillers or Botox. It’s particularly useful if the lip shape or position is a significant concern.

Combination Approach: Sometimes, a combination of treatments might be necessary to achieve the desired results. For example, fillers could be used to add volume and improve symmetry, while a small amount of Botox might help with the gummy smile.

It's advisable to consult with a board-certified dermatologist or plastic surgeon who can assess your specific anatomy and recommend a tailored treatment plan. They can provide guidance on which treatment—or combination of treatments—will best achieve your aesthetic goals.

Camille Cash, MD · Answer

You mentioned the three options that are used to address and improve the shape and volume of the lips.  You may find that you like the results when treatments are combined.  Perhaps start with the filler and see if that gives you a look you like.  You can talk to your injector about adding other treatments to improve your results.

Glenn Murray, MBBS · Answer

Hi there,
You could use wrinkle relaxer to treat a gummy smile by relaxing these muscles that cause excessive upper lip movement. Pairing this with lip filler can enhance lip volume and shape, giving a balanced, natural looking result. 
Hope this information helps. Thank you

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