How do lips get larger over time with filler?

Question

I've read that the more you get your lips done they will gradually get larger over time with each appointment. I am just wondering if there is any truth towards this (do they actually get larger over time or is it the same results w/ each appointment) /how this works if this is what happens, as I thought that everything completely dissolves after 6-9 months.

Hung William Song, MD · Answer

What we have noticed with hyaluronic acid fillers in the lips is that the first time a patient has a treatment, the product tends to get metabolized very rapidly. Sometimes the effects are gone within 2-3 months. What we have also noticed is that on subsequent treatments, the effects tend to last longer, sometimes for years. My theory is that filler particles get encapsulated with a protective film that makes it less accessible to your immune system thus allowing the filler to hide out in it's capsule and last a very long time. This is very unpredictable and different people react differently. If you want something that last longer you should consider a fat transfer. Biostimulatory fillers like Radiesse, Sculptra and Bellafill are not recommended in the lips.

Sacha Obaid, MD · Answer

Thank you for your question.  In my experience, I believe when initially starting with lip fillers, you may require treatments more often in order to reach your desired goal. Once your goal is achieved, you may not require lip filler injections as often as you did in the beginning. Please keep in mind that our bodies metabolize these products at varying rates. Best of luck to you!

Ryan Mitchell, DO, FAOCO · Answer

Hello,     Thank you for your question.  If we are talking about injecting temporary gel fillers such as Restylane or Juverderm into the lips to gain volume (increase in size and shape) the only way our lips will remain larger is by repeating the injections of these fillers over time.   If you stop injecting the gel fillers, eventually all of the product will dissolve and your lips will gradually reduce to their previous size.   In addition, as we age in years, we naturally lose volume in our faces, including our lips and our lips will become thinner with less volume and definition.      The more frequently you inject your lips and the greater amount of filler you have injected, the larger your lips will become.  Let’s say for example that Restylane will last in the lips for six months and by six months all of the filler has dissolved.   In general then, six months following the initial injection, your lips will have returned to their previous size and you will need to start over from your innate, natural lip volume.  If however, you go and receive more filler before the previous filler has completely dissolved, then you will be able to build upon the previous filler and your lips will either remain the size you choose or become larger and larger until they look unnatural and unattractive.  Lip filling is an art of balance.  If you desire to maintain a certain size, shape and volume for your upper and lower lips then you will have to return to your injector before the previous filler has completely reabsorbed.     However, there is one possible scenario where after you inject your lips they may become larger over time.  This may occur if you choose to use that your own fat to volumize your lips. If you have fat transfer, otherwise known as fat grafting into your lips over a period of time, until you are completely satisfied with the size and shape of your lips and then if you gain weight, you may very well also gain weight in your lips and your lips may become larger without having any further material injected.  This is actually one possible downside to having fat grafted into the face. Once the grafted fat takes up a blood supply and it is surviving just like any other fat in the body, if you gain a substantial amount of weight, the fat that was transferred into the face can now become overly inflated.     I hope the information that I have provided you is informative and has answered your question. If you have any additional questions please do not hesitate to reach out to me.Best regards,Dr  Mitchell

Daniel Barrett, MD · Answer

Dear ochiexx,
I perform a lot of lip injections with fillers such as juvederm and it works great. Many times I need to put more in one side than the other to attempt to even out the vermillion border (The red line of the lip). This helps provide more symmetry at times.
Another Option: For patients looking for a more long lasting result, I recommend fat grafting. That is, using your own bodies fat to make your lips naturally look more shapely. The bonus is that the results last many many years.
In general, I avoid using permanent prosthesis because I find that the lips are such dynamic and sensitive structures, the end result is not natural.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Eric M. Joseph, MD · Answer

Many people Metabolize HA quicker than others. Some people develop foreign body reactions to HA and that may cause collagen production and a persistent augmentation.Any injectable filler can lead to nodules and bumps as well. Hope this helps. Dr Joseph

Robert M. Tornambe, MD · Answer

ochiexxI completely understand your confusion with this regard. Unfortunately, the Internet can provide confusing information about Lip Augmentation. When lip fillers, such as Juvéderm are used, the results for a Lip Augmentation usually last 4 to 6 months.  The results can be maintained as long as the procedure is repeated. However having a Lip Augmentation with fillers over time does not make your lips fuller unless you keep having the filter replaced. Fat transfer to the lips is different. Studies demonstrate that anywhere between 30%-50% of fat transferred to the face stays permanently. So, theoretically, if you undergo fat transfer to the lips more than once, more fat should be maintained there for a longer lasting result. However, fat transfer is variable from individual to individual. Consult with a board-certified plastic surgeon in our area for a full evaluation and exploration into the best options for you. Good luck.

Dmitriy Schwarzburg, MD · Answer

Lip size may vary after filler injection and depends on multiple variables such as your anatomy, filler used, and your metabolism to name a few. The duration of the effect also depends on multiple factors and should be discussed with your physician at the time of injection.

Center for Aesthetics and Plastic Surgery - Grand Rapids · Answer

Hello there,
     I have seen this to be true in both myself, and my patients. My theory is that if patients maintain their results, the filler builds and layers on the leftovers, lasting longer with each appointment/injection. When I first began my lip filler journey, I was needing filler every few months to maintain my desired volume. At this time, I am able to go as long as two years in-between injections. I hope this helps. 
Sarah RN BSN

Jo Herzog, MD · Answer

Unfortunately having fillers over and over will not give you bigger lips forever. Different fillers, and even the same filler in same person at different times, do dissolve at different rates. However, when they are gone you are back to square one.

Leonard Grossman, MD · Answer

Every individual metabolizes fillers differently. In one person the same lip filler can last 3 months, in the next person in can last 6 months and in the third person it can last indefinitely. If someone metabolizes the filler slowly, each additional treatment will build up more volume resulting in a much larger lip. The choice of the lip size should be determined by the patient and not by the doctor but with the plastic surgeons help in knowledge of aesthetics. I hope this helps and good luck from New York City plastic surgery

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