Do I need filler added or removed to achieve a keyhole pout? (Photos)

It's difficult to partially dissolve filler to get desired results. Additional filler may give you the results you want. You'll want to see someone meticulous. Don't let distance dissuade you. See an expert. Best, Dr. Emer

Thank you for your pictures! You certainly have two options - you could either dissolve some of the filler or add more.  each has its associated risks.  Dissolving is not entirely predictable, meaning that the enzyme will dissolve the HA in its near vicinity.  So its very hard to be precise when trying to achieve a defined shape by "melting" filler away.  The second option of adding filler will give you that precision of placement, however, it will increase the size of your lips substantially and may throw off the proportions that you have achieved.  So, the answer likely likes somewhere in between.  You have a pretty result, and I would tell you to let things settle for a bit before making the next move.  Best of luck! I hope some of this helps. 

You should start out with 1cc of juvederm filler or restylane filler and go from there. You do not want to overdo too much filler in the lips. It also depends on the look you are going for too. You can always add more filler to the lips if needed. Just remember if you are going to do your lips and you do not want to bruise you should not take any aspirins or anything that will thin the blood since brusing can occur. One syringe is typically $550
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