Best Filler to Augment the Peri-oral Region?

I have a flat and downturned upper lip with thin and asymmetrical lips. I have gotten fillers on my vermillion border, but I find that while I like the subtle central pout, I still have a flat peri-oral region. I recently tried stuffing little pieces of cotton over my upper teeth and upper gums (to fill out between the vermillion and base of nose) and am amazed at how sensual my mouth looks. I had upper teeth show when I did that while I normally have none. What are my options? I'm 27.

Doctor Answers 9

Fillers in perioral area can give you what you are looking for

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Fat injections are another alternative. The cotton pieces can be replaced by filler in that region. Your doctor should be able to figure that out. Fat injections can be done all over the perioral region to achieve something similar to your desires. But not all things are possible and you have to be realistic. 

Bellevue Facial Plastic Surgeon

The Perfect Perioral and Lip Filler

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For aging and naturally thin lips the substance missing is fat which our bodies luckily make in quantity.  Finding fat is easy, obtaining it for grafting is a simple operation, processing the fat for reintroduction into the perioral area is quick and easy and once grafted it almost all stays in place forever. If part of the fat to be grafted is put aside and processed differently, fat "stem cells" can be obtained and reintroduced with the fat grafts to improve the "take" even further and also improve the quality of the overlying skin due to the multitude of healing and growth factors stimulated by the stem cells. Taking fat from where it is not wanted, processing it and placing it where it is needed to get a permanent improvement- fat is possibly the perfect filler.

Paul S. Howard, MD, FACS
Hoover Plastic Surgeon

Full natural appearing lips

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You are noticing exactly what so many practitioners miss!  The lip is not just the red vermillion, it is the area from the base of the nose to the chin and bordered by the nasolabial folds.  Commonly practitioners place a sausage shaped blob of filers that looks so unnatural.  It is all technique.  I always augment this area in lip augmentation and deliver natural results.  

My preference is Juvederm Ultra Plus XC because of its consistency and long lasting results.  Any Hyaluronic acid product should be safe and effective.  The ideal filler is your own body's fat but there is a longer period of swelling than HA fillers.  Fat has the advantage of being permanent.  I would avoid any kind of implant or permanent filler because of bad long term complications.  I would also avoid solid natural implants such as dermal fat grafts, dermis and fascia as lips witll not animate (move) naturally.  I hope this helps!  All the best,

RianA. Maercks M.D.

How to improve my lips

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Some combination of lip reshaping and volume may be helpful, provided you do not need or want orthognathic surgery (impossible to evaluate without photos and personal examination). 

Steve Laverson, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 50 reviews

Augmentation of the perioral region

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The hyaluronic acid fillers are nice products to use to improve the contour of hte perioral region.  These last anywhere from 6 months to a year depending upon the product used. 

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Best filler for lips

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After 25+ years of injecting lips, I find that either Juvederm or Restylane are the best options for lip augmentation. They are used to replace lost volume, define the vermilion borders and create a more youthful curl, elevate and lift the corners of the mouth, and correct vertical wrinkle lines. They can restore the natural contour of the upper and lower lip and enhance the Cupid’s bow area. Lifting the corners of the mouth gives a hint of a smile and reduces the “sad or angry look” when they are down turned. Please remember, your results depend upon the skill and experience of your physician injector.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

Filler around the mouth

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Sound like you need augmentation of pre-maxilla ( upper jaw ) . In my experience the best and longest lasting filler or implant is insertion of dermofat graft through inside of the upper lip. The second best option is fat grafting, which could be added on to achieve your desirable contour improvement. Sculptra or Rasiesse are the other option. Make sure your surgeon has enough experience with these procedures.

Best Filler to Augment the Peri-oral Region?

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Of course photos would make the evaluation easier but you may want to try Sculptra for that area combined with Alloderm or one of the other lip implants for a more permanent and significant lip augmentation.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Best Filler to Augment the Peri-oral Region?

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It sounds like you have Maxillary Retrusion or Hypoplasia and as such you could benefit from a combination of fillers to restore volume to the area. Either Perlane or Radiesse to the deep areas to build up the deeper areas and either Juvederm or Restylane to the more superficial portions of the lip.

Good Luck.

Peter a aldea, MD

Peter A. Aldea, MD
Memphis Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.