Does lip augmentation via injections/fillers (Juvaderm, Botox, etc) cause the upper lip to look longer from nose to cupids bow?

I've been noticing a similar look in a lot of women that get lip augmentations. It looks like the upper lip droops further from the nose (from the middle/tip of the nose, to top of cupids bow). Is this a side effect of prolonged use of injectables (especially in older women)? I'm 35 and have never gotten fillers in my lips, but am considering it for minor maintenance (tiny wrinkles etc), but I am afraid I will get the long upper lip.

Doctor Answers 9

Do Fillers Cause Increased Lip Length?

As we age, the distance between the nose and the top of the cupid's bow increases. It is rarely caused by fillers and is certainly not a result of prolonged use of injectables in the upper lip, so don't worry about that. If anything, use of fillers in the upper lip will encourage collagen growth which should help the lip resist drooping. The collagen will also help prevent those tiny wrinkles from forming.
Hope that helps!

Excess length of upper lip

Depends on where the filler is placed. More mature women often want the "smoker lines" above the lip filled. However, if you only fill those lines and it does not get balanced out with some volume in the vermillion (red part) of the lip, you will get the appearance of a long upper lip (or it frankly looks like a gorilla to me). Remember, as we age, our entire face loses hyaluronix acid and collagen fibrils get more lax across your entire body. Just filling one isolated area can create imbalance very easily. 

Lily Lee, MD
Pasadena Plastic Surgeon
5.0 out of 5 stars 22 reviews

Elongation of Philtrum Columns

Dear ejfilms13,

With age, the distance form the nose to the vermilion border elongates.  This is a normal aging process and not a result of fillers.  In fact, many people use fillers to decrease this distance and make the lips lift upwards. Given that you are concerned about your "tiny wrinkles", I think fillers would be a good option for you as it firms up the lips and decreases the tendency for the overlying skin to collapse when you purse your lips (like drinking from a straw or whistling).  The repetitive motion of bending the skin makes these "tiny wrinkles" etch into the skin and eventually become permanent (known as "lipstick lines", "granny lines", "bar code lines" or "smoker lines").  Botox is another good option for preventing those lines from etching in.  But it may make affect your speech a tiny bit.  The good news is that you have some options!  

Lip Fillers and Cupid's bow

You asked a very important question.  I often inject the cupid's bow at the same time as the lips to avoid this exact problem.  Please consult an expert.  Best, Dr. Green

Aging can cause elongated upper lip and poor placement of filler can worsen it

One of the signs of aging is an elongated upper lip, or increase distance between nasal ala and the upper lip red border. This is partly due to loss of volume in maxilla (the upper jaw bone), resulting in decrease anterior (forward) projection, coupled with loss of fat pads in an area called the pyriform aperture, which is right next to the nose. Any amount of filler placed in this area can therefore exacerbate this already existing problem, which offen happens as older woman want their smokers line treated with filler. An expert injector will use a soft, non-bulking agent such as boletero or restylane silk, combined with lasers or peels to treat smokers lines, to avoid further elongating the upper lip. Proper Placement of filler by an expert in the upper lip itself In your age should not be a problem, and can result in natural, fuller lips lasting up to 6 months. Good luck!
Dr. Vanden Bosch 

Neda Vanden Bosch, MD
West Palm Beach Physician
5.0 out of 5 stars 8 reviews

Lip Filler Like Voluma, Restylane Silk, Juvederm and Upper Lip Length

Filler will not increase the length between your lip and nose, this can be improved with a lip lift procedure. Lip fillers do great and look natural if done with skill and expertise. I suggest you see an expert for treatment and someone who truly understands contouring. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 159 reviews

Long upper lip

I have seen that long upper lip occur in many patients for several reasons. The most common is a combination of using the wrong type of filler in the wrong location in the wrong amounts. When correcting for tiny wrinkles around the edges of the lip, I prefer small amounts of the thinnest filler either directly into the wrinkles or still within the red portion of the lip. For patients looking for more lip volume, I use a more cohesive hyaluronic acid filler in the body of the lip, away from the upper portions. When filler is just casually injected into the red lip and spreads up into the skin, it makes the whole upper lip look long and stiff which can appear unnatural. Sometimes immediately after any injection, the lip will look long and stiff simply from swelling, but these effect should go away within the first 2 weeks. It is best to visit someone experienced in lip injections who can spend the time to listen to your goals and explain their treatment plan with you. Hope this helps! 

Johnson C. Lee, MD
Beverly Hills Physician
5.0 out of 5 stars 12 reviews

Does lip augmentation via injections/fillers (Juvaderm, Botox, etc) cause the upper lip to look longer from nose to cupids bow?

The short answer is no, if the injection is done properly. However, placing filler in a long upper lip can make the lip look even longer. It is far more likely that a woman with a long upper lip will develop the duck bill look when filler is placed in their red lip. In most cases, this can be prevented by performing a lip lift. If you're considering fillers consult with an experienced physician injector who performs beautiful lip filler treatments. They can advise you if you're a good candidate and let you know if some other type of treatment is more appropriate. I hope this information is helpful for you.

Stephen Weber MD, FACS
Denver Facial Plastic Surgeon

Lip augmentation causing long lip

Lip augmentation with fillers improve volume, shape, and projection of the lip. The increased in lip length is often due to injecting too much filler to add to the volume. You can always have the filler injected some at a time and then evaluate the results (which is usually immediate). If you have good volume but only want lip definition, you can get thread lift into the upper lip. Botox injected into the upper lip to treat lip lines can give the illusion of long lip as it relaxes the lip. 

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.