Most natural looking filler for fuller, softer lips?

Thank you for sharing your excellent question.  Though difficult to make a definite recommendation without a photograph of your current lips and goal results, I would recommend starting with a thin hyaluronic acid based filler, such as Volbella.  This offers little swelling during the first days after treatment and maintains a soft texture to the tissues of your lip.  Hope this helps.

Hi @mary457! Restylane Kysse is a great product to use for lip rejuvenation. The technique of the provider and the product used are both very important factors for a natural outcome. I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications.Best of luck, Dr. Nima!

Thank you for your question. You submitted a question without a photo, describing yourself as 48-years-old with lost lip volume, and looking for a filler that can last at least 6 months. You are confused between many different brand name products, and state you’re looking for a good injector who will help you look natural and not have duck lips.
I can share my approach to patients like yourself in my practice, and how I counsel them in doing exactly what you want, which is very common. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. Helping people look their best and deal with facial aging changes are very significant parts of my practice. Avoiding duck lips is the first thing every patient says to me before they decide they want to try injectable fillers.
What’s adding to your confusion is a saturation of messaging by companies competing for your attention for the best filler, with too much information making a choice for consumers is very difficult. This is always has been over 20-year career kind of a plague of the medical profession because pharmaceutical companies and hospitals are marketing directly to consumers. Although there is a certain strength to that, it results in a lot of confusion in choosing the best option for you.
I help my patients understand these products, regardless of what they are, are essentially tools for the practitioner. It’s the practitioner who has the knowledge and experience with these products to apply them to make the difference in results and the best outcome for you, the patient. One of the amazing I’ve really learned is how a strong messaging process from any company can not only act positively, but can act negatively in the minds of the patient. A patient can come to me and say, “I went to so and so and I had this xyz injectable treatment, and that injectable doesn’t agree with me.” My role as the doctor is to help guide you. If you didn’t have an allergy or any unusual reaction, which are very rare with injectable fillers, let’s differentiate the practitioner performing the procedure from the product.  
There is a real art to what we do, and there has to be a synergy between the patient and the physician. A lot of my patients will say, “I don’t want duck lips, or, “I don’t want to look like so and so celebrity.” So, why does that person look like that? It’s because they wanted a certain look, and they had a physician who decided that look is desirable. There was a willing patient with a willing doctor coming together and finding this type of outcome. The aesthetic vision of both the physician and the patient have to be in harmony to achieve best results.
Patients who come to me like yourself are looking for restoration of some lost volume. I always try to explain that people with the so-called duck lips never had those when they were younger, or at any time of their lives. They’ve exaggerated their appearance and created this augmentation that was beyond natural. For most of my patients, it’s about restoration or correction, so I discuss with them what I feel is the appropriate injectable for them based on their skin type, skin quality, the tissue,  and what I feel is the right tool for their desire.
This a really great time to have these procedures. Since 2005 where Restylane was the first hyaluronic acid filler to be introduced into the market, we’ve had a treasure chest of choices that come with tremendous flexibility. Like a painter choosing different paints and different textures, or for a sculptor, there are a lot of options for the practitioner to refine the results to what you like. The companies have been very good at developing better products and delivery methods. We definitely have a lot of great tools, but the tools are only as good as the physician who performs the procedure, and having the shared communication and understanding of the desired outcome.
Don’t hang your hat in just one particular injectable - you ask 5 doctors, you’re going to get 5 different answers. Find a doctor you feel shares what you want, and who you’re comfortable with. Once you find that doctor, start conservatively, develop an outcome and result you’ll be comfortable with, and achieve that 6-month longevity.
For the longevity of fillers, there’s a wide range. There’s a range companies provide us based on their pre-FDA approved or pre-market trials, but there is still a wide range among individuals. Some will go through certain fillers very fast, while some hyaluronic acid fillers can last a year and beyond. Understand there is a lot of flexibility in figuring out what is right for you, which takes some time and experience. That is why I emphasize the importance of finding the right doctor you want to work with.
Unfortunately, because of this emphasis on product, often these procedures become commoditized, so people keep searching for different discounted opportunities to go to somebody because it’s cheaper. Possibly the least appropriate way to get to find the right doctor is to base it price. Sometimes it might work, but it’s probably better to look for the doctor you’re going to be comfortable with, and just invest some time and resources to make that connection. I have patients who have been with me for years because even if I did their eyelid surgery 10 years ago, they stay with me to do their injectable fillers and other procedures along the way because we click. It’s a very important thing to find a doctor you click with. I hope that was helpful, I wish you the best of luck,and thank you for your question.