If I have very very thin lips, will an injectable filler make my lips look unnatural? (photos)

I have deep vertical lines above lip that I would like to get rid of. What is the best solution to remain natural looking.

Doctor Answers 6

Lip Injections and Vertical Lines

A combination of fillers such as Volbella and microneedling, chemical peels, and lasers will all help reduce these lines and can be done in a very natural way by an expert.  Please consult a board certified dermatologist trained with these facial injections.  Best, Dr. Green


New York Dermatologist
5.0 out of 5 stars 76 reviews

Filler or peel

Bepperboo, thanks for the question and great photos. Peri-oral lines can be very difficult to treat and there are two main approaches for dealing with them. The first is to have a filler like restylane silk or belotero used to inject the lip lines directly. This will soften them, but will need to be repeated i3-6 months. Another option for lip lines is to have a peel performed, either a TCA or phenol peel would improve the appearance of the lines on a more permanent basis. The down side of peels is that they usually have a 1-2 week down time associated with them. The peels may also produce hypopigmentation or lightening of the skin where the peel was performed. As always, make sure to see some one who is an expert in fillers and peels so that they are able to evaluate you in person. I hope this helps and best of luck in your area. ~Dr. Sieber

David A. Sieber, MD
Bay Area General Surgeon
5.0 out of 5 stars 31 reviews

Your lips can look fuller with fillers, but it's the doctor's touch that makes them still look natural and fit your face

Thank you for your question. You provided two photos, stating you have very thin lips, and are concerned if injectable filler will make your lips look unnatural. It’s very good the way you submitted the photos showing your lips at rest, and then your lips puckering showing the vertical lines.

I can share with you how I discuss this concern with my patients in my practice. A little background: I’m Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve been practice in Manhattan and Long Island for over 20 years. Lip enhancement in the area we refer to as the perioral area of the lower third of the face is a significant part of my daily practice. Facial aging is an area of significant focus for over 20 years I have been in practice. Certainly, your concern about looking unnatural is probably the first thing people always express when they want to do something for their lips

Unfortunately, there are a lot of people walking around with what is often referred to as “trout pout” or “duck lips” and other not so kind descriptions of people who appear quite overdone. So people who never have done anything are very afraid of having an outcome they’ve seen from television, movies, or magazines. Let’s take this opportunity to just learn a little about the anatomy of the lips, and how it is generally approached in my practice in a stepwise way, which I think is the right approach.

What’s happening with vertical lines forming are people always look at wrinkles when they think about aging, but aging more holistically or globally involves a lot of bone loss, and loss of fat in the soft tissue around the lips. In the lips there’s also loss of collagen in the skin. When you show your lips at rest, you notice there are some vertical lines called static lines. When you pucker you use a muscle called the obicularis oris muscle, which contracts and causes this vertical line to get deeper, which are called dynamic lines.

When you look at somebody’s lips,people always look at the lines, and notice the volume has diminished, and there are few ways to address this. If we looked at the anatomy in this area, there are a lot of different solutions that do involve fillers as well as other injectables that are relevant. Generally speaking, when someone like yourself is wearing lipstick, very often they are drawing more lip than they actually have. I usually tell my patients to differentiate the pink part from the skin where the lines are. From the pink part of the lip, there’s a transition point called the vermillion border. When it comes to just filler alone and restoring volume we actually have a good number of choices.

For lip fillers, I’m very happy about the number of options we have now,  from thinner fillers such as Juvederm Volbella and Restylane Silk which are very good for finer lines of the skin, to slightly thicker such as Restylane, and Juvederm that can be used for the pink part of the lips and the vermillion border, or the border in the line.

This comes back not so much to the product as I always caution people to differentiate product from the practitioner, as the products are tools. Although companies who make these products promote aggressively their incredible benefits, it’s the practitioner who applies these products who is important for the end results. Very often patients have come to me and say they tried XYZ product once which doesn’t work for me. I tried to distinguish and differentiate product from procedure, procedure and practitioner.

Being conservative is a very good way to approach this. Starting with limited quantities to help restore the pink part of the lips, maybe a little along the vermillion border and along the vertical lines with the different filler choices, which continuously evolve so it’s not about a specific brand or variety it’s really about the technique. Finding a doctor you can have a good dialogue with, understands your desires, and what the doctor sees as a good aesthetic outcome is the ideal process for you. Meet with a doctor maybe by referral,or seeing someone else who a friend shared with you, or just do research online like to start the journey of learning, and start conservative.

The volumes used in injectable fillers are relatively low. Each syringe sounds like a lot is typically one milliliter, which is not a lot of volume. Now certainly placement in the wrong area, or not so optimal areas can make someone not look so good, but it’s the art of using the volume and placing it appropriately. You cannot overdo it when you start conservatively, so again meet with doctors. There many doctors who do injectable fillers around the lips.

There is also a role for various neurotoxins like Botox®, Dysport, etc.for  refinement of the activity of the muscles. That’s a different story from volume.

People want to see the result immediately, and want to know they got something significant with their office visit. That’s where the fillers can be done nicely, artfully, look natural, and fit your face. I think that’s also a take home message - as long as the appearance fits your face, and it’s within your natural anatomy and history. I look at it more as correction versus augmentation. When we’re talking about making something larger than it is naturally, let’s say for  breast augmentation, we’re augmenting - we’re increasing. When it comes to facial aging, I look at it more as correction where we’re filling and restoring rather than augmenting. So hopefully with that I give you some guidance that will be helpful for you. I hope that was helpful, I wish you the best of luck, and thank you for your question.

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Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 70 reviews

If I have very very thin lips, will an injectable filler make my lips look unnatural

Thank you for your question.  You can create a nice natural result using fillers. There are a variety of different fillers avail to help volumize lips and smooth out the vertical lines.  Consult with a board certified plastic surgeon. Best wishes.  

Jeff Angobaldo, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 104 reviews

Vertical lip lines

Hello, and thanks for your question and photos. I generally like to treat my patient's vertical lip lines with a combination of fillers (Ie, Juvederm, Restylane) and Botox, and sometimes lasers as well. Obviously, everyone is a little different. In order to determine the best treatment plan for you, I recommend an in-person consultation with a well-trained dermatologist or plastic surgeon to determine the best treatment plan for you. Best of luck, Dr. Frucht.    

Corey Frucht, MD, PhD
Santa Barbara Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Filler for vertical lip lines

Thanks for your question.  There are many fillers available, but for vertical lip lines like yours I recommend Belotero Balance as it is very smooth and less likely to be noticed when used close to the skin surface in very superficial lines.  Have a blessed day!

Soumo Banerji, MD
Pasadena Physician
5.0 out of 5 stars 1 review

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