Limitations with Large Volumes of Lip Filler?

Question

Hello, I'm looking to achieve a look with very large overfilled lips. I've been getting aprox 1cc per lip (2 total) of Juvederm every 2 weeks for the last few months and I'm up to around 6cc per lip (12cc total). They still look good, feel a bit firm after fills but nothing concerning. However, my injector has said it's getting harder to inject and hesitant to do more. Is it safe? Is resistance ok to keep filling? Are there any concerns I should watch for? Thanks!

Anna Chacon, MD, FAAD · Answer

Hello,

Thank you for your question regarding the use of large volumes of lip filler.

It's important to understand that while achieving a desired aesthetic is significant, there are safety limitations when it comes to the volume of filler used, especially in sensitive areas like the lips. Here are a few key points to consider:

Tissue Capacity and Elasticity: The lips have a limited capacity to accommodate filler. Overfilling can lead to excessive stretching of the tissue, which may cause long-term damage, including the risk of the skin becoming permanently stretched or developing lumps and irregularities.

Vascular Compromise: The more filler that is injected, the higher the risk of compromising blood vessels. This can lead to vascular occlusion, which is a serious complication that can result in tissue necrosis (death of tissue) if not treated promptly.

Firmness and Discomfort: As you've noticed, the lips can become firmer and potentially uncomfortable with high volumes of filler. This is a sign that the tissue is becoming overly saturated and may not be able to accommodate more filler safely.

Injector Hesitation: If your injector is hesitant to continue adding more filler, it's likely due to these safety concerns. Experienced injectors are trained to recognize the limits of safe practice and prioritize patient health over achieving a certain look.

Potential Long-Term Effects: Continual overfilling can lead to long-term issues such as migration of the filler, chronic swelling, and changes in the natural lip structure.

It's crucial to have an open and honest discussion with your injector about your goals and the potential risks involved. They can help you understand safe practices and may suggest alternative approaches to achieve your desired look without compromising your health.

If you have any further concerns or questions, please don't hesitate to reach out to a board-certified dermatologist or plastic surgeon who specializes in cosmetic injectables.

Camille Cash, MD · Answer

If you are seeing an experienced injector for your treatment and you trust her/him it is best to listen to their advice since they are treating you and have had the benefit of examining you.  There can be complications with compromising blood supply to the lips.  Though you stated you want large overfilled lips, I'm sure it's not only about the volume and that you would like a nice shape as well which could be impacted as more and more filler is added.

Connie Hiers, MD, FACS · Answer

Yes, please stop! You risk interfering with the circulation of your lips and really big lips do not look natural, feel natural, or move natural.  When you do stop filling your lips, and you will stop someday, the lips will look much worse.

Limitations with Large Volumes of Lip Filler?

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