Botox to upper lip area for smokers lines

I had botox to my upper lip two days ago to get rid of the smokers lines. My injector did not put a large amount, but already i'm noticing a flattening of my upper lip and it looks longer than before. Is this possible for the lip to descend with botox? I hate the way it looks and I feel like I look like a muppet. Im scared to see what it will look like in 2 weeks!

Doctor Answers 12

Botox in Lips

Thank you for your question. Unfortunately this is a possible side effect with Botox when placed into this area. Nothing can be done to reverse the Botox. It typically wears off in 3-4 months.

Summit Emergency Medicine Physician
5.0 out of 5 stars 45 reviews

Botox results for upper lip lines

While Botox works well for vertical lip lines, particularly when combined with a filler such as Belotero, Restylane Silk or Volbella, it is important that a very low dose is used. I usually do not inject more than 4 units for theses lines. That being said, now that you have had the Botox injection, you will probably need to wait 3-4 months for it to wear off. Alternatively, you could have some filler injected to correct for the flattening caused by the Botox. 

Shaun Patel, MD
Miami Physician
5.0 out of 5 stars 55 reviews


I agree that botox in the upper lip (for smokers' lines) can lead to flattening of the philtral columns and elongation of the upper lip and lossof definition of the white roll and Cupid's bow.

Your doctor can salvage things by carefully putting some filler in the lip and vermillion border.

Once the botox wears off, another option to treat these lines could be with ablative resurfacing but make sure you see an experienced doctor for that.

Firas Al-Niaimi, MSc
London Dermatologist
5.0 out of 5 stars 4 reviews

Botox & Fillers Work Well For Upper LIp Smoker's (aka Bar Code, Lipstick Bleeding) Lines

While I certainly understand your concern and sincerely hope that the problem you are experiencing does not worsen over the next several days, your question does raise some very important issues worth discussing.

Personally, I have successfully been using Botox for reducing so-called "smoker's lines" (aka "bar code lines" or "lipstick bleeding lines") for well over two decades. For most people, this requires two four microdroplets of Botox for treating the upper lip (and a similar number for the lower) and hopefully the physician you chose to treat you possessed the skill and knowledge to treat this area properly and with the proper technique and dosages.

For persons who have become accustomed to the presence of these vertical lines for many years, their sudden flattening following Botox treatment may be the first time they have had to confront other aesthetic issues in the region that were being masked or overshadowed by the vertical lip lines. For example, flattening of the philtrum, loss of the Cupid's Bow,  loss of the white roll, and thinning of the vermilion border or of the vermilion body (the red part of the lip) itself--all of which can contribute to the appearance of a long, flat upper lip once the vertical lip lines have been addressed. Before I treat anyone in this region, I routinely discuss these issues in advance to avoid surprises, and often combine treatments during the same session

So, before hitting the panic button, it would be wise to look closely to see if any of the above issues may be playing a role in your disappointment and if so, to discuss how to proceed with your physician. Since much of the above falls under advanced injection technques, it would also be wise make sure you are being treated by a board certified aesthetic physician before going any further. Best of luck to you.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 29 reviews

Marge Simpson Lip after Botox

I'm so sorry this has happened to you. Unfortunately, this is a common problem, particularly with inexperienced injectors, although it can happen even with an expert injector if a patient turns out to be very sensitive to low doses of Botox.

Although it does take 3-4 months for any Botox effect to fully resolve, I have seen patients where in this area it did improve faster - sometimes 6 weeks or so, so I have my fingers crossed for you.

Even though many of my patients are troubled by these lines and this area, I do very little Botox or fillers in this area. At best, botox only makes it so you don't purse as much - it doesn't resolve the lines that are worked into the skin and at worst, it always carries the risk of the issues you're having. I think any filler in the upper lip skin outside the lip itself gives a very blocky, unnatural look - that Marge Simpson/trout pout projection when viewed from the side which is much reviled.

For this area, I think for most patients there are two good treatment options. Laser resurfacing is absolutely the best option and in good hands can literally plane the lines down to flat. It can be a transformative treatment. 

For people who can't handle the downtime of this, and also for all my resurfacing patients, I supplement this with fine dissolvable threads which provide scaffolding/support to the skin and also stimulate the growth of new collagen and smoother skin in the area.

Hope this helps and healing thoughts going out to you that your current Botox wears off quickly!

Rebecca Gelber, MD
Incline Village Physician
5.0 out of 5 stars 2 reviews

Botox in lips

I use very small amounts of Botox in the upper lip when patients choose not to use fillers. It works best for those patients who have a "gummy" smile, but many patients like the mild line resolution they get from this instead of using fillers here. The Botox you have had injected will resolve in about 3-4 months.

Pamela Stuart, MD
San Jose Physician
5.0 out of 5 stars 4 reviews

Other Options for Smokers Lines--Laser, Radiofrequency, fillers

Unfortunately, you will have to wait 3-4 months for the Botox to dissolve. However, Laser or radiofrequency, microneedling/prp and fillers work well to reduce these lines.  I suggest going to a facial contouring expert who injects fillers with cannulas to reduce complications.  Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews


Unfortunately after botox is placed you have to let it run its course. It will take 4 months for the neurotoxin to wear off. In the meantime, I would say you can look at trying to enhance your red lip volume with a filler. Hope this helps

Alan B. Brackup, MD, FACS
Philadelphia Oculoplastic Surgeon
5.0 out of 5 stars 31 reviews

Botox to lip

I sometimes put very small aliquots of botox into the upper lip smoker lines.  I have also used filler as well. THe botox will take 3-4 months to dissolve.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Botox above lip

Thanks for your question. There are many side effects when this treatment is administered above the lip area. Once the botox wears off, typically in 3-4 months, please visit an expert. You may want to consider a filler like Volbella- it is FDA approved and lasts up to a year. Volbella is designed to improve smokers lines while also giving the lips a natural, fuller look. Best, Dr. Katz

Bruce E. Katz, MD
New York Dermatologic Surgeon
3.8 out of 5 stars 17 reviews

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.