LIP IMPLANTS

Pros

• This lip augmentation procedure can create permanently fuller lips, eliminating the need for the ongoing expense and discomfort of lip fillers.  
• It’s a minor, 30-minute surgery (for both upper lips and lower lips), performed under local anesthesia or numbing and sedation.
• When it’s performed by a skilled plastic surgeon, scars can be virtually undetectable.
• The implants can be removed if problems arise, you don’t like your results, or you want to return to your natural lips—though this type of reversal is far easier with silicone implants than Gore-Tex.
• The size and shape can be customized to the look you want. 
• Fillers can be placed on top of the implants, if more augmentation or definition is desired.

Cons

• The change with an implant like PermaLip typically does not provide as much fullness as lip enhancement procedures like fat grafting or lip filler. If you’re looking for a dramatic difference, or a change to the shape of your lips, you may be disappointed.
• PermaLip implants are not FDA-approved. In fact, the FDA has warned their manufacturer that their lip implants can lead to complications like migration, protrusion, and extrusion through the skin. Larger implants are more likely to have complications. 
• Lip implants have a higher up-front cost than hyaluronic acid–based lip injections (though they can be more affordable than repeated injections over many years).
• “If lip implants don’t go perfectly, people can have little chronic problems, just because of the motion and their being in the mouth,” says Austin, Texas, plastic surgeon Dr. Johnny Franco. 
• There’s a small risk of infection or an allergic reaction. 
• You may need another procedure down the line to correct asymmetry, implant shifting, or lumps that develop over time.

	Lip Implants surgical	Juvéderm nonsurgical	Restylane nonsurgical	RHA Collection Fillers nonsurgical
Worth It Rating	80%	91%	85%	83%
Average Cost	$2900	$885	$1126	$920
Downtime	Up to 3 days of downtime	No downtime	No downtime	No downtime
Anesthesia	Local anesthesia	Topical anesthesia	Topical anesthesia	Topical numbing cream

Injectable lip fillers are a more popular lip augmentation option than implants, but it’s worth comparing the two. These are the key differences to consider:

• Hyaluronic acid-based lip fillers are injected into the lips to add volume, correct asymmetries, lift the corners of the mouth, create a more defined Cupid’s bow, and smooth lipstick lines.
• This injectable treatment is less invasive than lip implant surgery, but results last just 3 to 12 months, depending on the type of filler used and how your body metabolizes it. If you want to keep up your results, you’ll need to budget for follow-up treatments.
• Lip implant surgery costs more than 3x the price of injections (on average) and comes with up to 3 days of downtime, but results are considered permanent.

Related:Why I Decided to Get Lip Implants Instead of Filler

• Average Cost:
• $2,900

• Range:
• $1,500 - $4,300

The price you pay for lip implants will depend on your surgeon’s level of experience, their practice location, and a few other key factors.

See our complete guide to lip implants costs

The lip implant photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

According to Dr. Majmundar, the patients he sees most often for lip implants have had lip augmentation with injectable dermal fillers in the past and are now:

• Tired of the temporary nature of lip fillers
• Bothered by the sensitive injections to the lip (one of the most painful areas to get fillers) 

“We used to see people over 50 as the most common demographic for lip implants, because they were tired of the expense and years of recurrent injections, but now—with the boom of social media sites like Instagram and improved awareness of lip implants—most of the people seeking out lip implants are in their 20s to 40s,” says Dr. Majmundar.

Another advantage of PermaLip implants is that lip filler can be injected over the implant, to give people even fuller lips, if they desire, or create more precise shaping.

“I would say very few people do that, because they’re happy with their natural-looking implants,” says Dr. Majmundar.

“PermaLip implants are soft, flexible silicone tubes, tapered at each end, that augment without shaping,” explains Dr. Steve Laverson, a San Diego plastic surgeon. 

As the name implies, PermaLip implant results can be permanent, though “they’re easily removed if you don’t like them or if you have a problem such as migration, asymmetry, capsular contracture [a hardened capsule of tissue that can form around an implant] with immobility of lips, or a disappointing result.”

If you're considering PermaLip implants, it's important to be aware that they’re not approved by the U.S. Food & Drug Administration (FDA) for use in the lips.

Surgisil, the company that manufactures PermaLip, has FDA clearance for the Perma Facial Implant, with an indication for it to be implanted in the chin, jaw, and nose.

According to a warning letter the FDA sent to the company in April 2019, “use of the Perma Facial Implant for augmentation of the lips constitutes a major change/modification to its intended use for which you lack approval.” 

The specific concern is that the physiological and anatomical differences between the lips and the nose, chin, and cheeks (lack of bone structure, for instance) allow the implant to “free float," which “may cause migration or protrusion of the implant.”

Indeed, some RealSelf members have reported that their lip implants have migrated or protruded. 

Another issue, according to the FDA: “Since the lips are very actively used, the free-floating nature of implanted devices exacerbates risks such as device extrusions, which, when they occur, may require surgical removal and extensive dermal repair. Migration and protrusion also increase other risks to the patient, such as infection and chronic pain.”

Because the PermaLip implant is not cleared or approved by the FDA for marketing in the U.S., the FDA requested in its warning letter that Surgisil immediately stop distributing the device for use in the lip.

A disclaimer on the company website says that “the intended use of the PermaLip Product is not approved for distribution within the United States,” but it’s still featured on the company website and sold to plastic surgeons, many of whom mistakenly say on their websites that PermaLip is FDA-approved.

“The vast majority of plastic surgeons rely on PermaLip as the go-to implant material,” says Dr. Majmundar. While Gore-Tex can be used, results are less reversible and lips usually feel firmer. 

“If a patient with Gore-Tex is referred to my practice for implant removal, I usually turn them away—or I have a long discussion with them prior, to help them understand that the scar tissue induced by Gore-Tex will bind to the implant. This makes the implant much harder to remove and increases the chances that the lips will look deformed afterward.”

According to Dr. Majmundar, silicone implants are easily placed and easily removed, making the procedure completely reversible, without any lasting deformity to the lip.

A lip implant procedure usually takes less than an hour. Here’s what to expect:

• First, you’ll be given a local anesthetic (similar to what’s used during a dental procedure) in your lips, so they’ll be completely numb. It’s likely you’ll also get an oral sedative or pain reliever.
• When you’re comfortable and the numbing has kicked in, your surgeon will make small incisions at the corners of the mouth and use a thin surgical instrument to create tunnels.
• They’ll gently thread the implants through the tunnels into the desired position and trim away any excess material.
• Once your implants are in place, the incisions will be closed with tiny, dissolvable stitches.

RealSelf Tip: Your surgeon will recommend an implant size based on the thickness of your lip skin and desired result. “While most older patients with thin lip skin do well with the three millimeter implant, the majority of my patients have the four millimeter implant inserted,” says Dr. Kevin Ende, an Englewood, New Jersey, facial plastic surgeon.

“Four millimeters is the largest size recommended to put in the first time, since some lips may not be able to accommodate anything larger," says Dr. Ende. "Once full healing has taken place, the implant can be easily upsized to a five millimeter implant, if the patient desires fuller lips."

You'll need up to three days of downtime before you'll feel and look enough like your usual self to resume your normal activities. 

One RealSelf member says that her lips “were super-swollen the first two days—I’m talking Scarlett Johansson having an allergic reaction kind of swollen.” Talking, smiling, and drinking were a struggle for a few days as well, she says.

The most common side effects of this surgical procedure are swelling, bruising, or asymmetry, which can persist for up to a week. You can also expect significant soreness, especially the first day.

Your surgeon may prescribe pain medication for the first day or two; over-the-counter options may be enough to keep you comfortable after that. Gently icing your lips and elevating your head can also help reduce swelling.

After the first week, you’ll still have noticeably fuller lips, but the bruising will have faded and your lip shape may look more even.

Most of the swelling should be resolved within a month, and you should start to see your final results.  

Your surgeon will give you postoperative care instructions, to promote healing and reduce the risk of complications. 

Doctors usually recommend:

• Sleeping on your back, with your head elevated, for two or three nights
• Eating soft foods
• Keeping your activity minimal for three days
• Applying cool compresses
• Using lip balm regularly, to keep your lips moist 

After two months, one RealSelf member reported that she loved the result. “My friends think I look younger. For the first time in my life, I enjoy putting on lipstick!”

Others, however, have been disappointed with the subtle change in their lips after the swelling went down. 

During your consultation, be sure to discuss your “wish lips” with your provider so that your final result is sufficiently full and voluptuous. Photos can help ensure that your expectations are realistic and you’re on the same page as your surgeon.

Implants can be felt the most during the first three to six weeks of recovery time, when your body is forming a protective collagen capsule around the implant, Dr. Majmundar explains. “Once that forms, the lip continues to get softer and more natural feeling over a period of four to six months.”

According to RealSelf member jesicat, “After about a month, it feels completely normal. You can feel the implant in there, but it kinda becomes a part of you.”

Patients who start with very thin lips might not have enough soft lip tissue in their lips to provide a cushion over the implant, so they may feel the implant for much longer.

Dr. Majmundar believes that lip implants are safe. Like many other plastic surgeons, he was using PermaLip implants well before the FDA warning and continues to do so. “It seems to be very safe in my practice,” he says. 

Still, they do come with risks, side effects, and potential complications. These include:

• Bruising and swelling.
• Implant migration, which is a greater risk for people who tend to use one side of their mouth more than the other—for instance, they have an asymmetric smile and one lip pulls more than the other when talking or smiling.
• Infection, which is minimized when the procedure is performed in a sterile environment, such as an operating room instead of a clinic exam room. You can also lower your risk by following your surgeon's aftercare instructions for keeping your incisions clean as they heal.
• The potential for migration and even extrusion through the skin.
• Capsular contracture, a hard capsule of scar tissue that can form around the implant.

PermaLip implants are designed to be permanent, with no need to be replaced—though they can be removed in the event of a complication or if you want to return to your natural lip size.

“Surgisil, LLP.” U.S. Food and Drug Administration, FDA, 15 Apr. 2019.

“SurgiSil.” SurgiSil LLP | The Shape of Tomorrow, 2 Oct. 2018.