How long does it last?

The majority of lip fillers are designed to last from 6-12 months, though some newer longer lasting fillers are designed to last up to 15 months. This will largely depend on the type of filler used, how “cross-linked” it is, or in other words, how quickly it’s designed to be broken down by the body. The more cross linked the product, the longer it will last. Lips are the most mobile part of our bodies- you are constantly moving your lips; to speak, to eat, to smile, and it’s that constant movement that mean its one of the areas that will break down dermal filler fastest. Each time you have treatment, the results last longer and longer because the result is buildable session by session. Inevitably results will also depend on injector skill, individual tissue type, and lifestyle. Smokers often find filler doesn’t last as long as non smokers.

How can you tell if someone is qualified to do lip fillers?

Unfortunately in the UK, the industry is very poorly regulated, meaning as it stands today, anyone can inject anyone. This is worrying and there is a strong movement, with progress in parliament, to enforce better regulation and protect public safety. Anyone, medical or not, can open an Instagram page, and inject people with filler, with no anatomical knowledge or scientific background, and in any setting. They can also inject you with one of over 200 fillers in the market in the UK. NOT all fillers are the same, some are cheap as, many are not well tested and have a poor safety profile. In the states, the FDA regulation is strict meaning there are only approx 14 fillers on the market that have been rigorously tested for safety. Of course this means we are hearing of scary complications that non medical injectors are not able to diagnose or treat promptly, resulting in many cases hitting the headlines of patients turning up in hospital hours after lip filler with severe swelling, infection, death of lip tissue and permanent scarring. So it’s down to you to do your research and look for the following:

  • Is your injector a registered clinician? Are they a doctor, dentist or nurse prescriber with a license number with their registered council? This is important. Should you experience a complication, only a licensed prescriber can prescribe the medication or antidote to reverse and dissolve filler. 
  • Are they insured and indemnified to perform procedures? Don’t be afraid to ask!
  • What’s their background and experience? 
  • What’s their emergency protocol? It’s all well and good if everything goes well. If things go wrong though, are you able to get in contact with them and promptly assess and treat the problem?

Does it hurt?

Lips are full of nerves and blood vessels, and are one of the most sensitive parts of the body. So to make the procedure comfortable, the lips are usually numbed prior to injection. This can be done with a topical numbing cream applied to the lips 20-30 mins before the procedure, or a dental block can be given to completely block the feeling to the lips meaning you won’t feel anything during the process.

Is it expensive?

Prices will vary from clinic to clinic, depending on products used, and skill, experience and expertise of the injector. Most lip enhancements will cost around £300-400. 

Is it reversible?

Lip fillers using hyaluronic acid are reversible using an enzyme called hyaluronidase. This doesn’t come without risks, and must be used only by a medical clinician who will first perform a patch test as the enzyme to dissolve filler has a high rate of causing a severe allergic reaction. Ensure your injector is highly qualified and experienced, and understands the results you are after so that you are not in a position to need to dissolve your lips. 

Are there side effects?

Lips being one of the most vascular parts of the body can naturally swell and bruise post treatment. Most patients won’t suffer any significant swelling or bruising, and of course this will differ depending on technique (needle is more likely to bruise but offers greater precision vs round tipped cannula which is great for creating volume without perforating a blood vessel and therefore less likely to bruise). 

Are there risks?

Yes, all fillers carry potential risks and this must be thoroughly discussed with you prior to injection so that you are aware and make an informed decision. Whilst there are risks – these are thankfully very rare and most can be avoided by good technique and following the correct aftercare protocol. Risks vary from minor lumps and bumps that can easily be corrected to more serious issues like infection and blockage of a blood vessel known as vascular occlusion, which is an emergency as left untreated can result in death of the tissue affected and long term scarring. There is a 3 in one million reported risk of blindness from filler injections, though the lip area is not deemed a high risk area. 

What are fillers made of?

There are a range of different fillers on the market with different constituents. By far the safest fillers are those that can be reversed in the event of an adverse event. The only injectable dermal fillers licensed to be used in the lips are made of hyaluronic acid, which is naturally occurring and not animal based. Never let anyone inject your lips with silicone or calcium hydroxyapatite and make sure you are being injected with fillers that are FDA approved or CE marked and have the highest level of safety data behind them.  NOT all fillers are the same, and it is important that you know that, and know that cheap is not always cheerful. They also come in different particle size and different degrees of lifting capacity, some denser than others and some softer than others. Your clinician should understand the different fillers on the market, and know how to use each filler differently depending on your lip and tissue type and desired outcome. Using thick fillers that don’t integrate well will put you at risk of lump formation.

Are fillers safe?

Yes, billions of filler procedures are being administered world wide yearly, the majority of which are incident free. Having said that, there are risks involved as discussed above, and it’s up to you to weigh those risks and decide whether having a procedure is right for you or not. Reduce your risk of complications by seeing an experienced medically qualified clinician, who can diagnose, treat and sort any potential problems quickly, rather than seeing someone who doesn’t have the license to prescribe the right treatments to get you out of a complication should such a thing arise.

What if I don’t like how I look after I’ve had fillers?

Thankfully this is exceptionally unlikely if you have had a thorough consultation and you and your doctor are on the same page about what you wish to achieve. But if you were to find yourself in such a position, get in touch with your clinician so they can address your concerns and rectify anything needed. Remember in the first couple of weeks you may have mild swelling so it is best to wait until it has settled so you can accurately judge the final result. As hyaluronic acid fillers are fully dissolvable, any treatment can be reversed should the need arise. A patch test for the dissolving enzyme must first be performed to ensure you are not allergic to it and that the reversing procedure is performed safely.

Will my lips feel lumpy afterwards?

They can do in the first few days to weeks while the swelling is subsiding and the filler integrates well, but this should disappear quite quickly. It is not normal to feel lumps months after, so if it persists contact your clinician for correction.

Will my lips be numbed first?

This varies from clinician to clinician. I numb every single patient with numbing cream at the very least to ensure the procedure is comfortable, but if you are worried about pain we can give you a dental block to completely block the feeling of pain to the lip and you won’t feel a thing!

Can I just get one lip done?

This depends on your lip and facial proportions. For example if one lip was significantly disproportionally smaller than the other then yes, augmenting one lip will improve the overall proportions. In my clinic I see many patients who have not been appropriately counseled and come in to see me for corrective treatment after having their lips overfilled, or one lip protruding too far past the other, often with upper lip augmentation. Remember the golden PHI proportions of 1:1.618 where the lower lip should be 1.618 times the size of the upper for a natural, beautiful, Angelina Jolie type look rather than the overfilled upper “trout pout” effect.

Overall, stay safe, do your research and ensure your injector is fully licensed, insured and extensively trained and is a prescriber who can recognise, prescribe and treat any emergencies they come across promptly. 

How long does the procedure take?

This depends on the clinician, technique and the lips being injected. The injection time itself is usually no more than 5-10 minutes in experienced hands.

This information has been provided by Dr Yusra Al-Mukhtar BDS (Hons) BSc (Hons) MFDS RCS Ed MJDF RCS Eng. Dr Yusra is a dental surgeon and member of the royal college of surgeons of England and Edinburgh. She is highly experienced having performed over 15000 procedures and trains doctors and dentists on how to perform aesthetic procedures safely. She runs clinics in London and Liverpool moments away from the well known Crosby beach.

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