The lip flip procedure is a relatively new technique in which small, precise amounts of Botox(TM) or similar products (neurotoxins) are artfully injected at the border of the lips to evert the lip, causing it to move up and out. This alternative to lip fillers emphasizes the lip’s cupid’s bow shape, making the lip look a little bigger.

Hyaluronic acid lip fillers also enhance the shape and add volume, augmenting the lip. The lip flip is a more subtle enhancement, with no downtime, and is a less expensive aesthetic treatment. It is used more commonly in patients who start with good natural-looking lip volume. Lip filler will generally produce a more dramatic augmentation.

What is a Lip Flip?

A lip flip is a cosmetic procedure that involves injecting small, precise amounts of Botox (TM) or similar products at the vermilion border (the red-white border) of the upper lip or, less commonly of the lower lip, to enhance the natural appearance of the lip. This creates a fuller, appealing pout that emphasizes the cupid’s bow shape of the lip.

Patients who want to correct their gummy smile or emphasize shape without adding lip volume are good candidates for this technique.

What are Lip Fillers?

Hyaluronic acid is an injectable filler used to enhance the shape and volume of the lips (and other areas of the face). A variety of fillers exist with distinct characteristics (like stiffness or puffiness). Different fillers and injection techniques are used depending on whether a patient wants additional volume, enhancement of lip shape, or wrinkle reduction.

Lip Flip Vs. Fillers

For the lip flip procedure, small, precise amounts of Botox™ (about 4-6 units) are injected into the border of the lip to create a more pouty, youthful, and even sensual appearance. A slight volume enhancement is also achieved. On the other hand, dermal filler injections augment the volume of the lips, actually making them larger, while also enhancing shape. Filler is more dramatic.

When done properly, fillers will enhance the natural shape and volume of your lips, reduce wrinkles, and look natural.

Patients who want a more subtle lip enhancement, that emphasizes a pouty, youthful shape, but who don’t want or need to increase the volume of their lips, are good candidates for the lip flip, which uses Botox™ or other neuromodulators to relax precise areas of the lip muscle, causing the lip to evert, to unfurl. Younger patients often use the lip flip.

The upper lip is more commonly injected than the lower for the lip flip, but both can be treated. Ideal candidates start with good lip fullness. It takes 1-2 weeks for the neuromodulator to work; duration is highly variable, but a lip flip usually lasts 3-4 months. Many patients do feel that their lips do look somewhat larger after the lip flip because of the eversion effect.

Injectable fillers can achieve significant volume augmentation of the lips, depending on how much filler is injected. The shape is also enhanced; doctors mimic that natural anatomic shape of the lips when placing filler; this allows a natural look even with dramatic augmentation when done properly.

Different fillers and techniques can be selected for specific purposes, like emphasizing wrinkle reduction over volume augmentation, creating a little more puffiness, or increasing the height of the lips. Fillers increase volume immediately, but it takes 2-3 weeks to see the final result. There is usually noticeable swelling (that can look ducky) for 2-3 days.

Is a lip flip more natural than filler?

The lip flip treatment and results are more subtle than a dermal lip filler, so it almost always looks natural. Lip filler, done well, almost always looks natural too, but we have all seen obvious, overdone lips; these lips have filler.

What is Better, Lip Filler or a Botox Lip Flip?

The lip flip is best for patients who start with good lip fullness and want to optimize shape and have the appearance of slight volume augmentation. Fillers are used for patients who need more volume because of aging, wrinkles (lip lines), or because their lips are naturally thin – or for patients who want a dramatic change.

Because younger patients usually start with good shape and fullness, the lip flip technique is often the best choice for them. Young patients who want a dramatic enhancement are still often happiest with filler. Filler is better for patients who have thin lips naturally or who have lost volume due to aging, smoking, sun damage, or other factors.

Note that filler injection is not just about volume, it’s also about shape, often about enhancing the cupid’s bow appearance of the lips. A proper, artistic injection will emphasize and enhance the natural lip contours and shape, to produce a natural look.

Although some patients are candidates for both the lip flip and fillers, generally a lip flip is not needed in addition to filler injection because fillers add significant volume. Patients who have prominent lip lines (wrinkles) may benefit from both. Patient selection and procedural planning are just as important as the injection itself to achieve ideal results with either the lip flip or fillers.

What Hurts More Lip Flip or Filler?

The lip flip hurts less than fillers, just like Botox™ or Dysport™ injections hurt less than filler elsewhere in the face. Injecting neurotoxins is like injecting small amounts of water into specific areas, so the pain is minimal and is mainly from the needle itself.

Fillers hurt more because of the volume and thickness of the product. The lips are also more sensitive than most other areas. With neurotoxins or fillers, pain can be mitigated with ice, numbing cream, or vibration distraction.

What to Expect When Receiving a Botox Lip Flip

Most patients can return to work the same day after a lip flip. Tiny bumps from the neurotoxin may be present for 15-20 minutes. Small injection site bruises may occur, can be covered with makeup, and last several days. The eversion or flip effect is usually noticeable starting at one week and gains full effect in about 2 weeks.

Note: the potential side effects of lip filler treatments include swelling, redness, bruising, and pain. Although rare, some patients may experience cold sores or infections. Blindness and skin necrosis (death of a small patch of skin) are extremely rare complications of filler injection anywhere in the face.

Botox™ and similar products work by paralyzing specific, small areas of muscle into which they are injected. For a lip flip, the orbicularis oris muscle that comprises the lip is injected superficially at its border.

Relaxing the muscle in this area unfurls and everts the lip, allowing a more pouty appearance. The cupid’s bow shape of the lips can be emphasized, depending on exactly where the injections are placed.

Older techniques for placing botulinum toxin in the lips were actually designed to reduce wrinkles. Larger amounts were placed in wider areas and caused too much relaxation, so the mouth did not work normally afterward, limiting the usefulness of older techniques. The lip flip involves smaller, more precise amounts of toxin, so alteration of the movement of the lips is minimal and not noticed by most (not all) patients.

After a lip flip procedure, you should:

  • Avoid wearing lip balm and lipstick for an hour or so.
  • Avoid applying pressure on your lips.
  • Don’t sleep facedown.
  • Apply an ice pack intermittently to your lips for 10-20 minutes to reduce pain and inflammation.

Call Beachwood Plastic Surgery and Medical Spa Today to schedule your next lip treatment!