American Society of Plastic Surgeons
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Four reasons a person may want lip filler
There’s more to lip filler than just wanting 'sexier' lips

In recent months, as more Americans have gotten vaccinated, ditched the masks (for the most part) and returned to their pre-pandemic way of life, plastic surgeons have noticed a surprising trend: an increase in lip injections. While lip filler is popular among the young and old alike, it oftentimes falls victim to stereotypes and punchlines, but there's much more to the cosmetic enhancement than just wanting fuller lips (although that can play a role).

"There's an extremely broad spectrum of patients who benefit from lip filler," explains Michele Shermak, MD, a plastic surgeon with a practice in Maryland, dispelling the myth that the procedure is only for a small contingent looking for larger lips. "Filler does not necessarily look ducky," she explains. "The main issue is with regard to patient selection: whether the plastic surgeon can satisfy the patient's goals and the surgeon has to determine if the goals are realistic or appropriate."

In fact, Dr. Shermak has spent much of the last several years correcting overfilled lips and incorrect theories from patients. It's true that lip fillers have become synonymous with amping up the volume, but they have a number of lesser-known, but equally important, benefits, too. For these reasons and more, it's not surprising that according to the 2020 annual report from the American Society of Plastic Surgeons, 3.4 million Americans received soft tissue filler injections. Further, the type of filler commonly used for lips, hyaluronic acid, was injected into more than 2.6 million people, and although not everyone may have gotten lip injections, it's not hard to guess that a strong percentage did.

Below, Dr. Shermak and Boston-based plastic surgeon Kelly Sullivan, MD, shed light on all the ways lip filler can help improve a pout.

Corrects lip asymmetries

Everyone's face is somewhat asymmetrical, so subtly uneven lips aren't usually that obvious. But moderately disproportionate lips can be a serious concern that affects a person's self-confidence.

"If someone has one side that is not as full as the other, or someone's had a scar or something that has affected the shape of the lip, those are asymmetries that we could correct with lip filler," explains Dr. Sullivan. "With these patients, we'd change the shape of their lip to match the other. We will fix what is bothering them, and the goal is just to have the lips look proportional to one another."

Dr. Shermak explains that typically, the upper lip is smaller than the lower lip in Caucasian people, and in other ethnicities, the upper and lower lip are approximately the same volume, but that "patients will generally communicate the look that they're interested in, so I go by that" when evening out asymmetrical lips.

Reduces appearance of fine lines on lips and mouth area

"Lip filler is an incredibly rejuvenating treatment for women who are starting to show signs of aging, typically in their 50s and beyond," says Dr. Shermak, adding that studies have shown that one of the most noticeable signs of aging is lip thinning. "The great thing is that with the fillers available, we can provide a wide range of fill, from light to really full, depending on the patient's needs and goals."

According to Dr. Sullivan, many mature patients come to her office to address the fine lines around their mouths. "A lot of people refer to them as smoker's lines, even though most are not technically smokers, but they're these vertical lines that go up from the edge of the lip, and they want to address that."

Smokers or not, most people will develop these fine lines surrounding the mouth because they "result from dynamic imbalance between the muscle thickening with decades worth of activity and skin thinning" that naturally comes with age, says Dr. Shermak. But the fillers "do a great job" to smooth and treat these fine lines to reverse the signs of aging.

To prevent the dreaded (and tired!) stereotype of overfilled lips, Shermak says that injections can be staged to avoid overtreatment, but overall, "it's a great treatment for women who are looking for a rejuvenating, fresh option to improve an aging appearance."

Defines lip shape + Cupid's Bow

There's another category of patients who may not have asymmetrical lips, but rather, lips that are weakly defined, where the border kind of flows into the surrounding skin. Luckily, you can add dimension with a bit of strategically placed filler to sharpen the natural lip line and define the Cupid's Bow.

"This group of people also want to change the shape of their lip, but ever so slightly," says Dr. Sullivan. "For instance, maybe they don't have a very sharp Cupid's Bow, or they want to create more of a pouty, defined shape overall."

If this sounds like a subtle, slight difference you aren't wrong. This type of procedure is the perfect example of why you shouldn't trust just anyone to inject your lips (or anywhere).

"It's important to go to a board-certified plastic surgeon who has been trained and understands the nuances of the different kinds of fillers, the anatomy that you're working with and all the different elements involved," cautions Dr. Sullivan.

Adds natural fullness

"From younger women who want a fuller lip to older women who want a more refreshed look, there is almost no particular group that is not a good candidate for filler," says Dr. Shermak, noting that younger patients request more all-over volume than their older counterparts, who are just looking to restore a youthful lip.

"If you want to fill in volume and plump out the lips, you're going to use a thicker type of filler that you inject a little bit deeper," explains Dr. Sullivan, noting that lip filler should always be customized to a patient's anatomy, desires and goals.

Even so, her philosophy is to "start conservatively because we can always add more, but easing into it is the way to go," she says. "It's our job as plastic surgeons to educate patients about the dangers of injecting too much too fast."

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