beauty

Should I Get Lip Filler Or a Lip Flip?

Photo-Illustration: The Cut; Photo: GoodLifeStudio/Getty Images

A plump debate:

Dear Beauty Editor,

I’ve noticed lots of influencers are getting lip flips instead of lip filler, and the results look so much better and more subtle. How do I make sure I get that look and not something fake and overdone?

—Anon.

There are now hundreds (thousands? Infinite?) ways to augment your lips, including the temporary look of a very lip shiny balm or the permanence of a surgical lip lift. In between those poles, there are the semi-permanent cosmetic injectables — which is where things get confusing. An injector can change your lips in two ways: by giving you lip filler (with a dermal filler such as Juvéderm) or a lip flip (with an injectable neurotoxin, or neuromodulator, such as Botox). “Nowadays, I have more patients coming in asking for a lip flip than for filler,” says board-certified dermatologist Melissa K. Levin, M.D., the founder of Entière Dermatology. “But I have to talk to them to find out what they’re really after. I’d say probably 30 percent of them would be happy with a lip flip, the others would be happier with filler.”

Lip Flip: What It Is?

If you check out after photos of people who have gotten lip flips, it often looks like their top lip is plumper than it was before the procedure. But a lip flip doesn’t actually add any volume, according to Elizabeth Ranelli, a New York City–based aesthetic nurse at SkinSpirit. “It uses neurotoxin injections to relax the muscles around the lips, allowing them to appear fuller,” she says. The procedure is often a good option for people who don’t like how their top lip disappears or curls up when they smile.

“We often use neuromodulators to help with a gummy smile,” says Levin. But, she adds, the injections can do more than adjust the look of your smile or “flip” your top lip; they can also be used to rejuvenate and soften the appearance of your mouth or adjust the projection of your top or bottom lips. “Sometimes I use Botox to soften the muscles that pull down the outer corners of the mouth,” Levin says.

Where and how much your provider injects will depend on your lip shape and the way your mouth moves. But, in general, they will inject a small amount of Botox, Dysport, Xeomin, or Daxxify into the muscle above and/or below your mouth. The side effects and the results will last somewhere between a month and four months. “We charge $200 for a lip flip, which lasts about four to six weeks,” says Ranelli. If you go to an experienced injector, the side effects and risks are minimal and may include minor bruising or some swelling.

Lip Filler: What It Is?

If you feel like your top and bottom lip look thin even when you’re not smiling, or you want to add fullness or balance the symmetry of your lips at rest, filler may be a better option. There are multiple dermal fillers (including numerous options under the brand names Restylane, RHA Collection, and Juvéderm), which an injector can use to plump your top and/or bottom lip or smooth the lines around your mouth. “A lot of people will start with a lip flip, then they come in two weeks later for me to see how the Botox settles in, and they like it but they still want more volume, so they may also get lip filler,” says Levin.

The product your provider uses, where they place it, and how much they inject will depend on numerous factors. Ranelli says she’s looking at “lip shape, volume, symmetry, and overall facial harmony” when she’s advising her patients. “And it’s important to assess the lips while smiling and at rest to understand how they move and how the desired outcome will integrate with their facial expressions,” she says.

In general, fillers cost more and last longer than neuromodulators. At Ranelli’s SkinSpirit location, lip filler starts at $575. “And it can last anywhere from four months to one year, depending on the volume injected and type of filler used,” she says. Possible side effects include bruising or swelling, and there’s a small chance of infection or vascular complications that can lead to tissue damage.

Which is the Best Lip Injection?

How can you tell which type of lip injection — filler or neuromodulator — is right for you? My advice is not to decide on your own. Instead, find a provider you trust, talk to them about the changes you’d like to make, and then … ask them! Think of it this way: You never go into your dentist’s office with tooth pain and say, “Can you numb me with .5 mls of 2 percent lidocaine, and then remove the cavity and fill my tooth with a nanohybrid composite?” That would be absurd. But the plastic surgeons, dermatologists, and nurse injectors I consult for this column tell me that happens to them all the time: Patients request a particular procedure and product, usually because they saw a video or post online and want similar results.

So, rather than watching videos of injections and trying to find out which products were used on the people whose results you admire, put that effort into researching different providers in your area. “Look for someone who listens to your concerns, provides personalized recommendations, and prioritizes your safety and satisfaction,” says Ranelli. If you can spare the time, book a few consultations before you commit to anything. At clinics like SkinSpirit, consultations are free. And at many doctor’s offices, they’re either free or the appointment cost can be put toward any treatments you get. And whatever you do, don’t let a deal on a particular product affect your decision. You’re not buying a used car, you’re getting a medical procedure — your health should be your top priority.

Send your questions to AskABeautyEditor@nymag.com. (By emailing, you agree to the terms here.)

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