Lip enhancements have been around for many years and have continued to gain popularity in the Midwest. In Dermatology, we prioritize the importance of educating our patients on the world of medical aesthetics and helping them choose a journey that will best suit their aesthetic goals, financial limits and comfortability. Read below for everything you need to know about achieving your perfect pout!

Lip Anatomy:

Every basic lip consists of a Vermillion border, oral commissure, tubercule, cupid’s bow, Glogau-Klein points and philtral columns. The vermillion border is the ridge that outlines the lip itself and plays a large role in defining the lip while the Glogau-Klein points and philtral columns create the definition of the cupid’s bow and upward lift of the upper lip. The tubercle is the fleshy center of the upper lip and the oral commissures are the corners of the lip where the top lip meets the bottom lip.

In a youthful lip, the golden ratio of the vertical height of the upper lip to that of the lower lip is 1:1.6.

 Lip Restoration:

Collagen and elastin are the essential building blocks for maintaining a plump and luscious lip. As we age, our bodies naturally deplete these essential building blocks causing a loss of volume and structure. The vermillion border loses its definition and wrinkles start to form around the mouth, the cupid’s bow and philtral columns flatten and the oral commissures droop.

The goal of lip augmentation should be to restore lost volume and definition, bringing back a more youthful and proportioned lip.

Restoration can be achieved with several different treatments including Hyaluronic Acid Fillers, Neurotoxins and/or Platelet Rich Fibrin (PRF). Often, a multi-pronged approach to restoration will provide the most cosmetically pleasing outcome as well as longer lasting results.

Hyaluronic Acid (HA) Filler:

Hyaluronic acid (HA) is a naturally occurring substance found within the body and is responsible for hydrating the tissues and lubricating the joints. HA can be derived through fermentation of bacteria and purified for use as a soft tissue filler. HA fillers are completely reversible, making them as safe as they are effective. The hydration boosting effects of HA fillers make them ideal for the lips. Fillers are great for adding definition and shape, as well as increasing the volume of the lip(s). The key benefits of HA filler are immediate results that last around 6-12 months. The patient should expect 1-2 weeks of “downtime” with swelling and possible bruising.


Neurotoxins such as Botox and Jeuveau work by relaxing muscles to decrease the appearance of wrinkles. When injected into the lip, it is known as a lip flip. The orbicularis oris muscle is a circular muscle that surrounds the mouth on the outer portions of the lips. The upper portion of the orbicularis oris has a downward pull while the lower portion has an upward pull. Neurotoxins can be injected into the upper portion of the orbicularis oris to provide a lift of the upper lip and create a more defined cupid’s bow. They can also be injected into the lower portion of the orbicularis oris to create a more “pouted” bottom lip. The benefits of neurotoxin generally take effect within 1-2 weeks and last around 6 weeks. Lip flips are often best used when combined with HA fillers, but can be done as a stand-alone treatment. Though swelling and bruising can occur, the patient can expect minimal to no downtime. The patient may notice some decreased muscle movement around the lips (this is most often noticed with activities such as drinking from a straw). These effects are temporary and muscle tone will be re-gained.

Platelet Rich Fibrin (PRF):

PRF is a restorative treatment using the patient’s own blood. The blood is obtained and subsequently spun at a certain rate of speed for a specific amount of time. By doing this, the red blood cells are separated from the growth factor rich components of the blood (fibrin). When the PRF is injected into target areas, the body is triggered to rebuild collagen and elastin in those areas, providing long-term benefits of a more youthful appearance. PRF treatments are best done in a series of 3-4 treatments spaced 4 weeks apart, and optimal results are seen 90 days following the last treatment.

Through a heating and cooling process, the PRF can be turned into a gel-like consistency for use as a dermal filler giving an immediate result that last about 6 weeks while triggering the long-term benefits of collagen induction.

PRF can also be used in conjunction with HA filler for a treatment that combines the immediate and longer lasting effects of the HA filler and the regenerative benefits of PRF. The patient can expect 7-10 days of downtime (swelling and possible bruising) when treated with PRF alone.