Lip filler: what you need to know before and after

The examination: the lips are not assessed in isolation

The lips form a whole with the other parts of the face. For this reason, the examination looks not only at lip volume but also at the corners of the mouth, the fine lines above the lip, the area between the nose and the lip, and the surrounding tissues. Lip anatomy varies markedly from person to person, and the treatment plan is based on this anatomy^[1].

It is important to talk openly about your expectations at the examination. Your doctor assesses your facial proportions and the characteristics of your tissue, and discusses with you what is possible, how much filler (in ml) might be considered for which area, and whether the treatment should be done in stages if needed. The resulting appearance varies from person to person.

Proportion and a natural look

The aim of lip filler is not only to add volume. The proportion between the upper and lower lip, the definition of the lip border, the lines above the lip and the position of the corners of the mouth are assessed together. Lip structure also changes with age, and this change is seen not only in the lip itself but also in the surrounding tissues^[1]. For this reason, treatments for the surrounding areas may also be discussed at the examination for some people.

Your doctor determines the amount suitable for you, in ml, at the examination. If considered necessary, the treatment may be planned in stages rather than in a single session, with an additional treatment after the follow-up visit. This approach gives an opportunity to assess how the lips look once the swelling has gone down.

Before the treatment

• History of cold sores: If you have had cold sores on your lips before, be sure to mention this at the examination. Filler treatment can trigger a cold sore to come back; your doctor can plan precautions accordingly^[2]. If there is an active cold sore on the lip on the day of treatment, the treatment is postponed.
• Medication: If you take blood thinners, mention this at the examination; do not stop your medication without consulting your doctor.
• The last few days: You will be asked to stop products such as green tea a week beforehand, not to drink alcohol the day before, and not to wear lipstick or make-up on your lips on the day of treatment. These precautions are intended to reduce the risk of bruising.
• Pregnancy and breastfeeding: Treatment is not carried out during these periods.

The day of treatment

The topical anaesthetic cream is applied at your appointment time. The cream is left on for about 30 minutes. Most fillers also contain a local anaesthetic. The treatment takes 10–20 minutes on average. You can wash your face half an hour after the treatment.

The first days: what to expect

Because the lips are a mobile area with a rich blood supply, swelling and bruising are common after the treatment. Swelling is usually more noticeable in the first 1–2 days and decreases over the following days; bruising may take from a few days to about a week to clear, and this varies from person to person^[3][4]. In the first days you may feel mild tenderness or small irregularities in the lips; most of these disappear as the swelling goes down. During this period it is advisable not to rub or press on your lips and to follow the aftercare instructions your doctor gives you.

For the filler to settle into the tissue and for the final appearance to be assessed, it is necessary to wait until the swelling has gone down completely. This is why a follow-up visit takes place within 1 month of the treatment. Small adjustments, if needed, are planned at this visit. Until the follow-up visit, you can share any change you notice in your lips that worries you with your doctor without waiting for the follow-up date.

When to call your doctor at once

A rare but serious complication of filler treatments is vascular occlusion: the filler blocking or pressing on a blood vessel. Recognising this early is important; early intervention matters^[5][6]. If you notice any of the following signs, let your doctor know without waiting:

• Pain in or around the treated area that increases, does not go away or becomes severe,
• Paleness or whitening of the skin, or a later purple-grey, net-like change in skin colour,
• A feeling of coldness in or around the lips,
• Small blisters or sores appearing within a few days,
• Signs such as blurred vision, loss of vision or dizziness (in this case, go to the nearest emergency department without delay).

In addition, signs suggesting infection, such as redness or warmth that increases as the days go by, or a fever, also call for consulting a doctor^[4]. With hyaluronic acid fillers, hyaluronidase can be used if needed.

Further reading

• Dermal fillers and facial contouring
• How long does hyaluronic acid filler stay, and how is it dissolved?
• Preparing for an aesthetic treatment
• Botox or filler? The differences
• Lip Filler Aftercare Guide: Hydration and Collagen Support