Lip filler without the 'done' look: proportion, amounts and dissolving

Start from the face, not the lips

Lips sit between a nose and a chin and in front of teeth. A good result is one that fits that frame: the upper lip slightly smaller than the lower, the border defined but not sharp, the profile soft. The famous "ratios" are a guide, not a target, and a doctor who measures your face before touching your lips is the one to use.

Four different goals, four different treatments

• Hydration: dry, lined lips that have lost smoothness. A soft gel placed superficially, often under half a millilitre.
• Definition: a border that has blurred with age, or a cupid's bow that has flattened. Precise placement along the vermilion.
• Volume: lips that are naturally thin. Gel in the body of the lip, built gradually.
• Shape correction: asymmetry, a downturned corner, a gummy smile (which may be an anti-wrinkle injection rather than filler).

How much

Most first treatments use between 0.5 and 1 ml in total. That is a teaspoon divided across two lips. The clinics that advertise "2 ml packages" are selling product, not planning a face. It is far easier to add at a review than to wait out an over-filled result.

What the appointment involves

Numbing cream, then slow placement with a fine needle or a blunt cannula. A mirror check halfway through. Some swelling for 24 to 72 hours, so the result you see on the day is not the final one; the two-week review is where we judge it.

Dissolving

Hyaluronic acid filler can be broken down with hyaluronidase, an enzyme injected into the area. It works within a day or two. We use it rarely, but every patient should know it exists and that their clinic can do it.

How long it lasts

Six to twelve months, shorter in lips than elsewhere because they move constantly. Maintenance is usually a small top-up rather than a repeat of the first amount.

Related: Hyaluronic acid fillers or collagen stimulators.