Side Effects of Lip Fillers: Everything You Need to Know

Lip fillers have gained immense popularity in recent years for the temporary enhancement of the volume and shape of your lips. While the allure of a fuller pout is compelling, it’s important to understand the potential side effects that may accompany this treatment.

Here, we aim to provide a comprehensive guide on the potential side effects of lip fillers, helping you become a more informed and empowered patient.

What Are Lip Fillers?

Lip fillers, a subcategory of injectable dermal fillers, are substances injected into the lips to achieve a fuller, plumper appearance. They can also reduce the look of lip lines, the vertical lines on or around the lips caused by aging or genetics. 

Typically lasting from 3–6 months, lip fillers have a shorter lifetime than fillers placed in other areas of the face, as frequent movements of the mouth muscles lead to faster absorption.

Currently, only hyaluronic acid (HA) fillers are FDA-approved for use around the lips. Hyaluronic acid is a substance that occurs naturally in the body and holds many times its weight in water. When synthetic form of it is injected into the skin, the HA stays in place for several months, enhancing the size of that area until it’s gradually reabsorbed by the body.

HA fillers for lips include:

• Juvederm Volbella is ideal for subtle lip augmentation and correction of fine lines around the mouth.
• Juvederm Ultra XC is designed with a firmer formula for more dramatic lip enhancement and correction of deeper lines.
• Restylane Silk smooths the lips and is designed for flexibility, natural movement, and color enhancement.
• Restylane Kysse contains smaller HA particles and is ideal for subtle lip augmentation and correction of fine lines.

It is not recommended to use any other dermal filler off-label for use around the lips, as they can increase your risk of complications.

Common Side Effects of Lip Fillers

Let’s delve into some of the side effects most commonly associated with lip filler treatments. Side effects can vary widely in severity, from minor and temporary to more serious and long-lasting. 

Mild Side Effects

These side effects are quite common after getting lip filler, and are considered normal in the first 15 days after treatment.

1. Swelling and bruising: After the injection, you may experience some swelling and bruising at the injection site. This is common and is usually due to the physical act of injecting filler into the lips. The needles create tiny wounds that can cause localized inflammation.
2. Redness: You may notice some redness around the area where the filler was injected. This is typically a temporary response and can occur because the skin has been punctured.
3. Slight pain or discomfort: The lips are a sensitive area, and it’s normal to experience a bit of discomfort both during and after the procedure. Some fillers contain lidocaine, a local anesthetic, to minimize pain.

Moderate Side Effects

These complications are more rare, but still possible outcomes of getting lip filler.

1. Lumps and nodules: Occasionally, small, hard lumps can form under the skin. These can occur if the filler isn’t administered evenly or if it starts to clump together. 
2. Cold sores: If you have a history of cold sores caused by the herpes virus, the physical trauma from the needles could trigger an outbreak. Consult with your provider if you have this condition. Taking an oral antiviral for a few days before and after treatment can help prevent a recurrence.
3. Asymmetry: While some degree of asymmetry is natural, uneven results can occur if the filler is not evenly distributed between both lips or among different areas of the same lip.

Severe Side Effects

Lip fillers are associated with a few rare but serious side effects. They include:

1. Vascular occlusion: This is a rare but severe side effect where the injected filler obstructs a blood vessel, potentially leading to tissue necrosis. This occurs because the filler material can enter and block small blood vessels.
2. Allergic reaction: An allergic reaction to components of the filler or the local anesthetic used during the procedure could occur. Symptoms may include extreme swelling, redness, and itching.
3. Foreign body reaction: This refers to the body’s immune response to a substance it identifies as foreign or non-native. This can result in inflammation, lump formation, or even granulomas around the area where the lip filler was injected. Although uncommon, such reactions may require medical intervention for resolution.
4. Migration: While not common, there’s a risk that the filler could move away from the injection site over time, resulting in an unnatural appearance. This usually occurs due to incorrect technique or using the wrong type of filler for the lips.

Factors That Influence Side Effects

A few factors can either increase or decrease your risk of side effects–making it important to stay informed.

Type of Dermal Filler Used

The only fillers considered safe for lip injections contain hyaluronic acid. Generally, hyaluronic acid fillers are rarely associated with adverse reactions and have a very low incidence of long-term side effects, while long-acting dermal fillers have higher rates of long-term complications. 

Poly-L-lactic acid (PLLA) fillers such as Sculptra Aesthetic and calcium hypoatcitive (CaHa) fillers like Radiesse are not recommended for use around the lips. Collagen fillers often contain bovine collagen, which can be immunogenic (causing an immune response) and has a foreign body reaction rate of 1.3%.

Avoid so-called needle-free fillers, which are not FDA-approved and can cause severe injury to the skin.

Quantity of Filler

The more product being used, the higher your risk of adverse effects. For example, whereas migration of a small quantity of product may be barely noticeable, migration on dramatically enhanced lips will be more obvious. You’re also likely to experience more discomfort and swelling during the initial injections.

Skill of the Injector

The expertise of the person administering the filler injections plays a significant role in minimizing side effects. Filler placed too superficially can appear unnatural and are more likely to create bumps, itchiness, and even scarring. Always opt for a board-certified dermatologist or plastic surgeon with experience in lip filler treatments.

Underlying Conditions

Serious side effects after lip fillers are often the result of a preexisting condition. These include:

• Active localized infections
• Inflammatory skin conditions
• Immunosuppressive therapy
• Immunocompromisation
• Blood clotting disorders
• Certain autoimmune conditions

This is why it’s extremely important to discuss your entire medical history with your provider before getting filler injections or any kind of cosmetic procedure.

Keep in mind that these conditions don’t necessarily preclude you from getting lip fillers, especially if your symptoms are fully controlled. An experienced provider will be able to determine your eligibility.

How to Minimize Side Effects

Following a few basic steps before and after your lip filler appointment can reduce your risk of experiencing adverse events. These include:

1. Consult a medical professional: Always consult with a qualified dermatologist or plastic surgeon before undergoing any cosmetic procedure, including lip augmentation. Poor technique is a leading cause of injection side effects, so choosing an experienced provider is crucial.

2. Avoid blood-thinning supplements: In the days leading up to your appointment, skip supplements like fish oil and medications like ibuprofen that can thin the blood and increase the risk of bruising.

3. Avoid alcohol: Avoid consuming alcohol for 24 hours before your appointment, as it thins the blood and increases your likelihood of bruising.

4. Use ice packs: After getting injections, an ice pack can help reduce swelling and discomfort after the procedure.

5. Avoid strenuous exercise: Heavy exercise can increase blood flow and exacerbate swelling.

6. Don’t touch or massage the lips: The filler needs time to settle. Manipulating the lips soon after the procedure can push the filler away from the desired area.

7. Follow aftercare instructions: Your injector will provide a list of do’s and don’ts for aftercare to help minimize risks and achieve desired results.

Can Side Effects Be Reversed?

Hyaluronic acid fillers can be dissolved using an enzyme called hyaluronidase, which works to quickly break down hyaluronic acid. Hyaluronidase can reverse certain adverse events such as filler migration, but it won’t help reduce bruising or swelling. 

Other side effects are treated on a case-by-case basis; e.g. an infection may necessitate antibiotics, whereas asymmetry may be corrected with additional injections. Consult with your medical professional for individualized guidance.

The Bottom Line

Lip fillers offer a temporary but effective way to enhance the volume and shape of your lips. However, being informed about the possible side effects is crucial for a positive experience and outcome. 

The risks range from mild discomfort and bruising to rare but serious complications like vascular occlusion and allergic reactions. The type of filler used, the skill of the injector, and your own medical history all play roles in determining your risk level. 

To minimize side effects, consult with a board-certified dermatologist or licensed medical aesthetician experienced in lip filler treatments and adhere to recommended pre- and post-treatment guidelines. If any issues arise, certain side effects can be reversed using the enzyme hyaluronidase.
Ultimately, the key to a successful lip filler experience is to be well-informed and to select a qualified provider for the procedure. If you’re considering this treatment, always opt for a consultation with a board-certified dermatologist to discuss your options and any potential risks.