Lip treatments using dermal fillers are the second most popular treatment I provide after wrinkle relaxing injections. This treatment doesn’t just appeal to the 20-somethings either. In fact, the majority of lip filler treatments I perform are on the over 35s. There are differences in their approach, their questions, expectations and concerns. Let me explain…

Younger vs older clients

In my experience, the younger client usually asks about price first. Having lip fillers has become as acceptable for females born in the 90s as having highlights or a manicure. The over 35s are far more cautious. In fact, only this month I treated a lovely young lady who had not heard of Leslie Ash (how old did that make me feel!). The older client usually refers to Leslie Ash early on in consultation! I must stress the filler used in her case is no longer on the market and the safety profile of fillers used in lips has improved beyond recognition since those days. As more lip filler procedures have been performed worldwide each year, more evidence was gathered which enabled manufacturers to generate a much safer product and reduce unwanted side effects.

The trout pout

Another key difference is that the older client is concerned they will look like they have a “trout pout”. Often, the younger client wants the effect to be obvious. Depending on the volume of your lip pre-treatment and dental support that the lips have, an obvious effect is unlikely with a single syringe. Some clients are advised that having cosmetic dentistry to support the lips may be a worthwhile investment as without good support from the teeth no amount of lip filler will give the desired effect.

How do lip fillers work?

Lip fillers enhance the existing lip. They are made from synthetic hyaluronic acid (which exists naturally within the body) and they are efficient water-absorbers, which really help with lip hydration. It’s often a sign they are wearing off when you have to reach for the lip balm.

Vertical lip lines

I frequently recommend the use of lip filler to treat vertical lip lines. By injecting filler into the lip border, creating improved definition and subtle stretch of the border, the appearance of the vertical lip lines improve. Very few people don’t suffer with lip lines, whether they have smoked during their lives or not. Bone and tissue changes in the aging face contribute to their appearance. When I first suggest the use of fillers here many clients look horrified until I explain!

Taking lip fillers seriously

Horrific side effects from lip fillers are newsworthy. I welcome this. Lip fillers should not be undertaken lightly. The risks are real. Hence the in-depth medical history, the exceedingly detailed consent form and printed list of potential side effects I give you before the treatment.

I’m not trying to put you off (although it may feel that way)! I just don’t want you to choose to have lip fillers without being aware of the risks.

Now, these risks are vastly reduced by the technique I favour for lip fillers (the micro cannula rather than the needle). My level of understanding of clinical anatomy will also help to prevent side effects and their management in the unlikely event they do occur.

Getting the best results

One last point… clients have said that using a needle gives better results. I promise you the result is not down to the technique used to inject the filler. It’s down the size of the lip pre-treatment and product choice, which safety dictates. (My favourites are Restylane Kysse and Juvederm Ultra 3, for the record.)

Of course, client expectation is also critical. A 1ml syringe is the equivalent of 1/5th of a teaspoon… that will not create a huge lip unless your lips are fairly voluminous in the first place! It’s like spreading butter on toast – it will only spread so far before you lose the effect completely!

I will always favour the micro-cannula after the needle as bruising afterwards is rare, risks of vascular complications are hugely reduced and the immediate effect is far more pleasant than after a needle (only 2 visible entry points) and far more indicative of the final effect.


Whether you are looking to emulate your favourite celebrity, rebalance the lip as you believe the perspective is wrong (the perfect lip, by the way, should have 60% volume in the bottom and 40% in the top), improve the appearance of vertical lip lines, improve the lip condition or turn back the clock just a few years, lip fillers are more popular then ever.

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