Posted by Dr. Anil R. Shah
“Which type of fillers is best for lips?” is a common question for those seeking fuller lips. In our Chicago, IL based practice, we treat patients with all sorts of goals including lip edging, softer lips, longer lasting lips, no bumps, etc.
So What Are The Features In a Lip Injection Product We Should Look For?
Duration – How long a product lasts is really important in my opinion. If you are going to get injected in your lips, do it as less frequently as you can. Surprisingly many of the longer lasting products we are going to discuss will last long enough that many patients do not need to have repeated lip injections. Some of our patients have had product injected from several years ago so it does last longer than you think!!! Since the lips are very mobile, some products paradoxically will only last a few weeks so lets be careful here and select the longer lasting better investment.
Bumps – Lips are supposed to be soft. Bumps in the lips can be tactically annoying as well as visually. Some times bumps are due to bad technique, but other times the product can aggregate together leading to a lip bump. Putting too much filler in at one time can lead to lip bumps and lead to clumping of product. We prefer solid products that do not clump together.
Filler Migration – Some products will move from one area where the injector wanted and move to an area they did not want to like the white portion of the lip (skin bearing portion of the lip).
So Let’s Look At The Competitors
Most Common Products Used
The most commonly used products in the lips are Juvederm Ultra and Restylane-L. The problem with both of these products is that they tend not to last as long as other products and are not our products of choice. Juvederm Ultra is a hylacross product which in our experience can lead to clumping of product leading to bumpy lips. Restylane-L uses the original formulation of cross-linking and does not seem to last as long in our experience although it is a much smoother product.
Less Frequently Used Products and For a Reason
Belotero has not really taken off in the US market since the product does not last long. Belotero is supposed to be a nice transitional product to introduce patients to filler and avoid lasting or looking too overly done. In our opinion, patients want to see a result that lasts and this may be a shared view due to not being the most popular product on the market.
Restylane Silk has a similar profile as Belotero in that it is supposed to only last for a few weeks. Our view of this product is that it is highly inflammatory and does not last long enough to make it a worthwhile product.
Volbella is a Vycross product and is formulated differently than the Juvederm Ultra family. It has the least amount of hyaluronic acid in the Vycross family and the least duration. Touted as a nice temporary short acting filler, many of our patients like the products that seem to last longer. Vollure is the slightly stronger version of Volbella and is essentially the same product but lasts slightly longer.
Good Products to Consider
Juvederm Ultra Plus is similar to Juvederm Ultra but it has much more product in it that Ultra and seems to last longer. This product is perhaps underrated in its duration in the lips but has a tendency to clump. We have many patients who prefer this product over any on the market.
Restylane Defyne and Refyne are a newer hyaluronic acid formulation and are some of the best overall products on the market. In the lips, these products are OK being a slight notch below Juvederm Ultra Plus for duration. These products integrate with the surrounding tissues making them less likely to aggregate but they still do clump with some frequency.
Our Favorite Products
So, a newer product on the market is Restylane Kysse and it has many great qualities including perhaps the softest filler on the market. It is also a decent amount of duration. Restylane kysse is perhaps the best introductory filler on the market, meaning a first time patient who is seeking lip enhancement will more than likely be happy with Kysse. Kysse can clump (it is essentially a softer version of Defyne and Refyne) but the way it feels in lips is well… made for kissing. This product tends not to migrate due to its inherent stickiness.
Another product which is one of our favorites is Juvederm Voluma which has several qualities which make it superior. First of all, it has the LONGEST duration of any filler on the market at 2 years. We can attest that the duration can be seen in some patients for that period. Every patient naturally has an enzyme which can break up filler called hyalouranidase and patients with more of it tend to break all of the fillers mentioned faster. However, Juvederm Voluma is cross-linked so intensely that it is difficult to break up.
In addition, Voluma is a solid filler which gives it the advantage of not migrating to the surrounding tissues. For patients who want more dramatic changes, Voluma allows for more product to be placed with less risk of displacement. Surprisingly, even though the product is the thickest on this list, it feels very natural. In addition, we have found this product to have the least clumping even though this is a reported side effect.
Hope this helps you out!!!!