In the last year, nearly 400,000 people were trained in the art of administering lip injections. It’s no secret that lip injections have become one of the more popular procedures—but having work done on the lips is actually one of the most complex facial enhancements to carry out (and if you’re on the low tolerance end of of pain spectrum, it can be one of the most excruciating to receive). When it comes to your pout, natural-looking results matter, more so than most injectables; no matter how over-Botoxed someone’s face can get, the repercussion for a bad lip job is far worse than just messing with the unique symmetry of your face. According to Lynn Bartels, a UCLA educated medical pro and SkinSpirit’s aesthetic nurse practitioner, not all lip treatments are created equal. She would know—she’s been at the helm of administering injections for nearly 20 years, and ranks among the country’s top 1 percent tier of injectors.
The skin veteran is resolute about educating her patients about their procedures. “I’ve seen more and more bad lip jobs than ever before—patients coming in with complications and needing prior injections dissolved has also been on the rise with the surge of lip filler requests,” she says. “What I would tell anyone considering getting work done in this area is to always look for trained, certified injectors with years of experience and continued training. The bottom line is that your results and safety depend on doing your research before letting anyone touch your face. Duck face and pillows results are just one end of the spectrum—the other end is serious medical consequences from botched lip filler.” Bartels recently sat down with W magazine to discuss in detail the most essential guidelines and tips for anyone considering or continuing on with their lip injections.
In terms of filler, what are your preferred formulations or ingredients to use?
I use hyaluronic acid-based fillers like Restylane Kysse and Juvederm, which are lab-made to reduce the risks of exposure from other animals or humans. These fillers are recognized by our bodies as natural, making them highly compatible and safe to inject. Plus, they can easily be dissolved by an enzyme called hyaluronidase if you do not like the result.
All fillers are designed to integrate into our lip tissue because they are soft gels made of molecules that look, feel, and move naturally. The differences between filler types are in the molecular details. Different fillers have different properties like size, amount of water they attract, and stiffness. So the optimal choice of which filler to use is determined by what the desired overall goal is for your lips. For example, volume, or an increase size, requires bigger molecules whereas shaping is done with stiffer gel molecular formulation.
Honestly, this is why it is so important to pick an experienced injector and work closely with them to be sure they understand your goals and have experience with all the filler options. It takes years of injecting experience and study to master lip shaping and which filler to use. Think of it like an artist knowing which clay to use when creating a sculpture. Be sure you look at their past work and that they take time to understand your goals and create a realistic plan for achieving them.
What is the best prep before getting injected?
Three to four days ahead of your appointment, stop all supplements, Aspirin, Advil and, yes, avoid drinking alcohol. Because these are all blood thinners, they can make your bruising or swelling worse.
The day before, I recommend taking Arnica Montana, a well-known homeopathic available at most health food stores. There have been many studies that show it can also minimize or prevent bruising and swelling.
Let’s not forget it’s important to eat healthfully and be well hydrated starting the day before your appointment. This will make your body calmer and can prevent fainting if you’re nervous or afraid of needles. Protein is calming to the body, and the calmer you are the more comfortable the treatment will be.
If you’ve ever had a cold sore it is super important to take a Valtrex or Acyclovir the morning of your appointment. Lip injection can irritate or awaken the virus and spread it to all areas injected. To prevent this, take one pill that morning and suppress the virus.
And lastly, I recommend everyone should gargle with an antiseptic mouth wash immediately prior to the treatment to kill as much bacteria and virus, and make the treatment safer overall.
Are there absolute “no-no” places when getting lip filler?
I’d say there are not so much “no-no places” as simple areas to avoid. The lips are one of the most complicated areas to inject. The architecture of the lips is incredibly intricate, plus there are layers of blood vessels, muscles, and fat to consider. Add to that the fact that you’re injecting an area of the face with a ton of dynamic movement and you can imagine how complex this treatment is. An experienced injector will keep all this in mind while also working with a client’s existing anatomy to get them the results they’re looking for. It really is a true expert’s work and should only be performed by highly experienced injectors.
Right now, we’re seeing an epidemic of lip disasters in the medical aesthetics field. My colleagues and I are dissolving more lips gone wrong from in-experienced injectors than ever before.
What are the basic tenets of after care for the next few days following injections?
Immediately after treatment, you can expect your injector to cover your lips in an antibiotic cream and give you ice. I recommend tons of ice throughout the first day to minimize bruising and swelling. The more you ice, the less bruising and swelling you’ll see. And also, don’t forget, use a clean face mask when you leave your appointment.
It’s really important to take it easy and rest the day after any injection treatment. You don’t want to do anything that can increase your body temperature or your heart rate since this can increase your bruising and swelling, too. So, no workouts or anything vigorous. It’s a good day to baby your lips and rest your body. Staying well hydrated with water will work wonders during your recovery. Keep staying away from blood thinners for a few days. (Sorry, no alcohol yet!) It’s tempting to show off your fresh pout, and a lot of clients love that new-lip-swollen look, but it’s safer to give your face a few days of downtime to heal.
Cleanliness is key in the days post-treatment. Make sure you’re only wearing new clean masks, wash your pillowcases, mind your towels, stay away from old lipstick, and clean everything that can come into contact with your new lips.
How long are lip fillers supposed to last?
There is some variability here, so the range is pretty big—on average, filler will last anywhere from six to 12 months. How long your filler goes depends on your age, your metabolism, the amount used, and the type of filler used. I know many clients want to know exactly how long they can expect their new pout to stay perfect, but it’s hard to say exactly, so I recommend scheduling a follow up, and even your next appointment, with your injector the day of your treatment.
That being said, the most attractive lip results are done slowly and over time. The reason is that lips are by nature a confined space to fill; over time, they will adjust to accommodate new filler. If too much filler is stuffed into that small space too quick, you get that “duck lip” look that no one wants. Overstuffing too quickly can cause the filler to expand outside the lip boarders creating telltale unnatural lip results. Slow and steady building your ideal lip shape and size over the course of two or three treatments is the way to go! Personally, I say, when you’re starting out on your journey to lip perfection, you want to space out your second injection so it is no sooner than six months, or even yearly. That way, you can let the tissue expand naturally and create room for a follow-up injection; build on your base to slowly change your lip size and shape and get the results you want. Slow and steady wins the beauty race on this one, and all top injectors agree on this!
Taking into account that every body needs something different, what is general downtime until the real look comes on?
Lip filler is a journey! Expect your lips to change almost daily in the first few weeks. The first couple of days after treatment is when you can expect the majority of the swelling. Then, during weeks two to four, your filler will fully integrate into your tissue, the swelling will dissipate, and your new lips will start to look and feel their best. It’s not uncommon to get panicked when you see your lips on day one and think they’re too big and then see your lips on day 30 and miss how big they were right after your injections. This is why injectors always advise you to wait four weeks for your “settled” lip look.
Why is it so much puffier the next day?
Simply put, this is your body responding normally to the trauma of those little needle pokes to your tissue. Every injection is a site around which the tissue reacts by swelling. Additionally, the filler gel itself attracts water and that adds to swelling in the initial days after.
Help—I am bruised! What do I do?
Don’t panic. It happens to most people. I recommend hot compresses several times a day starting the day after. This can bring circulation to the area, which promotes healing and helps bruising go away faster. Also, continue to take Arnica Montana three times a day or apply it in cream form topically until the bruises are gone. A topical vitamin K cream can also help heal your bruises faster. Be patient, it will pass.
If it’s not for me, is it reversible?
Yes. If the filler used was made from an hyaluronic acid gel, it can be dissolved. Over the course of one to three sessions, lip filler can be dissolved by a professional and will not alter your natural structure or tissue. But be ready, reversal is done with tiny needles and can also cause bruising and swelling that will take a couple days to resolve before your lips will be restored to their original look.