Thin Lips &
Lip Filler
Thin, uneven or overfilled lips, and a lip that rolls in when you smile.
With Dr. Juliya Fisher and Dr. Shereene Idriss.
In Brief
Lips lose volume, shape and definition with age, or never had the fullness you’d like. Thin lips get lip filler, placed a little at a time. An upper lip that rolls in when you smile gets a Botox lip flip, lost density gets PRF from your own blood, and in overfilled lips the filler can be dissolved. Not every lip needs filler.
Diagnosis First
A lip is judged on how full it is, how long, how it moves and how strong its tissue is. Three changes matter most:
- Volume. As collagen declines, the middle of the upper lip starts to thin by our mid 30s; in our 40s lips lose fat and hydration too, and thin all across.
- Length. As the bone beneath changes, the skin between the nose and the upper lip gets longer, so the upper lip shows less, at rest and when you smile.
- Movement. Some lips look full at rest but thin when you smile, because a strong muscle rolls the upper lip in. That comes down to the muscle rather than volume.
Genetics set the blueprint, and smoking makes lip lines form faster, which is why SPF on the lips matters at any age. As lips thin, fine vertical lines form along their border; those have their own page, fine lines and wrinkles.
We look at your lips at rest and as you smile, because a lip that is thin and a lip that rolls in can look the same in a photo and are treated differently.
“I do inject lips with filler, but I do not inject all lips.”
What We’d Skip
Lips are the easiest thing to overdo.
Don’t fill a lip all at once
A lip has to get used to new volume, and it can’t hold on to it all at once. We build lips with small amounts over several visits about eight weeks apart.
Don’t fill a lip that only looks thin when you smile
If your lips look full at rest but the upper lip rolls in when you smile, the muscle is the cause, and Botox suits it better than filler.
Don’t get a lip flip just to look fuller
A lip flip relaxes the muscle along the upper lip, so at its peak, sipping through a straw, blowing out candles or pursing your lips gets harder. We use it for an upper lip that rolls in when you smile or a smile that shows more gum than you like, and plan it well ahead of any big event.
Don’t choose a filler you can’t undo
Hyaluronic acid filler can be dissolved if it ever needs to be; collagen stimulating fillers can’t be reversed the same way. And choose your injector for their training, never for a discount.
Don’t chase a bigger lip
Overfilled lips are easy to spot. “Subtle can be dramatic,” Dr. Idriss has said since very full lips were the trend, and a little filler placed for balance usually looks more like you.
How Are Thin Lips Treated?
Start with what your lips are doing. Are they losing volume or density, rolling in, or carrying old filler?
- Lips that look thin or uneven at rest. Hyaluronic acid filler (Dermal Fillers) restores volume and shape a little at a time, over several visits about eight weeks apart. Eventually the filler can linger, and you may not need a top up for several years.
- An upper lip that rolls in when you smile. Botox placed along the edge of the upper lip, the lip flip (an off label use), relaxes the muscle so the lip stays in view when you smile. It takes 10 to 14 days to set in and, in the lip, lasts about 8 to 10 weeks.
- Lips that have lost density, without filler. PRF from your own blood, placed in the lip, can make it firmer rather than bigger. Dr. Idriss chose it for her own upper lip. (PRP & PRF with Microneedling explains how PRP and PRF work.)
- Lip filler that looks overfilled or has moved. Hyaluronic acid filler (Dermal Fillers) can be dissolved with an enzyme called hyaluronidase. Your doctor looks at what is there first and, once it is dissolved, rebuilds slowly, or not at all.
- Lines around the mouth. Vertical lip lines are as much about the skin as about volume. See fine lines and wrinkles for PRP with microneedling, a little filler and Botox around the mouth.
Some lips need more than one, and every plan includes SPF on the lips.
The Treatments
Dermal FillersHyaluronic acid lip filler, built a little at a time, and dissolvable
BotoxThe lip flip, for an upper lip that rolls in when you smile- What Dr. Idriss chose for her own lips
PRP & PRF with MicroneedlingGrowth factors from your own blood, for firmer lips without filler
Side by Side
Lip filler adds volume, and the lip flip changes how the upper lip moves. Some lips need both.
| Treatment | How it works | Suited to | Downtime | Results | Sessions | In the lips |
|---|---|---|---|---|---|---|
| Dermal FillersHyaluronic acid fillers and Skinvive | Hyaluronic acid gel, placed in small amounts, restores volume and shape | Lips thin or uneven at rest; hyaluronic acid fillers are FDA approved, product by product, for the lips | Little; possible swelling or bruising | Right away | Built gradually; lips about 8 weeks apart | Built over several visits; the filler can then linger for years, and it can be dissolved |
| BotoxAlso Dysport, Xeomin and Jeuveau | A small dose along the edge of the upper lip relaxes the muscle that rolls it in | An upper lip that rolls in when you smile, or a smile that shows more gum than you like; it adds no volume | None; a small bruise is possible | Builds over 10 to 14 days; peaks at 2 to 4 weeks | One; repeat once movement returns | About 8 to 10 weeks; at its peak, sipping through a straw or pursing your lips is harder |
“I want to watch your lips move before I add anything. I build slowly, with hyaluronic acid, because it is a filler we can dissolve if we ever need to.”
In Their Words
“
I highly recommend Dr. Fisher. I followed her from her previous practice and I continue to be happy with my results. I’ve gotten fillers and laser. Whenever I’ve wanted to do more, she was always honest with me. If I didn’t need it, I could count on her to tell me
Lillian J.
“
Love Dr. Idriss and everyone on her team. I have been getting filler done for the past few years (39 y/o) and it’s always perfect/exactly what is needed to look great but not obvious – worth every penny!! She is so talented but also so personable – my appts have never felt rushed, no long waits, no pressure to get more treatments etc.
Caroline G.
“
Dr. Fisher is amazing! She answered all of my questions and never pushed me onto anything. She cares about her patients. Will definitely come to her again if I need an opinion on anything relating to hair or skin.
Zubaida M.
“
I would recommend Dr Idriss a thousand times over and over. She is extremely knowledgeable, knows what will work and what won’t and will always give you an honest recommendations. You will never feel pushed into moving forward with any injections or procedures.
Hiva F.
Bryant Park, New York
Your Dermatologists
Founder
Dr. Shereene Idriss
Candid advice, subtle results.
Board-certified, Practicing since 2013
Dermatologic Surgeon
Dr. Juliya Fisher
Trained to work in millimeters.
Double Board-certified, Columbia Mohs fellowship
Both doctors share one philosophy, so either is a good place to start. Book online with Dr. Fisher, or call (212) 612-1520 for Dr. Idriss.