Interest in professional skin care treatments and injectables has only grown over the past two years thanks to frequent video calls and social media. Lip augmentation in particular remains a popular request among younger and younger patients for a more pouty appearance. "We are seeing more and more patients in the twenties, even in college, coming in for lip injections as a plastic surgery intro," confirms Corey S. Maas, President of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). Now, the lip flip is becoming the procedure option du jour for fuller, pouty lips — no filler needed.
Not to be mistaken with the lip lift (a surgical procedure that permanently shortens the space between the nose and the upper lip) or lip filler, which injects hyaluronic-based fillers to plump and shape the lips, the lip flip uses injectable neurotoxins like Botox, Dysport, Xeomin, or Jeuveau to plump the pout for a shorter time-frame (since these tend to wear off more quickly). Aesthetic nurse practitioner Jennifer Hollander points out that her lip flip patients are frequently those that have not yet tried lip filler but want to get their feet wet. Aesthetic nurse practitioner Montana Dillenberg of SkinSpirit adds that patients often opt for the procedure for specific concerns like wrinkling on the upper lip or a gummy smile.
But what is it exactly? Here is everything you need to know about lip flips and whether the procedure might be right for you.
What Is A Lip Flip?
“A lip flip is a non-surgical and temporary cosmetic procedure designed to plump and enhance your upper lip,” says board-certified plastic surgeon Dr. Yannis Alexandrides, founder of 111 Harley St., who shares that it has become a popular procedure in his clinic over the last year.
Board-certified dermatologist Dr. Neda Mehr adds that there are two main reasons to use a neurotoxin around the perioral region of the mouth. “Number one is [for lessening smoker’s lines]. Secondly, because it softens the muscle around the lip, it can cause a lip eversion, or a pouting-out of the lip. The reason the lip curls inward is that some people have strong cheekbones or strong muscles above the lip, or sometimes people simply have super thin lips that disappear when stretched.”
While using an injectable hyaluronic filler increases the overall volume of the lips, a lip flip temporarily immobilize a specific muscle above the mouth. Because the muscular contraction was causing the lip to curl upward and inward, relaxing it allows the lips to “flip” outwards for a more pouty look. “[This makes] the lip appear fuller and plumper,” explains Dr. Alexandrides.
So what happens during the procedure? Physician Associate Cheyanne, founder of The Private Suite LA, says that “the goal is to relax the orbicularis oris muscle, which [is what] helps form and shape the lips." This is done using small injections of neurotoxins like Botox, Xeomin, or Dysport in select points along the vermillion border that stop the movement of the muscles that pull the lip inward. While these are the same neurotoxins used to minimize fine lines and wrinkles on areas of the face like crow’s feet and the glabella, by contrast, the lip flip uses significantly less units of neurotoxin (eight units on average, according to Dr. Mehr, compared to 10-30 units for the forehead alone).
The injections are placed in approximately four spots — two in the upper lip, and two in the lower lip —although you can do one lip and not the other.
Who Makes A Good Lip Flip Candidate?
Anyone that wants to treat smoker’s lines or desires for more of their lip to show when smiling, might consider a lip flip — whether the upper lip curls inward when smiling due to muscular anatomy, or they simply possess thin lips. But it is important to be assessed by an injector to determine whether you are a viable candidate. Dr. Alexandrides notes that those with a short distance between the nose and lip are not good candidates, nor are those with already full lips, while Hollander warns against those with “thin, flat lips” from opting for the procedure. "[But] generally speaking, people who lose their upper lip when smiling are the best candidates for this procedure," Hollander says. The use of a neurotoxin can also be used to correct asymmetry when placed on one side of the mouth.
Yet another candidate for a lip flip is someone with a so-called "gummy smile." "Lip flips may be particularly beneficial for individuals who have smiles that expose much of their gums," Cheyanne says. "Following a lip flip, less gum shows when the individual smiles because the upper lip elevates less." Thus, it can change the shape of your smile, which might be a factor to consider if you are on the fence about the service; the upside, however, is that it will only last a few months. Still, while a filler is reversible, you cannot speed up the process to eliminate a neurotoxin — you have to simply wait it out.
How Much Does A Lip Flip Cost?
The experts report pricing starts at $200, but this can range for location, injector skill, and unique patient presentations. Board-certified plastic surgeon Kimberly Lee points out that maintaining the look of a lip flip will require upkeep appointments every 3-4 months since the body metabolizes the neurotoxin (even more with the mouth’s frequent movement).
Lip Flip Aftercare
It takes roughly 3-10 days for the neurotoxin to take effect, during which time Dr. Alexandrides warns against any heavy massaging of the area in order to allow it to settle into its intended place. “Try not to over-use the area for a couple of days because that will make it metabolize quicker,” Dr. Mehr says. “So don’t drink from a straw, smoke, and take a break from social activities so that the neurotoxin can get into the muscle receptor before it metabolizes.”
Lip Flip Risks
To be clear, this is an off-label use of neurotoxins, but that is not necessarily something to be concerned about. “This just means [the use of neurotoxins for lip flips] has not gone through the rigorous and costly FDA-approval stage, even though we use FDA-approved neurotoxins,” says Dr. Mehr. “For reference, they were being used for roughly ten years for crow’s feet prior to FDA-approval. At the time, they were only FDA-approed for use on the glabella. It’s not uncommon to use off-label ingredients prior to FDA-approval.”
But as with any procedure, there are concerns like bruising at the injection site and general discomfort. Dr. Mehr also warns against this procedure if you are a musician. “It can cause you not to be able to purse your mouth, making it an issue for people that play instruments, for instance,” she says. This is because the muscles around the mouth are a sphincter, and by relaxing them, it makes activities like smoking a cigarette, drinking from a straw, singing, or whistling more challenging (though you’ll still be able to do all of these things with a lip flip — it might just feel a little odd at first).
There are also injector mistakes that can happen, making it even more important that you vet your pick carefully. “Too much [neurotoxin] can cause the puckering of the inside of the lip, making the lips look weird,” says Dr. Mehr. “But this can be corrected with just a touch more.” Just remember — choosing to get a cosmetic procedure and wanting to be as frugal as possible are not always the best combo.