Lips augmentation using hyaluronic acid

The lips…….holding the spot-light, it is essential for them to look great!

The lips ……. used for speaking, kissing, smiling!


In order to create the perfect lips, we need to know the defining elements that make them look the way we want (Cupid’s bow; philtrum; nasolabial fold, oral commissure; vermillion border).

In the ideal situation, the lip width (distance between the two commissures) must enter in the inter-iris space (Figure 1, the dotted lines). Regarding the proportion of the two, the upper and lower lip should be 1/3 both in volume (Figure 5) and in height. The distance from the nose base to the lower end of the upper lip will be a third of the distance from the chin to the opening of the mouth (Figure 1).

The lip protrusion depends on the thickness of the tissues, muscle tone, position of front teeth and subjacent bone. The eminence of the lips is measured by the distance that each lip projects in front of a vertical line arbitrarily established (Figure 2). At rest, the upper lip should not protrude more than 3mm over the dotted black line (passing through the nose base). Also, the lower lip should not exceed the blue line by more than 4mm.There are variables, depending on the race and type of skin, but these aesthetic rules shall comply with the facial global proportions.


It is preferably that the labial degree is slightly negative, which means that the upper lip circumscribes the lower lip with 2-3 mm (Figure 3). The naso-labial angle (Figure 4) is measured between the nose base and the upper lip. It is considered to be aesthetic when it has values of about 99*. When shaping lips, the left-right symmetry also requires?? a special attention. The two parts should be perfectly symmetrical!

Due to all these reasons, it is not wise to simply expand the lips and distort the proportions. If you want such a treatment, it must be done by a professional who understands the principles of balance between face and lips.


The lips can me modified by:

  • defining the contour;
  • eliminating the perioral wrinkles;
  • adding volume;
  • filling the commissural depressions (marionette lines);
  • redefining the ‘Cupid’s bow’.


  • Which are the products used to modify the lips?

The products that are currently used are generically called ‘Dermal Fillers’. They are viscoelastic gels of hyaluronic acid (HA) – natural biopolymer consisting of a chain of glycosaminoglycans. HA is found naturally in the skin and in other tissues of the human body (eg. joints). Various pharmaceutical companies are producing this hyaluronic acid gel, under various names: JUVEDERM, RESTYLANE, BELOTERO, TEOSYAL, etc.

  • How are these products used for modifying the lips?

The hyaluronic acid is injected in the areas where we want to add volume. Thus, we can achieve different effects: defining the lip contour, eliminating the wrinkles around the lips or just volume.

  • Does the injection hurt?

No, the injection does not hurt. One can feel only a slight discomfort during and after the procedure. The injection is made with an ultra fine needle so that the skin prick is as less painful as possible. The injection procedure of hyaluronic acid is performed under local anaesthesia. The area to be injected is previously anesthetized either with an anaesthetic contact gel or by a local anaesthesia by infiltration (intraoral).

  • Is the resulting effect permanent?

No, the resulting effect lasts about 6-9 months, depending on each patient’s metabolism. If a new injection is wanted after this period, it will be quantitatively lower than the first injection. If, after this period, the patient does not longer want a new correction, the lips come back to the initial shape, without any long-term side effects.

  • “¢ What should I expect immediately after treatment?

Immediately after injection, there is an edema (swelling) and / or ecchymosis (bruising). These are due to the injection, they are not mandatory to appear and disappear in 2-3 days after treatment. The patient can return to his / her daily activities immediately after the procedure.

The strenuous exercise, alcohol and sun exposure must be avoided in the first 24 hours.


A smile betrays confidence,

A smile is an artwork … created by God and redefined by us.

Dr. Raluca Dragomir M.D., D.M.D.

Specialist Oral and Maxillofacial Surgery

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