Aesthetics & Wellness
Lip Flip vs. Lip Filler: What's the Difference?
Published · Haute MD Editorial Team
A lip flip uses a few small injections of a botulinum toxin, such as Botox, along the upper lip to relax the muscle there, so the upper lip rolls slightly outward and looks fuller. It adds no volume. Lip filler is a gel, usually hyaluronic acid (HA), injected into the lips to add volume and shape. A lip flip is subtler and shorter-lived: about two to three months, according to the American Society of Plastic Surgeons (ASPS). HA fillers last about 6 to 12 months, according to the FDA. Several fillers are FDA-approved for lip augmentation, but using Botox for a lip flip is off-label: the lips aren't among its approved cosmetic uses. Some people combine the two.
At a glance
What it is: Lip flip: Small injections of a neuromodulator (botulinum toxin) into the muscle along the upper lip border. Lip filler: An injectable gel (most often hyaluronic acid) placed in the lips. What it changes: Lip flip: Upper lip rolls outward slightly, showing more of the pink lip; can soften vertical lip lines. No added volume. Lip filler: Adds volume and shape to the upper and/or lower lip. FDA status for lips: Lip flip: Off-label. BOTOX Cosmetic's label covers frown lines, crow's feet, forehead lines and platysma bands, not the lips. Lip filler: Approved for lip augmentation in adults over 21 (product-specific). When you see results: Lip flip: Two or three days or longer, with muscle relaxation greatest in the first two to three weeks (ASPS); fuller look after about a week (Cleveland Clinic). Lip filler: Lips look fuller immediately (Cleveland Clinic); some swelling is possible (ASPS). How long it lasts: Lip flip: About two to three months (ASPS); two to five months (Cleveland Clinic). Lip filler: About 6–12 months for HA fillers in general (FDA). Can it be undone?: Lip flip: No. You wait for it to wear off (Cleveland Clinic). Lip filler: HA fillers are easier to remove than other fillers; removal can require injections or other procedures (FDA). Common side effects: Lip flip: Temporary weakness around the mouth (trouble with straws, whistling or spitting), mild swelling, bruising. Lip filler: Bruising, redness, swelling, pain, tenderness, itching, rash. Most serious concerns: Lip flip: Spread of toxin effect (boxed warning on all botulinum toxin products). Lip filler: Accidental injection into a blood vessel (tissue death, vision problems, stroke). Sources: FDA, "Dermal Fillers (Soft Tissue Fillers)" and "Dermal Fillers Approved by the Center for Devices and Radiological Health"; BOTOX Cosmetic prescribing information (DailyMed); ASPS (May 29, 2025 and June 24, 2026); Cleveland Clinic, "Lip Flip." Checked Oct. 23, 2026.
What a lip flip is
A lip flip relaxes the outer part of the orbicularis oris, the ring of muscle around the mouth. When that muscle relaxes slightly, the upper lip turns up and out. What you see: ASPS member surgeons describe the pink part of the upper lip looking slightly taller and more exposed, with more fullness when you pucker and softer upper-lip lines. What the studies show: A 2026 prospective study of 17 women given 4 units of onabotulinumtoxinA found a modest increase in upper-lip height at 15 days, with no change in lip volume. The authors concluded that the lip flip works "through selective neuromodulation, not volumetric augmentation". A 2025 systematic review found that the procedure typically uses 4–6 units. It identified only seven studies that reported injection sites and doses. Off-label. The FDA-approved cosmetic uses on BOTOX Cosmetic's label are glabellar (frown) lines, lateral canthal lines (crow's feet), forehead lines and platysma bands in the neck. Injecting it into the lip is an off-label use, which doctors may choose based on their judgment. Ask your injector which product they use and why.
What lip filler is
Dermal fillers are FDA-regulated medical devices. FDA has approved absorbable fillers for lip augmentation and for perioral lines (small lines around the mouth) in adults over 21. Lip-approved HA products in FDA's approval database include: Restylane and Restylane-L, Restylane Silk and Restylane Kysse; Juvéderm Ultra XC and Juvéderm Volbella XC; Revanesse Lips+; RHA 3 and RHA 3 Mepi; Belotero Intense (+) Lidocaine, approved for lip augmentation on July 9, 2026. Not every product in the database is still on the market, so ask what your injector uses. How long it lasts: FDA says the effects of hyaluronic acid fillers last about 6–12 months. Duration depends on the product and where it's injected. Avoid: Liquid silicone injected to fill the lips is not FDA-approved for any aesthetic use, and FDA links it to serious injuries. Needle-free "hyaluron pen" devices are not approved for injecting fillers. Don't buy filler online, since it may be counterfeit or unapproved.
How long each lasts
Lip flip: ASPS says results with a neuromodulator "typically last between two and three months". One ASPS member surgeon puts it at 10 to 12 weeks. Cleveland Clinic says two to five months. Lip filler: about 6–12 months for HA fillers, per FDA. See How long do fillers last?
Side effects and safety
Lip flip: ASPS member surgeons say the upper lip can feel a little weak for a while. You may find it harder to drink from a straw, sip from a spoon or spit toothpaste neatly, and some sounds such as "p" and "b" can feel softer in the first two to three weeks. Bruising is more likely if you've recently taken blood thinners such as aspirin or ibuprofen (ASPS). Cleveland Clinic notes that if the injections are too close to the mouth, the muscles may relax too much, causing drooling or trouble drinking or speaking until the effect wears off. The label's boxed warning: all botulinum toxin products carry an FDA boxed warning that their effect may spread beyond the injection site, causing symptoms such as swallowing or breathing difficulty. The BOTOX Cosmetic label also states that no definitive serious reports of distant spread have been linked to its dermatologic use at labeled doses. Seek immediate care for any trouble swallowing, breathing or speaking. Lip filler (FDA): Common: bruising, redness, swelling, pain, tenderness, itching and rash. Less common: bumps under the skin (nodules or granulomas), infection, allergic reaction, and tissue death (necrosis). Most concerning: accidental injection into a blood vessel, which can block blood flow. FDA says the chance is low, but complications can be serious and permanent, including tissue death, vision problems including blindness, and stroke. Get immediate medical attention for unusual pain, vision changes, or skin near the injection site that looks white, gray or blue. Combining them: many injectors pair a lip flip with filler, and an ASPS member surgeon calls the combination "not an either/or choice." FDA notes that the safety of fillers used together with neuromodulators hasn't been evaluated in a controlled clinical study.
Which is right for you?
A lip flip may suit you if you want a subtle change, more upper-lip show when you smile, softer upper-lip lines or a trial run without adding volume. ASPS member surgeons also mention it for some people with a "gummy smile." Filler may suit you if you want more volume, shape or symmetry, or fullness in the lower lip, which a lip flip doesn't address. Both may fit if you want some volume plus upper-lip eversion and line softening. Talk with a board-certified dermatologist or plastic surgeon about your anatomy and goals.
Questions to ask at your consultation
1. Is a lip flip, filler or both right for my lips, and why? 2. Which toxin or filler product will you use, and is it FDA-approved for the lips, or off-label? 3. How many units or how much filler, and where exactly will you inject? 4. What results should I expect, how long will they last, and when would I come back? 5. What side effects are most likely for me, and what is your plan if a filler blocks a blood vessel? 6. Are you board-certified, and who will perform the injections? More: Botox and filler consultation questions.
Find a doctor
Browse dermatologists or Find a Doctor on Haute MD. Featured doctors: Dr. Lisa Airan, a board-certified cosmetic dermatologist in New York whose practice offers Botox and dermal fillers; and Dr. S. Manjula Jegasothy, a board-certified dermatologist at Miami Skin Institute in Coral Gables who offers Botox and dermal fillers. Haute MD members are featured through paid membership. Membership is not an endorsement or a ranking.
Sources
1. U.S. FDA, "Dermal Fillers (Soft Tissue Fillers)" (content current as of 07/06/2023). https://www.fda.gov/medical-devices/aesthetic-cosmetic-devices/dermal-fillers-soft-tissue-fillers (fetched 2026-10-23). 2. U.S. FDA, "Dermal Fillers Approved by the Center for Devices and Radiological Health" (HA duration ~6–12 months; content current as of 11/09/2020). https://www.fda.gov/medical-devices/aesthetic-cosmetic-devices/dermal-fillers-approved-center-devices-and-radiological-health (fetched 2026-10-23). 3. openFDA, device PMA dataset, product code LMH, approvals with lip augmentation indications (dataset last updated 2026-10-12). https://api.fda.gov/device/pma.json?search=product_code:LMH+AND+ao_statement:lip&limit=100 (fetched 2026-10-23). 4. BOTOX Cosmetic (onabotulinumtoxinA) prescribing information, DailyMed (published Jan. 8, 2026). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=485d9b71-6881-42c5-a620-a4360c7192ab (fetched 2026-10-23). 5. ASPS, "Perfect your pout with a lip flip" (May 29, 2025). https://www.plasticsurgery.org/news/articles/perfect-your-pout-with-a-lip-flip (fetched 2026-10-23). 6. ASPS, Alia Willson, "From gloss to surgery: Every lip augmentation option ranked" (June 24, 2026). https://www.plasticsurgery.org/news/articles/from-gloss-to-surgery-every-lip-augmentation-option-ranked (fetched 2026-10-23). 7. Cleveland Clinic, "Lip Flip." https://my.clevelandclinic.org/health/treatments/22362-lip-flip (fetched 2026-10-23). 8. Germani M, et al. "Lip Flip Revisited: Clinical Outcomes and Neuromodulatory Basis of Upper Lip Eversion." Aesthetic Plast Surg. 2026;50(11):4437–4440. PMID 41915065. https://pubmed.ncbi.nlm.nih.gov/41915065/ (fetched 2026-10-23). 9. Pitchford CA, Desrosiers AS, Tolkachjov SN. "The lip flip: a systematic review of botulinum toxin lip augmentation." Arch Dermatol Res. 2025;317(1):765. PMID 40377719. https://pubmed.ncbi.nlm.nih.gov/40377719/ (fetched 2026-10-23). 10. Bourmand R, et al. "Lip Filler Versus 'Lip Flip': Longitudinal Public Interest and a Brief Review of Literature." J Cosmet Dermatol. 2025;24(2):e70048. PMID 39936357. https://pubmed.ncbi.nlm.nih.gov/39936357/ (fetched 2026-10-23).
Medical disclaimer
This page is for general education and is not medical advice. Talk with a board-certified dermatologist or plastic surgeon about your situation.
Frequently Asked Questions
What is the difference between a lip flip and lip filler?
A lip flip relaxes the muscle along the upper lip with a botulinum toxin so the lip rolls outward; it adds no volume. Lip filler adds volume with an injectable gel, usually hyaluronic acid.
How long does a lip flip last?
About two to three months, according to ASPS. Cleveland Clinic gives a range of two to five months.
How long does lip filler last?
FDA says hyaluronic acid fillers last about 6 to 12 months. It varies with the product and the area treated.
Is a lip flip FDA-approved?
No. BOTOX Cosmetic is FDA-approved for frown lines, crow's feet, forehead lines and platysma bands, not the lips, so a lip flip is an off-label use. Several lip fillers are FDA-approved for lip augmentation.
Does a lip flip make your lips bigger?
Not in volume. A 2026 study found a modest increase in upper-lip height with no change in lip volume. The lip looks fuller because more of it shows.
Can you get a lip flip and filler together?
Many injectors combine them. FDA notes that the safety of using fillers with neuromodulators hasn't been studied in a controlled clinical trial, so discuss it with your doctor.
What are the side effects of a lip flip?
Most often temporary weakness around the mouth, such as trouble using a straw or whistling, plus mild swelling or bruising. Seek care right away for any difficulty swallowing, breathing or speaking.
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