What is lip dermal filler?
In lip dermal filler, a dermal filler product containing hyaluronic acid is delivered into the lip tissue with a fine needle or a blunt-tipped cannula.
The product used is a medical device (opens in a new tab). Unlike botulinum toxin, these products are not medicinal products for human use; they fall within the scope of medical device legislation. In Türkiye, medical devices are monitored through the Product Tracking System (ÜTS); the Turkish Medicines and Medical Devices Agency (opens in a new tab) defines the purpose of this system as “enabling medical devices and cosmetic products manufactured in our country or imported from abroad to be traced from the production line through to the place where they are sold and used”.
One thing to know first:
Dermal filler procedures carry a risk that botulinum toxin procedures do not: vascular occlusion. If the product enters a vessel or presses on a vessel, tissue damage may develop in the area supplied by that vessel. It is rarely seen, but it requires intervention within hours.
Dr. Suzan Alp, Specialist in Internal Medicine, performs the procedure at the practice (opens in a new tab).
Which factors determine whether the procedure is suitable?
The decision on suitability is made at the end of the consultation. The following factors are decisive in the assessment for this area:
- The structure of the lips, the thickness of the tissue and any existing asymmetry in the lips
- Whether there is a history of cold sores (herpes)
- Dermal filler previously applied to the area: its type, when it was given and whether it was of the absorbable type
- Oral and dental health; whether dental treatment has been received recently
- Which medicines are being used, and whether there is a bleeding tendency
- What is expected from the procedure
Existing asymmetry may not be corrected completely; the lips are not naturally symmetrical, and this is discussed before the procedure.
In which patients is the procedure not performed?
- In patients with a history of allergy to the product to be used or to its components
- In patients with a history of allergy to the dissolving enzyme (intervention would not be possible if it were needed)
- In pregnant and breastfeeding patients
- In patients under 18 years of age
Situations that require separate assessment
- Bleeding or clotting disorder, or use of blood-thinning or anticoagulant medicines
- Active infection or febrile illness (the procedure is postponed)
- Autoimmune disease in an active phase (the opinion of the relevant specialist physician is obtained)
- Treatment that suppresses the immune system (the opinion of the relevant specialist physician is obtained)
- Active oncological treatment (the opinion of the relevant specialist physician is obtained)
- Uncontrolled diabetes (healing may be affected)
Additional conditions specific to this area
The procedure is not performed if the following are present in the area to be treated:
- An active cold sore (assessed once it has resolved)
- An active infection, a dental infection or an open wound
In these situations, the procedure is planned subject to the physician’s assessment:
- Frequent cold sores (the procedure may trigger one; precautions are planned together)
- A non-absorbable type of dermal filler previously applied to the area (the opinion of the relevant specialist is sought; these products cannot be removed with the dissolving enzyme)
- Recent vaccination (the timing is adjusted accordingly)
- A tendency to keloid or hypertrophic scarring (a raised scar that spreads beyond the original wound)
If dental treatment has recently been carried out or is planned, the procedure is postponed.
How is the procedure performed?
- Assessment. The structure of the lips, symmetry and the thickness of the tissue are assessed. Any history of cold sores, previous dermal filler procedures and their type, dental treatment and the timing of vaccination are asked about. Any history of allergy, bleeding tendency and current medication are recorded. Blood pressure and pulse are measured.
- Product check. The ÜTS registration, packaging integrity and expiry date of the product to be used are checked. The dissolving enzyme must be available where the procedure is carried out.
- Information and consent. The procedure, the risk of vascular occlusion, the expectation of swelling and bruising, the possibility of asymmetry and possible side effects are explained in writing and verbally; the form is signed. The symptoms for which help should be sought without delay after the procedure are given in writing.
- Preparation. There must be no make-up on the area. Antisepsis is ensured; where necessary, topical anaesthesia is applied.
- Application. The product is delivered into the intended layer, in the planned amount.
- Observation and follow-up. The patient is kept under observation after the procedure; the area is checked for signs of vascular occlusion. Vital signs and observations are recorded in the file. A follow-up appointment is arranged.
All materials used are single-use.
When is the effect seen, and how long does it last?
The appearance seen in the first few days is not the final result. Swelling is more marked here than elsewhere on the face, and it is allowed to subside before the result is assessed. The follow-up appointment is planned accordingly.
The effect is temporary. The product used is absorbed over time; the duration varies from person to person, by area and by product, and cannot be stated in advance.
What should you do before and after the procedure?
Before the procedure, report:
- A list of all the medicines and supplements you use (in particular blood thinners, painkillers and herbal products)
- Your known allergies
- Your pregnancy and breastfeeding status
Come with no make-up on the area.
For this area, also state the following:
- Do you have a tendency to develop cold sores?
- Have you had dermal filler in this area before? When, and of what type?
- Have you had dental treatment recently, or are you planning any?
- Have you been vaccinated recently?
After:
- Swelling and bruising are to be expected and may be marked in this area; they may increase in the first few days
- The area must not be massaged or rubbed
- You are advised to avoid very hot, very cold and spicy foods for a period
- You are asked to avoid drinking through a straw and movements that strain the lip for a period
- The period given for make-up, hot environments, saunas, sunbeds, swimming pools and intense exercise must be observed
- You are asked to keep the written list of warnings you are given
Recommendations and time periods specific to you are given in writing at the end of the procedure.
Risks and side effects
Requiring urgent assessment
- Vascular occlusion. It is rarely seen, but it requires intervention within hours. The signs: pain that is more severe than expected and increasing, blanching of the skin, a purple-red change in colour in a net-like or spotted pattern, coldness of the area, and crusting and sores at a later stage
- Tissue loss in the skin (necrosis); may develop as a result of occlusion
- Infection and abscess at the site of the procedure
Commonly seen
- Swelling (marked in the lips, and may increase in the first few days)
- Bruising and tenderness
- Pain
- Temporary change in sensation
Others
- Asymmetry (a different appearance in the lips)
- Firmness, irregularity or a nodule that can be felt by hand
- Displacement of the product over time
- Triggering of a cold sore
- A bluish change in colour in the skin (may be seen where the product is placed close to the surface)
- Swelling and redness appearing at a late stage
- Allergic reaction
- Swelling that does not resolve
Results vary from person to person. No guarantee can be given as to a result or a duration.
When should you see a physician without delay?
If you experience these symptoms during treatment, contact your physician without delay:
- Increasing redness, increased warmth, swelling or discharge in the area
- A high fever
- Crusting or the formation of sores on the skin
- Widespread rash, itching
In the event of pain that is more severe than expected and steadily increasing, blanching of the skin, a purple-red change in colour in a net-like or spotted pattern, or coldness or paleness of the area, contact your physician at once; if you cannot reach them, go to the nearest emergency department. In the event of any change in vision, or rapidly increasing swelling of the lips and eyelids, go directly to the emergency department.
Frequently asked questions
What is the most serious risk of lip dermal filler?
It is vascular occlusion. If the product enters a vessel or presses on a vessel, tissue damage may develop in the area supplied by that vessel. It is rarely seen, but it requires intervention within hours. In the event of blanching of the skin, a purple-red change in colour in a net-like pattern, or pain more severe than expected, consult a physician without delay.
Can dermal filler be reversed?
With products containing hyaluronic acid, a dissolving enzyme may be used; this enzyme must be available where the procedure is carried out. Non-absorbable types of dermal filler cannot be removed in this way; for this reason, if such a product has been applied before, it must be stated at the consultation.
How much swelling is there after the procedure?
Swelling and bruising are to be expected, and in this area they may be more marked than elsewhere on the face; they may increase in the first few days. The swelling is allowed to subside before the result is assessed; the follow-up appointment is planned accordingly.
I have a tendency to develop cold sores — can I have lip dermal filler?
If there is an active cold sore around the mouth, the procedure is not carried out. In those who develop cold sores frequently, the procedure may trigger a cold sore; suitability and the precautions to be taken are assessed separately. State your history of cold sores at the start of the consultation.
My lips are asymmetrical — will this be corrected completely?
Existing asymmetry may not be corrected completely; the lips are not naturally symmetrical. Asymmetry is also among the side effects reported after the procedure. For this reason, discussing expectations in detail before the procedure is particularly important for this area.
How long does the effect of dermal filler last?
The effect is temporary; the product used is absorbed over time. The duration varies from person to person, by area and by product, and cannot be stated in advance.
I am having dental treatment — can the procedure be done?
In those who have recently had, or are about to have, dental treatment, the procedure is postponed. State your dental treatment plan at the consultation.
How do I know that the product used is safe?
The product used must be registered in the Product Tracking System, its packaging must be intact and its expiry date must be valid. You can ask about this before the procedure.
Is lip dermal filler performed during pregnancy?
No. The procedure is not performed during pregnancy or while breastfeeding.
Sources
- Ministry of Health of the Republic of Türkiye, Turkish Medicines and Medical Devices Agency, Tıbbi Cihaz ve Ürün Takip Sistemi (ÜTS). https://www.titck.gov.tr/faaliyetalanlari/tibbicihaz (opens in a new tab)
- Ministry of Health of the Republic of Türkiye, Turkish Medicines and Medical Devices Agency, Tıbbi Cihaz Yönetmeliği, Official Gazette 2 June 2021 / 31499 (repeated). https://www.mevzuat.gov.tr/mevzuat?MevzuatNo=38657&MevzuatTur=7&MevzuatTertip=5 (opens in a new tab)
- Ministry of Health of the Republic of Türkiye, Ayakta Teşhis ve Tedavi Yapılan Özel Sağlık Kuruluşları Hakkında Yönetmelikte Değişiklik Yapılmasına Dair Yönetmelik, Official Gazette 7 January 2025 / 32775. https://www.resmigazete.gov.tr/eskiler/2025/01/20250107-3.htm (opens in a new tab)
