Botox Lips: Lip Flip and Other Botulinum Toxin Treatments
Botox lips—do they even exist? Botulinum toxin isn't injected into the lips, but Botox can still affect the appearance of the lips.
Botox in the lips does not increase lip volume like fillers do. Instead, botulinum toxin affects the muscles surrounding the lips. When carefully selected muscles relax, the position of the lips changes subtly.
Botulinum toxin treatments are used in the lip area for four specific purposes:
- lip flip treatment
- correcting a gummy smile
- lifting the corners of the mouth that have turned downwards
- for reducing vertical wrinkles on the upper lip, i.e., smoker's lines
I am Ville Männistö, an oral and maxillofacial surgeon specializing in aesthetic botulinum toxin treatments. In this article, I will discuss what Botox can do for the lip area, how the treatments work, and who they are suitable for.
Summary: What can Botox do for the lip area?
- Botox does not increase the size of the lips, but affects their position.
- A lip flip can make the red area of the upper lip more visible.
- Botox can also be used to correct a gummy smile.
- Vertical wrinkles on the upper lip, known as smoker's lines, can be reduced with botulinum toxin treatment.
- The effect usually begins in 3–7 days and typically lasts for 2–4 months.
Can lips be shaped with Botox?
Yes, you can, but botulinum treatment affects the lips differently than many people expect. Botox does not fill or plump the lips. In other words, it does not affect their size. Instead, botulinum toxin can relax the muscles around the lips that cause wrinkles, inward turning of the lips, excessive exposure of the gums, or other aesthetic problems.
When the muscles surrounding the lips are adjusted with a small amount of botulinum toxin, the position of the lips can change subtly. This can, for example, reveal more of the upper lip when smiling, balance the smile line, or soften the lines around the mouth.
Botulinum toxin treatment in the lip area is particularly suitable for people who want a very natural change. The goal is not to achieve larger lips, but a more balanced overall appearance.
Lip flip – the most popular Botox treatment for lips
Lip flip Botox treatment before and after. The upper lip turns slightly outward, making the red area of the lip more visible. More treatment results:
Lip flip is one of the most well-known botulinum treatments for the lip area. In this treatment, a small amount of botulinum toxin is injected into the muscle surrounding the upper lip (orbicularis oris). When the muscle relaxes, the upper lip turns slightly upward and outward. This makes the red area of the lip more visible.
Lip flip does not increase the size of the lips or change their shape. The fuller appearance is created by better highlighting the natural shape of the lips.
If you would like to read more about lip flip treatment, you can find a separate guide here:
You can find a comprehensive overview of botulinum toxin treatments here:
Gummy smile – correcting a gummy smile with Botox
A gummy smile refers to a situation where more gum tissue than usual is exposed when smiling.
This is often caused by the muscles that lift the upper lip being very active and pulling the lip upwards too strongly.
A small amount of botulinum toxin can relax these muscles.
Smoker's lines, i.e., vertical lines on the upper lip
Over time, small vertical lines may form above the upper lip. These are sometimes called smoker's lines.
Vertical wrinkles on the upper lip are often associated with the activity of the muscle surrounding the lip (orbicularis oris) and skin aging.
Lifting of downturned mouth corners with Botox
Some people have downturned mouth corners, especially when their face is at rest.
This phenomenon is partly due to the action of muscles that pull the corners of the mouth downwards. These muscles are called depressor anguli oris.
As a result of Botox treatment, the corners of the mouth may settle into a more neutral position.
The position of the corners of the mouth is influenced by the balance between several facial muscles. The key muscle in this group is the depressor anguli oris, whose function is to pull the corners of the mouth downwards.
As we age, collagen in the skin decreases, skin elasticity weakens, and subcutaneous fat tissue changes. This can accentuate the effect of the downward-pulling muscles, causing the corners of the mouth to appear droopy.
Botulinum toxin acts on the neuromuscular junction by blocking the release of the neurotransmitter acetylcholine at the injection site. When the nerve signal is not transmitted normally, muscle contraction is weakened and the muscle relaxes.
As a result, the force pulling the corners of the mouth downward is reduced, and the corners of the mouth can settle into a slightly more neutral position.
Botox treatments for the lips are off-label treatments.
Botulinum toxin treatments in the lip area are so-called off-label treatments.
Off-label use of a drug refers to a situation where a drug is used for a purpose other than that for which it was originally officially approved.
In Europe, doctors have the right to use drugs for off-label purposes when treatment is based on medical assessment and the patient receives sufficient information about the treatment.
Botulinum toxin is used in aesthetic medicine for many treatments related to facial muscle balance, including in the lip area.
However, it is important to understand that treatment response is individual. In some patients, the results may be excellent and clearly noticeable, while in others the change may be modest.
Since the response to treatment cannot be fully predicted in advance, the first off-label treatment should be considered a kind of trial treatment.
Frequently asked questions about Botox in the lips
Can Botox make your lips bigger?
Not really. Botulinum toxin does not increase lip volume like a filler does.
When does Botox start to take effect on the lips?
The effect usually begins within 3–7 days of treatment.
How long does lip Botox last?
In the lip area, the effect typically lasts for about 2–4 months.
Can Botox affect speaking or drinking?
If the dosage is too strong, lip function may be temporarily affected, for example when drinking from a straw.
Can Botox spread to the wrong place on the lips?
Botulinum toxin mainly affects the area around the injection site.
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