Where to Inject Botox for Lip Flip
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Last Updated On: February 1, 2024

Where to Inject Botox for Lip Flip?

Published on: Apr 18, 2023

Enhancing the appearance of the lips can significantly improve facial aesthetics and increase attractiveness. However, not all individuals are naturally endowed with their desired lip shape and volume. Aging can also lead to sagging and loss of definition. 

Fortunately, aesthetic medicine offers various interventions to address these concerns without resorting to surgical procedures or fillers, with striking and natural-looking results. 

The Botox lip flip injection technique presents a viable option for augmenting and defining the lips.

What Is a Botox Lip Flip?

If you buy Botox for a Lip flip, it is based on rejuvenation and natural enlargement of the lips. Botox in this procedure tightens and improves the lips’ shape, making them fuller. 

Botox, or botulinum toxin, relaxes the muscles of the lips, making them more visible. Note that usually, only the upper lip is treated. Unlike fillers, Botox does not increase the lip’s volume; but turns them upwards so that they become optically larger and fuller.

A lip flip won’t stop the aging process or structure of the lips, but it makes them look fuller without adding volume. It can help a person achieve a desired look, boosting their self-esteem.

Patients may request a lip flip to enhance the appearance of their lips. Common reasons include wanting fuller lips, reducing the appearance of wrinkles, or covering an excessive gingival display. 

Patients may prefer a lip flip over lip augmentation or fillers due to less swelling, bruising, and cost. A lip flip may also improve the philtrum, inter-commissural distance, and overall body image, increasing self-confidence.

How Many Units of Botox Will Be Needed For The Lip Flip?

The number of units of Botox needed for a lip flip procedure can vary depending on the individual’s anatomy and desired results. However, it usually requires 4 to 10 units of Botox for lip flip injection sites.

Lip Flip vs. Lip Filler

The difference between lip flip and lip filler is distinct. While the lip flip procedure focuses on enhancing the visibility of the top lip, lip filler primarily aims to increase the lips’ volume. 

The former requires injecting botulinum toxin type A into the muscle, causing an increase in the top lip’s visibility. In contrast, the latter involves using hyaluronic acid gels to augment lip volume, improve lip shape, and provide moisture to the lips.

The advantages of Botox treatment compared to dermal fillers:

  • No risk of swelling and bruising.
  • The effect develops over two weeks, so that the patient’s gradual transformation will be barely noticeable to others.
  • The shape of the patient’s lips does not change; only the lips become plumper.
  • A less expensive procedure.
  • Lip Flip treatment is quick (10 minutes) and easily tolerated.
  • The effect lasts 3-4 months. If the patient wishes, they can repeat it (2-3 times per year).

If the patient already has a decent amount of volume in their lips, but wants to alter the shape, a lip flip might be the best choice for them. If the patient wants added volume and longer-lasting results, lip fillers may be what they are looking for.

Lip Flip Procedure

Before the procedure, meet with your patient for an introductory consultation. 

You must evaluate your patient’s general health, including preexisting conditions and risk factors. Talk to your patient about their allergies, especially cow milk – some botulinum toxins contain albumin (a protein in cow milk). 

Ask about any prescription or OTC (over-the-counter) medications your patient takes, as they may interfere with healing.

Recommend your patient to avoid alcohol, cigarettes, and aspirin at least one week before the procedure. Alcohol and aspirin thin the blood, making the healing process more difficult. And cigarettes may increase the risk of bruising at lip flip Botox injection sites.

It’s advisable to take photographs of your patient’s face and lips before the treatment for their medical record.

The lip flip procedure is quick, taking only 10-20 minutes.

It is also worth emphasizing that the treatment is not very painful. Still, people with low pain tolerance may benefit from anesthesia. The sensation during the procedure can is comparable to a light pinch, so most patients do not use anesthesia.

The injections are superficial, and the procedure is performed with thin needles, usually injecting about 10 ml of Botox into the muscles around the lips. Botox lip flip injection points are the corners of the mouth (oral commissures) and the edges of the lips (vermillion border). Four evenly spaced injection points of 1 unit each along the lip are required.

The botulinum toxin relaxes the muscles around the patient’s upper lip, which makes their lip “flip” upwards a tiny bit, and the pink part becomes visible. In addition, Botox injection shortens the distance between the mouth and the tip of the nose.

As a result, the contour of the lips gains a more expressive shape. Also, mimic wrinkles become smaller, which is an additional positive effect of the procedure. 

Post-procedure, the patient should be monitored for 15 minutes to ensure that side effects such as allergic reactions, dizziness, nausea, angioedema, and substantial bleeding do not occur. Once it is determined that monitoring is no longer required, the patient can be discharged. 

Botox does not cause fatigue, so the patient may drive home. Individuals may experience slight swelling, sensitivity, or numbness in their lips, which usually resolves within 24 hours. 

To promote healing and prevent Botox from migrating to other areas of the face, patients should apply ice to the treated area, avoid wearing lip products for at least 3-4 days, refrain from using pressure on the lips, and avoid sleeping facedown.

Although the procedure is non-invasive, and your patient can return to their daily activities immediately after the procedure, there are a few rules to follow:

  1. Patients should avoid heavy physical exertion or lying on their stomach after the Botox lip flip placement.
  2. It’s not recommended to tilt the head up to 4 hours after the procedure.
  3. Massages, facial treatments, and sudden temperature changes (sauna or tanning beds) must be avoided for up to 7 days after Botox injection.
  4. Do not eat messy foods that may cause wiping the face or lips for at least three days.
  5. Avoid drinking straws or smoking for at least three days. Puckering or contracting the lips may cause the Botox to migrate.
  6. Refrain from drinking alcohol for at least 24 hours after the lip flip procedure. Alcohol thins the blood, which can cause bruising on the lips to worsen.

Botox Lip Flip Benefits

Botox lip flip technique allows achieving the full lips effect without invasive procedures and intervention in the body. The result is visible almost immediately after the injection. 

The process is short and usually lasts a few minutes. In addition, the procedure does not cause swelling or redness around lip flip injection sites, so your patient can return to their daily activities immediately after the procedure.

However, the full effect after a Botox injection will be noticeable after about two weeks, lasting up to 4 months. After this time, the course of treatment can be repeated.

Alternatives to a Lip Flip Treatment

There are several alternatives to a lip flip, depending on the desired outcome. For example, lip fillers, such as hyaluronic acid-based fillers, can add volume and plumpness to the lips. 

Another alternative is a lip lift, which involves surgically shortening the upper lip to increase the part of the pink lip show. 

Lip implants and fat transfer procedures can also enhance lip shape and volume.

FAQ

What muscle is injected for lip flip?

For a lip flip procedure, a small amount of botulinum toxin (Botox) is injected into the orbicularis oris muscle, the circular muscle around the mouth. By relaxing this muscle, the upper lip can slightly roll outward, giving the appearance of a fuller upper lip.

Can a lip flip be done on the bottom lip?

The lip flip procedure involves injecting Botox around the upper lip into the muscles to relax them, causing the upper lip to roll slightly upward, giving the appearance of fuller lips. 

While injecting Botox into the muscles around the bottom lip is possible, it is not a common procedure. The results may not be as significant or predictable as with the upper lip, as the muscle responsible for the “flip” effect is typically stronger in the upper lip. 

There is also a risk of affecting the mobility and function of the lower lip, interfering with normal speech and facial expressions.

How many pokes is a lip flip?

The procedure takes two to four precise punctures on the lip flip injection site along the upper border of the lip.

References

Teixeira, Jeffrey & Ostrom, Jonnae & Hohman, Marc & Nuara, Michael. (2020). Botulinum Toxin Type-A for Lip Augmentation: “Lip Flip”. The Journal of craniofacial surgery. Publish Ahead of Print. 10.1097/SCS.0000000000007128.

Pero, Raffaela, et al. ‘Botulinum Toxin Adverse Events’. Botulinum Toxin, IntechOpen, 19 Dec. 2018. Crossref, doi:10.5772/intechopen.79761.

Carruthers J, Fournier N, Kerscher M, Ruiz-Avila J, Trindade de Almeida AR, Kaeuper G. The convergence of medicine and neurotoxins: A focus on botulinum toxin type A and its application in aesthetic medicine. Part II. Dermatol Dermatologic Surgery. 2013;39:510-525. DOI: 10.1111/dsu.12148

Montgomery, Emily & Vincent, Aurora & Hohman, Marc & Teixeira, Jeffrey. (2023). Lip Lift and Lip Augmentation. Operative Techniques in Otolaryngology-Head and Neck Surgery. 34. 10.1016/j.otot.2023.01.007.

Baudoin, Julien & Meuli, Joachim & Di Summa, Pietro & Watfa, William & Raffoul, Wassim. (2019). A comprehensive guide to upper lip aesthetic rejuvenation. Journal of Cosmetic Dermatology. 18. 10.1111/jocd.12881.

Matarasso, S. L., & Carruthers, J. D. (2018). Lip Flips Using Botulinum Toxin Type A. Plastic and Reconstructive Surgery, 142(4S), 53S-58S.

Stacey, M. A., & Spring, M. A. (2020). The Lip Flip: A Review of Techniques and Outcomes. Aesthetic Plastic Surgery, 44(6), 2138-2145.

De Boulle, K., Heydenrych, I., & Keen, M. (2019). A Multi-Centre, Double-Blind, Randomized, Placebo-Controlled Study of the Efficacy and Safety of IncobotulinumtoxinA Injections in Men with a Lower Facial Height Discrepancy due to Shortened Distance between the Nose and the Upper Lip (Sn-L) Angle. Clinical, Cosmetic and Investigational Dermatology, 12, 423-431.