Botox Lip Flip: Everything you need to know

What is the Botox Lip Flip? 

A Botox Lip Flip is a popular, inexpensive, and minimally invasive cosmetic procedure that results in a natural-looking fuller upper lip when smiling.

How does the Botox Lip Flip work?

First, let’s consider how Botox itself works.

Botox is one brand name of the neuromodulator botulinum toxin type A (BoTA), a potent substance produced by the clostridium botulinum bacteria. There are 4 additional FDA approved brand names of BoTA: Dysport, Xeomin, Jeuveau, and Daxxify.

Botox, like all other brands of BoTA, works to temporarily block acetylcholine (ACh) at the neuromuscular junction. ACh is required for muscle contraction so when Botox blocks it the muscle in the treated area remains relaxed.

The lip flip procedure involves injecting Botox into the orbicularis oris muscle just along the vermillion border of the upper lip (edge of the pink lip). Now that this area relaxed it won’t curl under when smiling resulting in more pink show (a.k.a. lipstick real estate).

It is important to note a few things. 1.) there is minimal aesthetic effect when the mouth is relaxed. This is because Botox can ONLY relax muscles the area where it is injected. This means if the muscle(s) are already relaxed you won’t notice a huge difference. The muscle needs to be engaged in order to see the  maximum results (smiling). 2.) There is no actual “flip” of the lip. Meaning, the treatment will not cause a ducky appearance of the lip.

Will a Botox Lip Flip fix my gummy smile?

To effectively treat a gummy smile (excessive gingival display when smiling) a slightly different placement of Botox is used. A lip flip can be used in connection with gummy smile correction.

How long will a Botox Lip Flip last? 

A Botox Lip Flip result is temporary and last, on average, 2-3 months.

Over time the Botox will wear off as your body naturally metabolizes it. When the “Botox bouncer” disappears ACh is allowed to re-enter the neuromuscular party and full muscle movement (curling under of upper lip) will resume.

What should I expect at my treatment?

The Botox Lip Flip treatment can be performed in less than 5 minutes.

Topical numbing can be applied. For this request, plan to arrive about 10 minutes early to your appointment.

Your injector will administer 4-10 units of Botox on the vermillion border of the upper lip. It is a bit spicy but it’s super quick with just 4-6 needle pricks.

Patients usually begin to see partial effects of the Botox Lip Flip 2 days after the treatment with the final results being visible 14 days post injection. For the first two weeks you may feel a bit dribble-y when drinking through a straw. You can still pucker, speak, and kiss normally.

The procedure has no downtime and you can return to your normal activities immediately after the treatment.

Minor bruising is possible (although unlikely) and about 10 minutes of light swelling at the injection sites should be expected.

Should I choose the Botox Lip Flip, dermal filler, or both?

When choosing between these procedures, it’s important to consider their differences in terms of how they work, expected results, and possible side effects.

Lip flip - Great for just a tiny bit more upper lip show or for reducing the amount of upper “lip loss" when smiling (lip curling under). Cost effective. Extremely low adverse event rate. Not ideal for additional volume or symmetry at rest. Not ideal for straw lovers or whistling champions. Lasts 2-3 months on average.

HA Dermal filler - Best for adding volume or adjusting symmetry/proportion in the lips . The HA also does a nice job of keeping the lips soft and hydrated. Not ideal 2 weeks prior to a major event as short-term swelling and bruising are common. Lasts 6-12 months depending on amount used.

Of note: The only type of dermal filler to be used in the lips is a hyaluronic acid (HA). Currently, we have about 20 different types of HAs that are FDA approved. The differences lie in manufacturer, manufacturing process, consistency of the HA gel, and recommended depth of injection for a particular brand. The Restylane family of products, to include Resylane Kysse, are some of the most popular as they swell less, have lower migration outcomes, and when injected properly, produce soft and natural-looking results.

Both - I’ll take the cake and icing. I frequently combine a Botox Lip Flip (4-6 units) with a small amount of dermal filler, like Restylane Kysse, for optimal results. By doing this, I can put less dermal filler in the lip (soft and natural) and still get great pink show even when smiling thanks to the lip flip.

Still not sure what is right for you or have additional questions? Give us a call or pop in for a chat. We are home to board-certified nurse practitioners, physicians, and master aestheticians who are all knowledgeable in providing outstanding patient care and assuring safe cosmetic procedure outcomes.