Is Permanent Lip Filler a Thing?

You know what they say: It’s a mile to your first lip filler treatment and a minute to the second one. Actually, that clever little adage, once related to tattoos, can also sum up the pursuit of fuller lips. 

While anyone can give their lips a boost using dermal filler, it’s still a temporary solution that needs continual maintenance. So, we have to ask, how long can lip filler last and are there any options for permanent filler? We went out to our lip-plumping pros to find out if there is a long-term cure for lip-filler fatigue.

Lip Implants: Yay or Nay?

New York dermatologist Marina Peredo, MD says for lips especially, a permanent solution may not be the best. “As we age, our face changes and our lips begin to change as well. Anytime you put something permanent in the face unless, you’re doing a chin implant, it’s never ideal. Especially for the lips because we use them all of the time to speak, to kiss, to drink. With something permanent, you have to consider, what if it doesn’t look good? What if it shifts? Then your only recourse is surgical removal.”

Although there have been permanent solutions in the past, including lip implants, Dr. Peredo says filling the lips with something more pliable and allows for a better-looking result. “You want to fill with something soft. People used to use something called SoftForm to enhance the lips. It was an implant you could place in the vermillion border, it almost looked like a little pipe cleaner. It was semi-soft, semi-permanent, but it ended up looking really fake.”

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The History of Lip Plumping

“The very first filler used in the early 1900s was paraffin wax,” explains Vero Beach, FL plastic surgeon Alan J. Durkin, MD. “The paraffin was injected in liquid form and as you would expect, it was not successful. In the 1960s, silicone was used until concerns about safety came up and surgeons began using bovine collagen. At the time, it was not as easy to get injections as it is today. An allergy test was required before treatment to make sure the body didn’t reject it and results would take weeks to be seen.” We can point to Barbara Hershey’s role in Beaches for the first major public reaction to lip filler. Hershey reportedly had collagen lip injections prior to filming, but by the time the movie was released in 1988 her body had absorbed the collagen and her lips returned to their original state. “Once hyaluronic acid fillers came on the market, which are made of the same substance we naturally produce, we no longer had to rely on collagen,” he says.

Adding Fat For Fullness

Fast forward to today and hyaluronic acid fillers are the gold standard for creating the pronounced pout many patients desire. For those looking for an option that lasts longer, Dover, OH facial plastic surgeon David Hartman, MD says he recommends fat: “Whatever fat survives the first few weeks or months, will remain essentially forever,” he says. “I love fat grafting as it is perhaps the only procedure in cosmetic surgery that actually rejuvenates—from the stem cell reaction—the skin and soft tissue around the grafted fat while adding volume to the lips.”

Despite fat grafting’s reputation for being all-natural, Dr. Peredo cautions it can leave patients looking anything but if weight fluctuation is an issue. “The minute you gain weight, you gain it everywhere, including the fat transfer site. This can end up leaving the lips looking over-inflated. So while this option is longer-lasting, it has its own drawbacks.”

Is Temporary Better Than Permanent?

Although fillers don’t last forever, both Dr. Peredo and Dr. Hartman agree they are the best choice for lip augmentation, even if you have to make a couple of visits a year to the doctor. “A hyaluronic acid lip filler will typically last for six to nine months before the patient wants to have more filler placed,” says Dr. Hartman. “Conveniently, most of my patients getting lip filler will also be keeping up with their neurotoxin and laser treatments, and facials, peels or skin-care products—so they are coming to see me regularly anyway.”

Dr. Peredo says, “If there were a permanent filler that you could maybe reverse with an injection, then that would be different. But right now, we don’t know what future innovations will come that will make lip augmentation last longer. But until we do have something that looks good, is safe and is reversible, I prefer to use hyaluronic acid fillers on my patients. My best advice is to wait until we have those innovations, because you don’t want to put something in your lips that you will regret later. Be patient.”