In short
- The lip flip exists, it is real and it has been described. It consists of relaxing with toxin the muscle that keeps the lip rolled inwards, so that the red border everts and more of it shows, without adding volume.
- It has a systematic review of its own (2025): of 48 articles found, 7 met the criteria; it describes consistent eversion of the upper lip and improved contour, with high satisfaction and minimal recovery time.
- ⚠️ And very characteristic side effects: difficulty whistling or drinking through a straw, mild, temporary and resolving within weeks.
- 🔑 The lip flip does not shorten the lip. It acts on the muscle, not on the skin. It is temporary and has to be repeated.
- Threads in the lip exist in the descriptive literature, but no systematic review or controlled comparison of their use in this area has been found. It is the option with the least support of the four.
- 🚨 And “permanent lip augmentation” deserves a serious warning: when that name denotes a material that is not reabsorbed, what is being talked about is something that cannot be dissolved and that may require surgery to remove years later.
- What has the most evidence, by some way, is hyaluronic acid filler: a meta-analysis restricted to randomised trials.
- 🔑 None of the four competes with the lip lift at what it does. Only surgery shortens the distance between the nose and the lip.
Around the lip circulate half a dozen trade names promising similar things and doing very different ones. This page sorts them out: what each one is, what it acts on and how much evidence there is behind it.
One of them, besides, is not a treatment: it is the friendly name for a problem.
What each one does, in a sentence
| What it acts on | Does it shorten the lip? | Is it reversible? | Is it done here? | |
|---|---|---|---|---|
| Lip flip (toxin) | The muscle that keeps the lip rolled in | No | Yes — it wears off on its own | Yes |
| Hyaluronic acid filler | The volume of the red lip | No | Yes — it can be dissolved | Yes |
| Lipofilling (your own fat) | The volume, with your own tissue | No | No — it is permanent | Yes |
| Threads | The support of the tissue | No | Partially | No |
| Permanent fillers (other than your own fat) | Volume, with foreign material | No | No | No |
| Lip lift | The length of the skin | Yes | No | Yes |
The lip flip: what it really is
It is the one that causes most confusion because its name suggests a lift, and it is not one.
The mechanism. The upper lip is surrounded by the orbicularis muscle, which among other things holds it under a certain inward tension. By relaxing the upper portion of that muscle with a small dose of botulinum toxin, the border of the lip everts — unfurls outwards — and more red lip shows without anything having been added.
What the evidence says. A systematic review published in 2025 found 48 articles, of which 7 met the criteria by detailing injection points and doses. Its conclusions: consistent eversion of the upper lip and improved contour, high patient-reported satisfaction and minimal recovery time.
⚠️ The side effects are mild, temporary and very recognisable: difficulty whistling and drinking through a straw, resolving within weeks. It makes sense — it is the same muscle that does all three things.
🔑 What the lip flip does not do: it does not shorten the philtrum, it does not change the position of the lip and it does not add real volume. And it is temporary, like any treatment with toxin.
⚠️ On botulinum toxin, this page gives general information about the procedure and mentions no brands, doses or prices, because advertising medicines to the public is prohibited. The indication, the regimen and whether it suits your case are for a professional to determine in consultation. Our botulinum toxin page covers the treatment in general.
Threads: the option with the least support
Threads — of absorbable material, with small barbs along their length — are used in several areas of the face in an attempt to support or reposition tissue.
In the lip there are descriptive articles about volumising threads combined with filler. But on looking for higher-level evidence about their use in this particular area, no systematic review and no controlled comparison has been found.
🔑 That does not mean they do not work. It means that, of the four options on this page, it is the one least is known about — and that is worth knowing before deciding, especially if they are presented as equivalent to surgery.
It is exactly the same pattern as in other parts of the body: the promise of a “non-surgical lift” runs ahead of the evidence to support it.
⚠️ We do not offer them here, and that is the reason: for this area there is no evidence to justify proposing them over the alternatives that do have some.
Lipofilling: permanent volume with your own tissue
It is the option missing from almost every list of this kind, and it is the only one on this page that adds volume permanently without introducing any foreign material.
What it involves. Fat is taken from the patient herself — abdomen, flanks, thighs — by a small liposuction, processed and grafted into the lip. The tissue put in is yours.
What sets it apart from the others:
- Compared with hyaluronic acid: it does not have to be repeated periodically. In exchange, it cannot be dissolved — there is no enzyme that breaks down your own fat.
- Compared with permanent fillers of foreign material: that is the decisive difference. Here we do perform permanent lip augmentation, but only with autologous fat. With permanent substances that are not your own fat, no. The reason is in the next section.
- Compared with the lip lift: it does not shorten the distance between the nose and the lip either. They are different problems.
⚠️ Its limits, worth knowing beforehand: some of the grafted fat is reabsorbed, so more than one session is sometimes needed; the volume added per session is less than that of a filler loaded in at one go; and you need enough fat at the donor site. The technique, in general, is described in augmentation with your own fat.
🔑 And one practical consequence of the list above: if what you want is volume that lasts without carrying inside you anything that is not yours, this is the answer — not a filler advertised as “permanent”.
🚨 “Permanent lip augmentation”
Here the tone has to change, because this is not just another option on a list.
“Permanent” in a filler means the material is not reabsorbed. And that, which sounds like an advantage — no need to repeat it — has a trade-off that is rarely explained with the same clarity: if you do not like the result, if the material migrates or if complications appear years later, it cannot be dissolved.
Unlike hyaluronic acid, which has an enzyme capable of breaking it down, a permanent material can only be removed surgically — and not always completely, because it tends to integrate with the tissue.
⚠️ It is a problem ICPM knows well from another direction, that of permanent materials injected into other parts of the body. Everything known about why they are a problem, what long-term complications they cause and how they are removed is in the removal of biopolymers.
🔑 And a practical warning: a product advertised as “permanent”, “definitive” or “long-lasting” deserves you asking exactly what material it is, whether it is absorbable and what happens if you want it taken out. It is a legitimate question and the answer should be immediate and in writing.
✅ Our position, so there is no doubt: we do not use permanent fillers other than autologous fat. If what you want is lasting volume, the route is lipofilling — your own tissue — and not a synthetic material that cannot be removed.
What to choose according to what bothers you
- “Not much red lip shows, but I do not want volume.” The lip flip acts exactly there — with the caveat that it is temporary.
- “My lip is genuinely thin.” That is volume: the territory of hyaluronic acid filler if you want it reversible, or of lipofilling if you want it lasting and with your own tissue. It is compared in lip lift or hyaluronic acid.
- “The distance between my nose and my mouth is long and my tooth does not show.” None of the three alternatives on this page resolves that. Only surgery shortens that distance: lip lift.
- “The vertical lines bother me.” That is the quality of the skin, not its length or its volume: upper lip lines and the barcode.
- “I show a lot of gum when I smile.” That is muscular dynamics, and it depends on the cause: lip lift, gummy smile and teeth.
Book an appointment
You can book your own appointment. Pick the day and time from the free slots in the diary, in a panel that opens right here, without leaving this page.
Frequently asked questions
Does the lip flip replace the lip lift?
No. The lip flip everts the border of the lip by relaxing a muscle; the lip lift shortens the skin. They act on different structures and the effect of the first is temporary.
How long does each one last?
It depends on the treatment, and it is worth having them together:
| How long it lasts | |
|---|---|
| Lip flip (toxin) | 4-6 months |
| Hyaluronic acid | It depends on the product used |
| Lipofilling | Permanent (once the initial reabsorption has settled) |
| Lip lift | Permanent — excised skin does not come back |
⚠️ With the usual caveat on the two permanent ones: “permanent” means the change does not undo itself. Ageing carries on and the lip keeps changing over the years.
Can I have a lip flip before deciding whether to have surgery?
It is a reasonable idea within the logic of trying the reversible option first, with one condition: that what bothers you is the border showing too little and not the length of the lip. If the problem is the distance, the lip flip is not going to give you useful information about the result of surgery.
Do threads lift the lip?
That is what is advertised. What can honestly be said is that no systematic review or controlled comparison has been found of their use in this area, unlike the lip flip and filler, which do have some.
Who decides which suits me?
It is a practical advantage of how the practice is set up here: our surgeons are also experts in aesthetic medicine, so the same person who assesses whether surgery suits you can assess whether it does not and do something else instead. There is no need to go to two places or to add up two opinions with different interests.
What if I have already had something permanent put in?
It is a situation assessed case by case and not resolved by reading. The information on permanent materials and their removal is in removal of biopolymers. And if the lip has also been deformed by years of filler, that is in after years of fillers.
Which is cheaper?
Non-surgical treatments have a lower cost per session and have to be repeated; surgery has a higher one-off cost. The comparison over five or ten years depends on specific prices and on how often maintenance is needed, and each person should do it with real figures.
Sources
- Pitchford CA, Desrosiers AS, Tolkachjov SN. The lip flip: a systematic review of botulinum toxin lip augmentation. Archives of Dermatological Research, 2025. PMID 40377719. — Systematic review searching PubMed and Ovid; 48 articles were identified, of which 7 met the inclusion criteria by detailing injection points and doses; the procedure consists of injecting botulinum toxin type A into the orbicularis oris muscle and produces consistent eversion of the upper lip and improved contour without adding volume; patients report high satisfaction and minimal recovery time, with mild, temporary side effects such as difficulty whistling or drinking through a straw, resolving within weeks.
- Edward Wen Y, Perez Rivera LR, Wyatt HP, Lee WY, Oh C, Boyd CJ, Karp NS. Efficacy and Safety of Hyaluronic Acid Lip Fillers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Aesthetic Surgery Journal, 2026. PMID 41186199. — Meta-analysis restricted to randomised controlled trials; 16 articles included from 2,038 identified; level of evidence 1.
- Komisarek O, Banasiak Ł, Olichwer V, Burduk P. The Bullhorn and Beyond: Evidence-Based Review and Clinical Recommendations for Lip Lift Techniques. Journal of Cosmetic Dermatology, 2026. PMID 41731334. — PRISMA 2020 systematic review of 7 studies and 1,754 patients; the surgical lip lift shortens the cutaneous upper lip and increases vermilion show.
- Sturm A. Lip Lift. Otolaryngologic Clinics of North America, 2022. PMID 35750522. — It describes the orbicularis oris muscle as the structure that must be preserved in surgery, and which is the target of the lip flip with toxin.
Book your consultation
If you have got this far with a list of names, the useful thing is not to choose one: it is to describe precisely what bothers you — the border showing too little, the volume, the distance or the lines. With that, an in-person assessment tells you what acts on it and what does not, including the possibility that the most sensible thing is to do nothing for now.
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Last reviewed: 6 September 2026. This content is for information only and does not replace an individual assessment by a healthcare professional.
