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August 24, 2018

Can you remove lip fillers?

Infrequently Asked Questions seeks the answer

Never has a person's lips been shrouded in such mystery. 

The internet was aflutter with gossip when Kylie Jenner surfaced in a photo earlier this year with lips looking It was remarkable, given how much attention her lips had attracted from critics, admirers and entertainment news sources alike in the year prior.

But can you really take out lip fillers? 

Curious if it is so simple, we reached out to Jennifer Perry, a certified nurse injector from 3000BC, a Center City spa and beauty customization lab, for answers.

What is a lip filler?

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There are many different materials that have been used over the years to add volume to lips, some of which are silicone, bovine collagen, a patient’s own fat, implants, absorbable threads and Hyaluronic acid.

In the ‘80s, there was bovine collagen, but that has gone by the wayside, as some people can be allergic to it and they’re animal-derived, which throws in some controversy.

Then there is fat, which can be harvested from the patient, and re-injected into the face and/or lips. This is commonly done in combination with other procedures when the patient is undergoing surgery, as the patient also has to endure the pain of having the fat taken from another part of the body. 

The most common lip fillers I see today are Hyaluronic-acid-based fillers such as Restylane, Juvederm and Belotero. Hyaluronic acid is a carbohydrate, like a sugar molecule, that occurs naturally in the body. It is found in cartilage, synovial fluid, and connective tissue. Its job is to bind to water and provide lubrication.

Hyaluronic acid fillers can have different compositions depending on the type. Ultra-smooth fillers such as Belotero Balance, Restylane Silk, or Juvederm Volbella or Vollure, provide a natural, subtle plumping, hydration and can fill those tiny peri-oral “smoker’s lines” because of their ultra-thin nature.

Restylane Refyne, Restylane Defyne, Juvederm Ultra and Ultra Plus will give you a bit more plumping and lift, but they may feel somewhat thicker or lumpy because of their larger composition. 

Since Hyaluronic acid occurs naturally in the body, it is recognized by the body as safe, and broken down and absorbed naturally, just as any other carbohydrate would be. They typically last between six to 18 months, depending on the type of filler used, with the average being about six months.

The 'IAQ' Fast Facts

• Lip fillers can be a variety of materials, but the most common today is Hyaluronic-acid-based fillers

• There's little difference between getting fillers when you're younger or older, in terms of practice.

• Shape matters: Anyone seeking an injection should take into account the natural symmetry of their lips.

• You can reverse lip fillers using an enzyme injection; this was not always the case.

Who often wants lip fillers?

It’s a variety of patients. The younger population tends to want more of a plump look. Then, the 30-to-45 population just wants to change the shape, make it prettier, not look overdone. And then, in the 45-60 age group, it’s women who might get their lips shaped back to normal or lifted a little bit, which you can do with the fillers and a little bit of Botox and then just re-volumize it.

Is it better to do this when you’re younger or older?

Doesn’t really matter.

Even with scarring?

If you’re one of those people who gets it done every six months, then yes, you have a possibility you can scar. Just because any time you’re injecting anything in the body, or causing trauma to the body, there’s potential for bruising, inflammation, scarring. There are things you can do to prevent scarring, such as using a special needle called the cannula. It causes a lot less bruising, bleeding, and the only downside is it’s hard to shape the lip like you can do with [a different] needle. But the needles we use are so small, the holes we leave heal very quickly. Unless you have a tremendous amount of bruising or swelling; the scarring is minimal.

Can you remove those fillers? What does that look like?

So, you can remove your fillers. There is an enzyme called Hyaluronidase, and if it’s injected in the area where the filler is placed. It breaks it down. It takes a few days to up to two weeks to break everything down. Now, if there was scar tissue involved, it will not break that down. Some people do have to get that taken care of with a steroid, or if it’s severe, surgically excised. But that’s rare.

When people get lip injections, and they go wrong and look bloated, what’s usually happened?

Sometimes, when things go wrong, if it’s just aesthetically you’re speaking about, there can be too much placed at one time, it can be placed too superficially—too close to the surface of the skin. You can feel that it wasn’t placed in the right area, or plane. They can seem asymmetrical, where maybe one side looks higher than the other—and interestingly, most people’s lips are not perfectly symmetrical anyway. You have to take that into consideration when placing fillers. You may have to adjust one side more than the other. It’s a good thing to have shape in mind when treating a patient.

[For example], if you just fill the upper lip without fixing the shape, you can end up with one long line of filler, with no shape to it. I like to make sure the shape is nice before I actually fill. And then if you over-volumize the top lip, you don’t adjust the bottom, you tend to have duckface. And I think a lot of people just want their top lips filled, but an over-injected top lip and an under-injected bottom lip is not aesthetically pleasing to the eye.

Do men get this?

They do. They don’t get them for plump, but to fix the shape that’s changed over the years.

When did lip fillers first get used? Why are we so fascinated with fuller lips?

Going way back in time, anthropology can tell you that when we get sexually aroused, certain organs and parts of your body react. The pupils in your eyes will dilate and parts of your body will swell and get red. Your lips are one of them. Researchers thought that’s probably why the ancient Egyptians always put red lipstick on. They always wanted to appear more attractive to the opposite sex and they found men’s eyes tended to a woman’s mouth before any other feature on the face.

Lip fillers probably got popular 30 years ago, but not as much as it is now, and I think it’s because we have better fillers. They’re reversible, you’re not as likely to get an allergy from them.

We often point out jobs gone wrong, but can you think of any celebrities who are a good example of lip fillers?

If it’s really good, it’s hard to tell, right? That’s the problem. You really shouldn’t be able to know. Actually, Kylie Jenner’s lips look really nice now and I don’t think she had them completely dissolved. They just look more natural.

What should someone look for when seeking good filler?

You want to make sure you go some place the experience of the injector they’re not just training, you want to make sure you choose good filler for what you’re looking for, because different fillers have different jobs…

The experience of the injector is important. Lips are not easy; they’re challenging. It’s not a one-size-fits-all.