Lip Enhancements

There are many different ways to utilize lip enhancement techniques to create a beautiful smile and increase overall facial appearance. Dr. Pia will consult with you and decide which is the best approach for your desired results. That may include Juvederm for plump, fuller lips, to using Botox for procedures known as lip-flip or lip-drop.

Lip enhancement with Botox can:

  • Provide a subtle more prominent “pout” to your lips
  • Create a fuller upper lip when you smile
  • Give you fuller-looking lips without added volume
  • Fix a “gummy smile”

Lip enhancement with Juvederm can:

  • Provide additional volume in the upper and/or lower lip
  • Address more severe vertical lip lines
  • Improve overall lip shape and symmetry
  • Create a longer-lasting lip enhancement (6-12 months)

Of course, during your consultation with Dr. Pia, she will go over all your lip enhancement options in detail and together you will decide which is the best lip enhancement treatment for you.

Lip Fillers: Juvederm

What is Juvederm?

Juvederm is a hyaluronic acid-based dermal filler. There are several products in the Juvederm family. They all are used to help people address the facial signs of aging. Each product in the Juvederm line features different bonding and concentrations of hyaluronic acid. The different products are each tailored to target specific problems when injected into different areas and depths. Juvederm fillers have a smooth, gel-like consistency.

Juvederm types:

  • Juvederm Voluma XC adds volume beneath your skin’s surface to increase the size of your cheeks.
  • Juvederm XC and Juvederm Vollure XC address the loss of skin elasticity and fill out wrinkles and lines around the mouth and nose — known as smile lines.
  • Juvederm Ultra XC and Juvederm Volbella XC work as nonsurgical lip enhancement treatments.

Preparing for Juvederm

Before a Juvederm treatment, speak with a medical professional about your cosmetic goals and expectations. Juvederm procedures are minimally invasive so they’re frequently done on the same day as the consultation. The procedure is minimally invasive and doesn’t need much preparation.

Simple instructions to follow before your consultation and treatment generally involve avoiding medication like aspirin, ibuprofen, and St. John’s wort. And you’ll want to avoid alcohol in the weeks leading up to treatment. Smoking is also discouraged before treatment. Avoiding these things can help prevent bruising. Also let your doctor know of any allergies or sensitivities.

Target areas for Juvederm

  • cheeks: Juvederm Voluma XC
  • around the nose and mouth: Juvederm Ultra Plus XC and Juvederm Vollure XC
  • lips: Juvederm Ultra XC and Juvederm Volbella XC

Before and After Pictures

How does Juvederm work?

Juvederm works by adding volume to the facial tissue through its active ingredient, hyaluronic acid. Hyaluronic acid is a natural substance found in the human body. It stimulates the production of the connective tissue that plumps the skin (collagen). As you get older, the production of hyaluronic acid and collagen decreases. This increases the appearance of sagging and wrinkling of the facial skin.

During the procedure, your doctor, physician assistant, or nurse typically uses a pen to mark the areas to be treated. Your doctor will then inject Juvederm into the target area. They will also lightly massage the area to ensure an even distribution and reduce the chance of swelling. The entire procedure usually takes between 15 and 60 minutes, depending on the area treated.

Juvederm injections contain a small amount of pain-reducing lidocaine. This will help minimize any pain or discomfort you feel during treatment and make it go away quickly.

Risks and side effects

You can expect some swelling and bruising. Other common side effects include:

  • redness
  • tenderness
  • lumps or bumps
  • minor pain
  • itching

All of these side effects usually subside within two to four weeks.

More serious side effects are typically associated with unprofessional handling, like injecting Juvederm into a blood vessel unintentionally. Complications can include permanent scarring, vision abnormalities, blindness, or stroke. That’s why it’s very important to choose your doctor wisely. Make sure that they are trained, certified, and licensed to perform the procedure.

What to expect after Juvederm

Recovery time is minimal. But, people are advised to avoid strenuous activity, sun exposure, wearing makeup, and consuming alcohol for at least 24 hours post treatment.

Most notice the effects of Juvederm right away, or after the swelling reduces. Results typically last between six months and two years. This depends on which Juvederm product was used.

How much does Juvederm cost?

As of 2020 the national average cost of hyaluronic acid injections such as Juvederm was $750-1500 per syringe. The cost of a Juvederm treatment can vary depending on your physician’s experience, geographic location, and the number of syringes used. Since dermal fillers are an elective treatment, health insurance does not cover the cost.

Botox “Lip-Flip”

Interested in the Botox Lip Flip?
Here are 5 things you need to know.

Full, youthful lips are always in style—and lip plumping is one of our most popular uses for dermal fillers. However, not everyone who wants their lips to look fuller necessarily wants or needs fillers to achieve their desired effect. Perhaps you want a very subtle result, or you would prefer to try out a shorter-term option (fillers can last 6 to 12 months). If you would like to enhance your lips but feel like fillers aren’t your style, you might consider Botox injections, in a quick procedure called a “lip flip.” Our injectable specialists have been getting requests for this lip enhancement option at Cosmetic Dentistry Center NYC, and patients who try it love their results.

Be sure to choose a qualified provider who has plenty of experience performing the Botox lip flip. Overtreating is a real risk and can limit your ability to move your lips normally. It takes a high level of skill to achieve the right effect.

What is the Botox lip flip?

As the name implies, the Botox lip flip involves using Botox to enhance the upper lip. Just a few quick injections can help the upper lip relax and roll slightly upward, which allows more of the upper lip to be visible. It is an excellent alternative to fillers for patients who want a more subtle enhancement than fillers provide, or for those who want to enhance the shape of their upper lip with minimal effort.

How does the lip flip work?

To perform a Botox lip flip, our injectable specialists make a series of injections just above the upper lip, into the orbicularis oris muscle, which encircles the mouth. Botox temporarily relaxes the part of the muscle over the upper lip, causing the lip to roll slightly upward so it appears more voluminous and defined. This muscle relaxation can also help smooth vertical lines around the lips. Most patients notice the effects within a few days of treatment, with full results in about one week. The effects of Botox for lips lasts up to three to four months.

The Botox lip flip can be an excellent alternative to fillers for patients who want a more subtle lip enhancement, as well as those who want to enhance the shape of their upper lip with minimal effort.

Botox lip flip vs. lip fillers

The Botox lip flip isn’t a substitute for lip fillers. We perform both at Cosmetic Dentistry Center NYC, as we have patients who are better suited to one treatment or the other, or both. Our injectable specialists consider your natural lip anatomy, your desired outcome, and your personal preferences when deciding whether Botox or a dermal filler, such as JUVÉDERM VOLLURE™or Vollbella XC, is the best lip enhancement option for you.

You likely will be happy with the Botox lip flip if:

  • You would like a subtly more prominent “pout” to your lips
  • You feel your upper lip looks invisible when you smile
  • You want fuller-looking lips but do not want additional volume
  • You want a more temporary treatment (3-4 months)

Fillers are likely a better lip enhancement option if:

  • You would like additional volume in the upper and/or lower lip
  • You would like to address more severe vertical lip lines
  • You would like to improve overall lip shape and symmetry
  • You want a longer-lasting lip enhancement (6-12 months)

In some cases, the best solution for a patient is to combine Botox with fillers. Using fillers to enhance lip volume and Botox to lift the upper lip slightly can achieve a beautiful effect for patients with very thin lips.

How much does the Botox lip flip cost?

The typical Botox lip flip costs $200-500 per treatment. If you’re surprised at how inexpensive this seems, consider that we only need a few units of Botox to achieve the desired “lip flip” effect. It is important to keep in mind that the Botox lip flip only lasts three to four months, and you’ll need to return for treatment about two to three times as often as you would for filler injections. That said, Botox can be a very cost-effective solution for patients desiring a subtle, but meaningful improvement in lip appearance.

How can I get a natural lip flip result?

While it may sound simple to get fuller looking lips with Botox, not every injector is qualified to perform a lip flip. It takes a very high level of skill and knowledge of anatomy to achieve the right effect, so be sure you choose a highly qualified specialist who has specific training and plenty of experience performing the Botox lip flip. Over-treating is a real risk with inexperienced providers and can limit your ability to move your lips normally. For instance, you may not be able to whistle or use a straw until the Botox starts to wear off if too much Botox is used or if it is injected into the wrong location.

Gummy Smile: What it is and how to fix it

Gummy smile (GS) is an aesthetic disorder for some patients, which can be corrected by injection of botulinum toxin. In this study was to collect information about the responses of the muscles to the same dose Botulinum Toxin-A (Botox) and to assess whether there is a correlation between the amount of the upper lip drop and the amount of gum displayed during smiling.


The patient injections were made in the middle of the triangle formed by LLS, LLSAN, and Zmi bilaterally with a dose of BTX-A of 2.5 U. Followed by bilateral injection of 2.5 U BTX-A into their lip elevator muscles. BTX-A injections to reduce excessive gingival display. Gingival display was described as the difference between the lower margin of the upper lip and the superior margin of the left or right incisor. Before injections patients when full smile, the average GD ranged from 3 to 7 mm. Injections of BTX-A into the associated muscles of the upper lip reduce the upward movement of the lip and cause the lip to drop, thus, resulting in a less gummy smile. The lip drop amount was calculated the apparent length of the central crown height was extracted from the total height by using after photos.


There was a decrease in the degree of gum display in all patients. The general average of gingival display before treatment was measured 4.62 ± 1.17 mm. The mean of lip drope was measured 5.17 ± 0.88 mm after two weeks from injection. A statistically significant correlation was found between the amount of the pre-treatment gingival display during maximum smiling and the amount of lip drop.

Before and After for Gummy Smile


The use of botulinum toxin is much less invasive, and the development of complications is less frequent with quite satisfactory results for patients compared to the other methods used in the treatment of GS. The authors conclude that in the cosmetic correction of GS, the amount of the mean lip-drop is 5-6 mm and there is a positive correlation between the lip-drop and pretreatment gingival display.