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Hyaluronic acid fillers: Can fuller lips be too full?

A recent study has reported that thicker lips were considered less attractive by respondents after augmentation. (Image: Kourdakova Alena/Shutterstock)

MARINGÁ, Brazil: Lips come in many shapes and sizes, but fuller lips are often seen as a physical representation of youth and beauty. To that end, thousands of women undergo lip augmentation procedures every year. But do lip fillers always increase lip attractiveness?

Various studies show that facial appearance plays a vital role in social interactions, which is one of the reasons why facial aesthetic treatment has become mainstream. Lip augmentation procedures, especially, are easily accessible and especially trendy among celebrities and people with naturally thin lips.

According to the 2017 American Society of Plastic Surgeons statistics report, surgical lip augmentation increased by 60% between 2000 and 2017. In 2016, 2.6 million filler procedures were performed in the US, and the number is projected to grow every year.

Hyaluronic acid is a minimally invasive treatment for lip augmentation that is safe and predictable and has high patient satisfaction. To guide clinicians in their use of hyaluronic acid that is tailored to the patient, researchers from Brazil investigated whether natural lip thickness before filling affects attractiveness after lip augmentation. They asked dentists, specialists in facial harmonisation and laypersons to evaluate the attractiveness of the lips of 16 women, grouped into eight with thin and moderately thick lips and eight with thick and full lips, before and after filling with hyaluronic acid.

The researchers reported that, according to the respondents’ evaluations, participants who had thinner lips pretreatment were assessed as having significantly improved lip attractiveness after the filling procedure. However, they found that, although thicker lips were considered more attractive than thinner lips both before and after lip augmentation, they decreased in attractiveness after the filling procedure.

Patient from the group with thinner lips (a) before lip filling and (b) ten days after lip filling. (Image: De Queiroz Hernandez et al., licensed under CC BY 4.0)

Patient from the group with thinner lips (a) before lip filling and (b) ten days after lip filling. (Image: De Queiroz Hernandez et al., licensed under CC BY 4.0)

Patient from the group with thicker lips (a) before lip filling and (b) ten days after lip filling. (Image: De Queiroz Hernandez et al., licensed under CC BY 4.0)

Patient from the group with thicker lips (a) before lip filling and (b) ten days after lip filling. (Image: De Queiroz Hernandez et al., licensed under CC BY 4.0)

The findings suggest that greater lip volume is not always more aesthetically pleasing. “There seems to be a limit to the amount of filler to be injected in patients who already have a certain volume in the lips before filling,” the researchers wrote in the study.

In light of the findings, they suggested that dental professionals should recommend to their patients the amount of filler to be injected based on the patient’s lip volume pretreatment and other factors that significantly impact lip shape preferences, such as ethnic background and profession. “Clinicians must be aware that beauty is an ever-evolving concept subject to trends. The patient expects his doctor to be up to date with the latest scientific literature published in the field and aware of beauty trends. A good talk between the professional and the patient will awaken trust between them,” they concluded.

The study, titled “Evaluation of the attractiveness of lips with different volumes after filling with hyaluronic acid”, was published online on 21 March 2023 in Scientific Reports.

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