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Why Lip Filler Does Not Always Work

By Dr Tim Pearce, MBChB BSc (Hons) MRCGP

I have occasionally come across cases where lip filler seems almost completely ineffective at enhancing lips.

There are two main reasons I have experienced-

  1. The first is biochemical
  2. The second is structural.

Hyaluronidase is a naturally occurring enzyme in our skin, but it is usually in very low levels.  Some people seem to have a genetic predisposition to produce much higher than average levels of natural hyaluronidase.  I have had two such cases, who destroy the injected HA in a matter of weeks.

The second cause, is the structure of the untreated lip.

The lip hangs below the top teeth at rest, and may also be very thin, it becomes impossible to create any projection to the lip or to show any more pink of the lip.  All that happens is that more thickness is added to the entire upper lip, white and pink.  The result from 0.5ml in the top lip is very little difference that the client feels it is disappointing.  Trying with more filler often leads to just more thickness to the entire white area of the lip.

It is not a rare scenario, since the extremely thin lip is an obvious trigger to seek augmentation.    Client selection as always, improves with experience.  The initial enthusiasm to try and improve an extremely thin lip should be tempered with bitter experience discovering that these lips are in fact the hardest to enlarge.


dr tim pearce

Dr Tim Pearce MB ChB BSc (Hons) MRCGP

Clinical Director

As Clinical Director of both SkinViva Training and SkinViva Ltd, Dr Tim Pearce is a fully-qualified and experienced doctor specialising in non-surgical aesthetic rejuvenation. He has over 5 years’ experience in cosmetic medicine and has performed thousands of treatments.

Since the launch of SkinViva Training Academy, he is also Lead Trainer for Botox and dermal filler injection techniques to fellow clinicians entering the aesthetics industry.

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