All About Lip Flips


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Many patients seeking fuller lips are nervous to get lip filler and often opt to start with a lip flip. Some are also nervous about a ducky appearance and have heard that a lip flip can help with this!

In this article we’ll dive into what lip flips are, how much they cost, and why it may make sense for some patients to pair a Botox lip flip with traditional lip filler. We’ll also talk about who may be a candidate for a surgical lip lift if a lip flip is not enough. 

What is a Botox lip flip?

A lip flip is an “off-label” procedure done by injecting Botulinum toxin into the border of the upper lip into the lower portion of the orbicularis oris muscle. This is the circular muscle that controls lip pursing (known as duck face). 

By injecting botulinum toxin into the lower region the lower muscle is slightly deactivated. This allows the upper portion of the orbicularis oris to flip the top lip up a bit. It also helps with “smoker’s lines”around the lips.

The effect is a modest 1mm change to the upper lip that lasts around 2-months.

How much does a Botox lip flip cost?

Lip flips are generally for cosmetic purposes and are not covered by insurance. Pricing depends on how many units are needed, who is doing the procedure, and also if the procedure is done alone or with lip filler. Most patients use 4-10 units of Botox which can cost $100-$500. This is generally less expensive than getting a full set of lip fillers which can cost $500+.

Who is a good candidate for a Botox lip flip?

A Botox lip flip is the perfect procedure for:

  • People looking for a fuller appearing top lip without adding volume
  • Individuals hoping to get a more visible upper lip while smiling
  • Those that plan to get lip filler but have a longer philtrum column and don’t want to look ducky (more below)

A Botox lip flip should be avoided by:

  • Those allergic to botulinum toxin
  • Women that are pregnant
  • Patients with active infections or illnesses

Is a lip flip the same as lip filler?

No, they are actually quite different but patients can use both depending on the goals. A lip flip uses Botox and lip filler uses dermal fillers.

Lip filler is a non-surgical procedure where a gel-like substance is injected into the lip to enhance the shape, volume and contours of the lip. When done in a certain way it can flip up the top lip and shorten the philtrum column (distance between the bottom of the nose and top of the lip). See image above. 

When necessary, patients can use it in combination with a lip flip to enhance the upper lip.

What are the benefits of a Botox lip flip compared to lip fillers?

One benefit of the lip flip over lip fillers is the cost. Most lip filler procedures cost between $600-800 whereas a lip flip might start out at $125.

Both the lip flip and lip filler can decrease lines in the lips called “smoker’s lines” or “kissing lines.” The lip filler will last longer on average though.

For someone with a long philtrum column (the distance between the bottom of the nose and top of the lip) the lip flip can be used with lip filler. This works to prevent a ducky appearance. In some other cases, if the distance is severely long, patients may need a surgical consult for a lip lift (see below).

Another major benefit of this procedure is that it can be a good intro into lip procedures, only lasting 2 months. Only lasting 2 months can also be a con when you consider lip filler lasts roughly 8-12 months. In the long run, the lip flip can be more expensive if done regularly.

What is a lip lift?

A lip lift is a surgical procedure where a plastic surgeon removes a small amount of skin from the philtrum column. This shortens the distance between the nose and the top lip. The goal is usually to have a few mm of top teeth showing when the mouth is relaxed but lips are slightly parted. The lip lift procedure costs on average between $2000 and $5000

What is the difference between a lip flip and a lip lift?

A lip flip is where Botox or another Botulinum toxin is injected into the top lip. This temporarily flips up the cupid’s bow and shortens the philtrum column (around 1mm).

A surgical lip lift is a permanent surgery to do the same thing. The difference is that the surgeon can measure exactly how much skin to take for each unique person. The average is around 3-7mm or 1/3rd of the distance depending on the person and their unique appearance.

What are the pros and cons of a lip flip versus a surgical lip lift?

The pros of the lip flip over a surgical lip lift is that the Botox lip flip is temporary, only lasting 2 months or so. It’s also cheaper in the short term. The cons are that it only lasts 2 months and that the change is very modest, around 1mm. So someone with a very long philtrum column the lip flip will not do much.

The pros of the surgical lip lift is that it’s permanent and the exact amount of change for the best aesthetic results can occur. The cons are that it is surgery which always comes with risks and it will leave a small scar. It is also permanent in the rare case the top lip has been shortened too much, though it does relax and “stretch” out over time. 

Should I get a lip flip or lip lift?

One thing you can do at home to determine if you have a long philtrum column is look at yourself in the mirror with your face and lips still and neutral.  Then open your mouth about 1-2 cms. Do your top teeth show at all or does your top lip cover them completely?

If your top teeth show then your best bet is likely lip filler with or without the lip flip depending if you have lip lines or how much top teeth show.

If your top teeth don’t show, then you should consider whether you would undergo surgery to enhance the appearance of your lips. If you would not, then make an appointment with an experienced injector and see what they think about lip filler with a lip flip. They may be able to do it, but in severe cases may recommend you have a surgical consultation with a surgeon. They usually have someone they trust that they can refer you to.

If you know you want a permanent change, do your research and get a few consults with well known, board certified plastic surgeons for a lip lift procedure.

Does a lip flip hurt?

In most cases, ice or numbing cream is used before the injections for a lip flip. The lips are very sensitive and because the needle is being injected deeper, into the muscle, this area can be quite tender. It is very quick though and most people tolerate it well

Is a Botox lip flip safe?

Botox, and other neurotoxin treatments, are safe and highly researched. Due to the small amount of medication being injected, the risk is even smaller than many other procedures. That being said, you should always consult and book with a pro that has performed the procedure numerous times like Ali from EMA. The most expensive aesthetics procedures are the ones you have to have twice due to a poorly trained injector.

What are the side effects of a Botox lip flip?

Minor side effects of a Botox lip flip include:

  • Swelling
  • Bruising
  • Soreness in the area injected
  • Inability to fully purse lips or annunciate certain words

Talk to your injecting provider for a complete list of side effects and warnings to look out for after any procedure.

Does a lip flip change your smile?

A lip flip can make the top lip show a bit more when smiling but the effect is subtle. In rare cases, when the injection is not done correctly it can actually cause a crooked smile as well. Make sure you go to someone that has experience in lip flips before having this procedure done.

What is Lip Flip Aftercare?

Talk to your injecting provider and ensure that you are following all of their specific recommendations after any procedure. In general, aftercare is simple and usually involves keeping the site clean, avoiding massaging the area and avoiding intense exercise for 4-8 hours post procedure

How long until I see results from my Botox lip flip?

Depending on which medication is used (Botox, Xeomin, Dysport, Jeuveau) results will likely start to show within 4-5 days with final results between 10-14 days.

How long will my Botox lip flip last?

Unfortunately, results only last up to 2-months in this high movement area. That means the procedure needs do be done again every 2 months.

Are lip flips worth it?

Having any type of aesthetic procedure is a personal choice and you have to decide for yourself if it is worth it.

We have done many lip flips at Elite and find that lip filler tends to have a more desirable and longer lasting effect, with or without the lip flip. 

We’ve also found that many people look “ducky” from poorly placed or migrated filler done elsewhere and when we dissolve and redo it we get a great result.

In rare cases, we have also referred clients for plastic surgery consults. But for most clients we can give at least a subtle treatment to enhance their look.

If you want to learn more or chat about these procedures book a consult below to chat.

Read more about how to tell if you’ll look lucky ducky in this article.