In short. The swelling curve, the lumpiness that is ordinary, the asymmetry that is not yet real, and the signs that mean being seen sooner.
Key points
- Photograph your face straight on and in profile, at the same time each morning and again in the late afternoon, for two weeks.
- A lip that is fuller in the morning and closer to normal by the afternoon is behaving like fluid.
- A lip that is uneven in every photograph at every hour is closer to the real shape, and that is a question for the review rather than for a second injection.
The lip swells more than any other injected site and is the site where swelling is most visible. That combination produces more unnecessary alarm than any other part of this treatment, and most of it comes from judging the lip on a day when the judgement cannot be made.
Day one to day three
The lip is distorted within minutes of the injection. That is anaesthetic fluid, needle trauma and swelling together, and none of it is the result. Swelling peaks over the first three days and can look considerably larger than anything that was planned for. Bruising is common and often appears away from the entry points. The lip feels tight, and patches of numbness are usual. Cold packs help, and so does keeping the head raised; nothing done in these days changes the final shape in either direction.
Day four to day fourteen
Swelling falls, but not evenly. One side commonly settles before the other, so the lip looks mismatched for about a week, and this is the single commonest reason people ask whether something has gone wrong. Small lumps and firmness are usual in this period too, and most soften without treatment. By the end of the first week most people are presentable in ordinary company, and by the end of the second the lip is close to its settled shape.
The fortnight of photographs
Photograph your face straight on and in profile, at the same time each morning and again in the late afternoon, for two weeks. A lip that is fuller in the morning and closer to normal by the afternoon is behaving like fluid. A lip that is uneven in every photograph at every hour is closer to the real shape, and that is a question for the review rather than for a second injection.
The review, and why it sits where it does
Two to four weeks is when the volume is close to settled and a top-up or a correction can be judged rather than guessed at on the day. It is also when the interval to any further treatment is estimated from your own response. A lip that is uneven at two weeks may be even at eight, which is why adding material at the first review is usually the wrong first response.
Signs that mean being seen sooner
Most swelling is ordinary. Some is not, and the distinction is usually whether the lip is settling or worsening, and whether the tissue still looks like tissue.
Contact the clinic the same day if
- The lip is more swollen after the third day rather than less, or is painful, hot or red.
- The lip or the skin around it turns white, grey, mottled or dusky.
- There is severe pain out of proportion to the injection, or any change in vision.
What swelling is allowed to hide, and what it is not, is set out in Risks Specific to Injecting the Lip. What each visit commits you to is described in What Lip Filler Costs You in Visits and Weeks.
Frequently asked questions
How long should my lip stay swollen?
It is distorted for the first three days, visibly swollen for about a week, and uneven between the two sides for perhaps a fortnight. It is close to its settled shape at two to four weeks, which is why that is the review point. Most people are presentable in ordinary company after the first week.
Is it normal for one side to look bigger in the first week?
Yes. Swelling falls unevenly, and one side commonly settles before the other, so the lip looks mismatched for about a week. That is the single commonest reason people ask whether something has gone wrong. An unevenness that is increasing rather than settling is a different matter and should be assessed.
Can I go back to work the day after lip filler?
Most people physically can, and many would rather not. The lip is the one facial area where a treated look is difficult to conceal, and it is at its most distorted in the first three days. If your work involves being in front of people, planning a week is more realistic than planning a day.
Risks & Limitations
- Vascular occlusion is a time-critical emergency, and the lip is a small area whose arteries vary in course between people and between the two sides. Severe pain out of proportion to the injection, or tissue turning white, grey, mottled or dusky, requires immediate assessment.
- Every filler result is temporary, and the lip fades unevenly: the border often loses definition before the body of the lip flattens. Maintenance treatment is required to keep a result continuous.
- The lip tolerates very little added volume before the change reads as treated, and only the reversible class of material can be broken down at all. A stretched vermilion and a border that has been filled across do not revert when the material goes.
- Lumps, nodules, asymmetry and delayed inflammatory reactions can occur, and an injection commonly reactivates cold sores in someone who has had them before. The lip is the most mobile injected site, so material inside it is being deformed continuously.
When to Seek Care
- Any change in vision, including blurring or a patch of lost sight — seek emergency care immediately.
- Severe pain out of proportion to the injection, or pain that is worsening rather than settling.
- Tissue turning white, grey, mottled or dusky anywhere on or around the lip.
- Swelling that is increasing after the third day rather than settling, or fever with spreading redness, warmth or discharge.
References & Further Reading
- American Society of Plastic Surgeons (ASPS) — procedure and safety guidance
- National Institute for Health and Care Excellence (NICE, UK) — relevant guidance
- Cochrane Library — systematic reviews
- Chinese Medical Association Plastic Surgery Branch — clinical guidance
This page is patient education, not medical advice, and it does not cite individual studies. Discuss your own case with a qualified clinician. To arrange an assessment at Chongqing West District Hospital, see Contact & Consultation.