Some things people bring to a med spa need a doctor rather than a treatment room. Some things people bring to a med spa are not aesthetic problems and need a doctor rather than a treatment room. See a physician or a dermatologist, not us, if you have a mole or a mark that has changed shape, colour or size, or that bleeds, itches or will not heal; a sore anywhere that has been there more than three weeks; a rash you cannot explain; a patch of skin that is newly numb, hard or ulcerated; sudden hair loss in patches, or hair loss alongside fatigue or weight change; or swelling, heat and spreading redness that could be an infection. And if you have had filler treatment anywhere and the area becomes white or mottled, severely painful, or your vision changes, that is an emergency — telephone us immediately if we treated you, and go to an emergency room if you cannot reach somebody within minutes. We would far rather you rang a doctor and never rang us at all.
Lips thin with age, lose their border definition and roll inward, and the little vertical lines above the upper lip become more visible as they do. Filler placed carefully can restore that, and it can also improve a shape somebody has always disliked or balance two halves that were never symmetrical — no lip is, and part of the consultation is pointing out the asymmetry you have not noticed so it does not come as a surprise afterwards.
The amount required is much smaller than the internet suggests. Half a syringe restores a definite change in most people; a whole syringe in a lip that has never been treated is a great deal. The look everybody recognises and most people say they do not want is the accumulated result of a full syringe every six months for four years, each session judged against the last one. We treat a fraction at a time, we review, and we frequently tell somebody that they do not need more.
The swelling is the part nobody is warned about properly. Lips swell more than anywhere else on the face, they swell most on the second morning, and for about forty-eight hours they will look considerably bigger than the result you are going to keep. People who panic on day two almost always love it on day fourteen. Do not book this in the week before an event, and do not judge it in a bathroom mirror on Tuesday.
What we can and cannot change
Four things people ask for, and honest answers about each.
Volume that has been lost
The most successful use of lip filler and the least likely to look done. Restoring a lip toward what it was ten years ago is a modest amount of product placed to rebuild the body of the lip rather than to push it forward, and it usually reads as looking well rather than as having had something done.
Definition and shape
The border of the lip and the small dip in the centre of the upper lip lose their crispness. A very small amount along the border restores that, and it is often the single change that makes the most difference — including for people who came in wanting considerably more volume.
Asymmetry
Improvable, rarely perfectible. Everybody's lips are asymmetrical, most of us have never looked closely enough to notice, and the underlying cause is frequently in the bone or the muscle rather than in the lip. We can improve the appearance; we will not promise to make two halves match, and anybody who does is setting you up to be disappointed.
The vertical lines above the lip
These improve somewhat with support at the border, but they are largely a skin-quality problem caused by sun and, in some people, by smoking. The treatment that actually addresses them is resurfacing or microneedling across several months. Filling them directly is a well-known way to produce a shelf above the lip, and we will not do it.
The two weeks after
The realistic timeline, which is more dramatic than most clinics tell you.
The first two days
Substantial swelling, worst on the second morning, along with tenderness and often bruising. This is normal and it is not the result. Sleep with your head raised, use something cold for the first evening, and avoid alcohol and hard exercise for a day. Do not make plans.
Days three to seven
The swelling comes down unevenly, which means one side will look different from the other for a few days. It is very common and it is not an error. Small firm areas can usually be felt with a fingertip, which is also normal; they soften over a fortnight.
Day fourteen
The result. This is the day we look at it together, and the day we would add a small amount if the plan calls for it. The review is free and it is in the diary before you leave, because a lip judged on day two produces the request that leads to too much.
Six to twelve months
How long a lip treatment generally lasts. Lips move constantly, which breaks the product down faster than in areas that are still. When you come back we assess what is left before adding anything, rather than treating on a calendar.
Who we will not treat
This is the treatment where we decline most often, and the reasons are worth stating.
Anybody under eighteen
No exceptions, no parental consent route, no conversation. This is the treatment most requested by people who are too young for it and it is the easiest place in aesthetics to do lasting harm to somebody's relationship with their own face.
Anybody on their first visit
We do not treat lips on the day of a first consultation. You get the plan, the price and the risks in writing, and you book the treatment afterwards if you still want it. A surprising number of people do not, and that is a good outcome rather than a lost sale.
Anybody with a cold sore history who has not prepared
Injecting a lip reliably provokes an outbreak in people prone to them. If you get cold sores, tell us and we will arrange antiviral cover to start before the appointment. Untreated, it is a genuinely miserable week and it can affect the result.
Anybody asking for a specific person's lips
A photograph of somebody else is a conversation, not an instruction. Faces are different sizes and shapes and a result copied from a photograph lands on your face rather than on theirs. We will talk about what you like in the picture and what of that is achievable, and sometimes the answer is very little of it.
Lip Enhancement in western Queens
Filler placed in the lip to restore what has thinned, improve a shape or balance an asymmetry. Done well it is unremarkable. Done to excess it is the most recognisable treatment in aesthetics.
Every treatment here starts the same way: a full hour at a table in a room with no treatment couch in it, a proper medical history, your skin looked at in daylight, and then a plain statement of what we think would achieve what you described. You are told what it costs, how many sessions it usually takes, how long it lasts, what the recovery looks like and what can go wrong — on paper, to take home and read somewhere other than a treatment room. If the honest answer is a different treatment, or nothing, or a dermatologist, that is what you get instead, and it costs exactly the same.
Aesthetic treatment is elective medicine, and this page is not medical advice for you. Aesthetic treatment is elective, it is medicine wherever it breaks the skin, and nothing on this website is medical advice for you in particular. We do not diagnose disease. Every treatment here begins with a consultation and a medical history, because your health, your medication, your skin type and what you have had done before all change what is safe and what is sensible. Some people are told no. Being told no is a normal outcome of a consultation here rather than a failure of one, and it costs exactly the same as being told yes.
No before-and-after photographs, and no promised outcome. There are no before-and-after photographs on this website and there never will be. Every set you have seen somewhere else was chosen from a much larger pile, and the second picture is usually taken in different light, at a different angle, at a different time of day, often with makeup and frequently after retouching. Even an entirely honest pair shows you what happened to somebody else's face. What we publish instead is what a treatment typically changes, by roughly how much, how long it lasts, how many sessions it usually takes and how often people are disappointed. We do not guarantee an outcome, we cannot, and anybody who does is either guessing or selling.
The risks, plainly. Every treatment on this site has side effects and some carry real risks. The common ones are minor and short-lived — redness, swelling, tenderness, bruising, a day or two of looking like you have had something done. The uncommon ones matter more: burns, blistering and long-lasting pigment change from light-based treatment, which is a greater risk on deeper skin tones and on recently tanned skin; infection anywhere the skin is broken; and lumps, asymmetry and, very rarely, a blocked blood vessel from injectable filler, which is the one true emergency in this field. We screen for what makes each of these more likely, we tell you your own risk rather than the average one, and we decline to treat when the answer should be no.
What a med spa does not treat. We treat the appearance of healthy skin, hair and body. We do not diagnose or treat disease. If you bring us a mole, a changing mark, an unexplained rash, a sore that will not heal, skin that has become hard or numb, psoriasis, eczema, an autoimmune skin condition, or hair loss that came on suddenly or in patches, what you will get is the name of a doctor rather than a treatment plan. Aesthetic treatment applied on top of an undiagnosed skin problem can mask it, delay the diagnosis and occasionally make it worse. We would rather lose the booking.
Questions
Lip Enhancement — the questions we are asked most
Will everyone be able to tell?
Not from the amount we would place at a first treatment. What is recognisable is volume that has accumulated over several years, product pushed forward rather than built within the lip, and a lip that is out of proportion to the face around it. Half a syringe placed to restore shape reads as looking well rather than as having had something done.
How much does it hurt?
Lips are the most sensitive area we inject and this is the treatment people find most uncomfortable. Numbing cream is applied for twenty minutes beforehand and the product itself contains a local anaesthetic, so the second half is markedly easier than the first. It is unpleasant for a few minutes rather than painful for long.
Why will you not treat me on the first visit?
Because deciding to have a permanent-feeling change to the centre of your face is not a decision to make while lying down with your lips numbed and somebody standing over you. You get the plan and the risks on paper, you read them at home, and you book if you still want it. Some people do not come back, which is exactly what a cooling-off period is for.
Can I have it dissolved?
Yes. The fillers used here are broken down by an injected enzyme, usually within a day or two, and the lip returns to how it was. It is its own procedure with its own swelling and small risks, and we would much rather not need it — but it means nothing done here is a one-way decision.
I have had lip filler elsewhere. Can you top it up?
We will look at it first, at a normal consultation, and give you a straight answer. Sometimes there is considerably more product still in place than people realise, in which case adding more is exactly wrong and we will say so. Occasionally the honest recommendation is to dissolve and start again, and occasionally it is to leave it alone entirely.
Will filler stretch my lips permanently?
In the amounts used for a normal treatment, no — the product is broken down and the lip returns to its own shape. Repeated large volumes over many years are a different matter and can leave tissue that does not fully recover. That is one of the reasons we treat conservatively and assess what is still there before adding anything.
Related
Often seen alongside this
Injectables & Facial Balancing
Wrinkle-Relaxing Injections
A small amount of a purified protein placed in a specific muscle so it stops pulling as hard. It softens the lines that appear when you move. It does very little to the lines that are there when your face is still.
Read more
Injectables & Facial Balancing
Dermal Fillers
A gel placed under the skin to restore volume or change a contour. It works immediately and lasts months to years. It is also the treatment in this building with the smallest margin for error.
Read more
Injectables & Facial Balancing
Under-Eye Treatment
The hollow under the eye is the most technically demanding area on the face and the one most often treated badly. Half the people who ask for it here are advised against it, and the reasons are on this page.
Read moreA written plan and a written price before anything is booked
Book a consultation
Pick a clinician and an hour from the calendar — it shows only the times each of them genuinely has free. A consultation is a full hour at a table with no treatment couch in the room, and it costs $85, or $120 with the medical director. If you go ahead, that comes off your first treatment. If we tell you the answer is nothing, or a dermatologist, it costs exactly the same.