Lip Flip / Botulinum Toxin


Philtrum Shortening with Botulinum Toxin

When Botulinum toxin is injected around the mouth area, the upper lip lifts, causing a shortening of the philtrum (the area between the nose and the upper lip). This results in a smaller face effect, and the lips appear thicker and fuller due to the upward lift, especially the red part.

This treatment requires no incisions and offers the convenience of a non-surgical approach. Also called non-surgical philtrum shortening, lip flip, or lip lift.

Recommended for:

  • Those with thin lips.
  • Those seeking a smaller face effect.
  • Those who want to subtly enhance their facial impression around the mouth area.

Flow of treatment

The actual treatment process is as follows. For more information on the formulation and needles used, see the Botulinum toxin treatment page.

Examination / injections / records

We will examine any asymmetry in the lips and the position of the orbicularis oris muscle to determine the dosage and injection sites for the Botulinum toxin treatment.

All information such as the injection site, depth, and number of units will be recorded in the medical record along with photos, so you can receive treatment with confidence from the second time onwards.

Consultation after 2 weeks (free touch-up)

The effectiveness of botulinum toxin is maximal after two weeks. Muscle movement and wrinkle formation are examined to determine the effectiveness of treatment. The lip flip effect of botulinum toxin is mild.

If the effect is insufficient, additional injections (touch-ups) will be given free of charge. Additionally, if the effects are too strong, injections of acetylcholine chloride, a relief preparation, may be given.

The size and movement of muscles vary greatly from person to person, and the effects also vary from person to person, so the area and number of units will be recorded in the medical record for the next treatment.

  • Touch-up is only applicable to wrinkle and philtrum shortening treatments, and is not applicable to treatments for masseter muscles, hyperhidrosis, and hay fever. Free for one injection at the same site (up to three injections of acetylcholine chloride, a botulinum toxin reliever). Please note that a separate re-examination fee will be charged each time. A fee will be charged if it is more than 3 weeks (or the day before if 3 weeks fall on a holiday) after treatment.
  • We are very busy with reservations, so if you are making a last minute reservation, you may not be able to get a reservation. If you are unable to make a reservation for more than 3 weeks, you will still be charged a fee, so we recommend that you make a reservation for 2 weeks later on the day of your treatment.
3-4 months later

Since the effectiveness of botulinum toxin wears off, you will be asked to make an appointment for a follow-up visit after a period of at least 3 months, and the injection will be performed again.

Even injections once every six months are effective in preventing wrinkles.

Case photos of lip flip with botulinum toxin injection

L:Before treatment / R:After treatment

The orbicularis oris is the muscle responsible for closing the mouth. By relaxing the orbicularis oris with Botulinum toxin injections, the lips lift, leading to a shorter philtrum and achieving a smaller face effect.

While the effect is mild, it naturally lifts the lips, adding volume to the red part, providing an attractive impression around the mouth area.

Side effects and precautions

For information on side effects and post-treatment precautions, see Potential side effects of botulinum toxin injections.

Price for lip flip with botulinum toxin injection

At our clinic, we use “Coretox” as a botulinum toxin preparation.

ItemFee (tax included)
First visit ¥3,850
Revisit ¥1,650
Lip Flip¥18,700
  1. Each injection requires a consultation every time. Please be aware that a separate consultation fee will apply.
  2. For lip flip treatment with Botulinum Toxin, a complimentary touch-up is available for the same area and limited to one time, two weeks after the initial treatment. A consultation is also required for the touch-up, and a separate consultation fee will apply. If you wish to maintain a natural expression, it is possible to start with a conservative amount in the initial treatment and make additional adjustments during the touch-up.
  3. Any touch-up after three weeks (or the day before if 3 weeks fall on a holiday) from the initial treatment will incur a fee. Even if it exceeds three weeks due to difficulty in booking an appointment, it will still be considered a paid touch-up. Therefore, we recommend making your appointment as early as possible.

Frequently Asked Questions About Botulinum Toxin Injections for Lip Flip

For general inquiries about Botulinum Toxin injections and post-injection questions, please refer to the “Frequently Asked Questions about Botulinum Toxin Injections.”

How long is the downtime?

Please refer to “Questions after injection“.

Is the treatment painful?

In our clinic, we use an extremely fine 34G needle to minimize discomfort. However, the area around the lips is sensitive, and there may be a strong sensation during the injection. It’s a quick process, so anesthesia is not necessary.

How soon will I feel the effects after the injection?

The effects gradually appear a few days after the injection, reaching their maximum at around two weeks. The duration of the effect typically lasts 3-4 months.

Can I receive this treatment along with other Botulinum toxin treatments, such as wrinkle reduction?

It is possible to receive both philtrum shortening and injections in other areas on the same day. However, getting wrinkle reduction around the lips and philtrum shortening together on the same day is not possible.

If the results are unsatisfactory, can I receive a complimentary touch-up?

During the follow-up appointment two weeks later, if the results are unsatisfactory or if there is asymmetry in the lips, we offer a complimentary touch-up (additional injection).

Please note that the philtrum shortening effect of Botulinum toxin is mild. Be aware that increasing the additional injection amount may lead to an increased risk of side effects, and there are limits to the achievable effect.

List of references/websites
  1. Teixeira JC, Ostrom JY, Hohman MH, Nuara MJ. Botulinum Toxin Type-A for Lip Augmentation: “Lip Flip”. J Craniofac Surg. 2021 May 1;32(3):e273-e275. doi: 10.1097/SCS.0000000000007128. PMID: 33170825.
  2. Li Y, Chong Y, Yu N, Dong R, Long X. The use of botulinum toxin A in upper lip augmentation. J Cosmet Dermatol. 2021 Jan;20(1):71-74. doi: 10.1111/jocd.13731. Epub 2020 Oct 26. PMID: 32969573.
  3. Han Y, Niu Z, Ma T, Zhou Z, Wang M, Yang Z, Zhao G, Tao R. Three-dimensional measurement and analysis of botulinum toxin A injection for improving the aesthetic appearance of upper lip. J Plast Reconstr Aesthet Surg. 2021 Nov;74(11):3196-3211. doi: 10.1016/j.bjps.2021.06.005. Epub 2021 Jun 20. PMID: 34217650.

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