Lip Enhancement Treatment in Marylebone, London
Lips that have thinned with age, lost their border definition, or were always asymmetric can be refined with hyaluronic acid filler. The brief here is a natural, balanced lip in proportion with the face — not a bigger lip.
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What you're seeing
The concern
Lip enhancement with hyaluronic acid (HA) filler restores or refines the shape, border, and hydration of the lips using a soft, reversible gel. With age the lips lose volume and the vermilion border softens, the corners can turn down, and fine vertical "smoker’s" lines appear above the upper lip. Many younger patients instead want to correct a lifelong asymmetry, a thin upper lip relative to the lower, or an undefined cupid’s bow. The same product addresses both — what changes is the plan.
Dr Elgey’s approach to lips is conservative and proportion-led: the aim is a lip that looks like a good version of your own, not a different mouth. A GP-trained whole-face assessment matters because lips are read in relation to the chin, the philtrum, and the lower-face balance — over-projecting the lip in isolation is the single most common cause of an unnatural result. HA filler is fully dissolvable with hyaluronidase, so if a result does not feel right at review it can be adjusted or reversed — an important safety net that distinguishes HA from permanent or semi-permanent products.
Why it happens
What drives it
- Age-related loss of lip volume and softening of the vermilion border
- Reduced collagen and hyaluronic acid in the perioral skin
- Lifelong natural asymmetry or a thin upper lip relative to the lower
- Downturning of the oral commissures (corners) producing a tired or sad resting look
- Perioral "smoker’s" lines from repeated lip movement and, in some, smoking
- Cumulative UV damage to the perioral skin
Treatment approach
How Paul treats it
Dermal Fillers
By consultationHyaluronic acid filler restores volume, redefines the border, balances asymmetry, and supports downturned corners. Product and technique are chosen to the individual lip — a soft, hydrating gel for definition and hydration, a more structured gel where projection is needed. Fully dissolvable at review if the result does not feel right. Results typically last 9 to 12 months.
See treatment detail →Anti-Wrinkle Injections
By consultationFor a "gummy" smile or a downturned mouth, a small, carefully placed dose of anti-wrinkle injection relaxes the relevant muscle and complements filler — a "lip flip" relaxes the upper-lip muscle to show a little more lip without added volume. Planned together with filler where appropriate.
See treatment detail →Polynucleotides
By consultationWhere the perioral skin is crepey and fine vertical lines are the main concern rather than volume, polynucleotides improve skin quality in the area — addressing the texture that filler alone cannot, often as a short course alongside lip work.
See treatment detail →FAQ
Common
questions
Will lip filler make my lips look obviously "done"?
Not when the plan is proportion-led and conservative. The "done" look comes from over-volumising — too much product, projected too far forward, ignoring the rest of the face. Dr Elgey assesses the lip in relation to the chin, philtrum, and lower-face balance and doses to refine your own lip shape. Most patients want subtle definition and hydration rather than size, and the result should read as a good day, not a different mouth.
Does it hurt, and is there downtime?
The lips are sensitive, so a topical numbing cream is used and most HA products contain a local anaesthetic. Most patients describe it as very tolerable. Expect some swelling for 24 to 48 hours and the possibility of small bruises; the lips look their most natural at around two weeks once the initial swelling has fully settled. Plan around any social events accordingly.
Can lip filler be reversed?
Yes — this is a key safety advantage of hyaluronic acid. If a result does not feel right, or in the rare event of a complication, the filler can be dissolved with an enzyme called hyaluronidase, which breaks down the HA over a day or two. Permanent and semi-permanent lip fillers do not offer this and are not used here for that reason.
How long does lip filler last?
Typically 9 to 12 months, though the lips are a mobile, high-movement area so the visible effect can soften a little sooner than filler placed elsewhere. The rate varies between individuals with metabolism and lifestyle. Many patients have a smaller top-up before the full effect has gone to maintain the shape rather than rebuilding from scratch each time.
I just want to fix asymmetry, not add size — is that possible?
Yes, and it is one of the most common requests. Filler can be placed unevenly by design to balance a naturally lopsided lip, define an undefined cupid’s bow, or support a downturned corner, with little or no overall increase in size. The consultation maps your specific asymmetry first so the plan corrects it rather than simply enlarging the lip.
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Dr Paul Elgey Aesthetics • Unit 1, Orchard Street, London W1H 6HJ
BookAppointments typically available within 1–2 weeks