Lip flip before and after: real results

Before a lip flip, your upper lip sits where it naturally sits.

After one, that same lip rolls slightly outward — everted — because the orbicularis oris, the muscle that circles the mouth, is relaxed.

The change is one of position, not volume.

A 2025 systematic review, which included 7 studies out of 48 screened, describes the result as upper-lip eversion and improved contour, produced without adding volume.

The 2026 prospective study measured it directly: 17 women given 4 units of onabotulinumtoxinA showed a modest increase in upper lip height at 15 days, with no change in lip volume.

In profile, the change the study's authors describe is enhanced lip projection through selective neuromodulation, not volumetric augmentation.

If your lips are naturally thin, note what the flip does not do: add volume — building the lip itself is what filler does.

Keep the word modest in mind.

The review's evidence base is small, the measured study followed 17 women, and a result measured in 17 women describes that group — never a guarantee of your own before-and-after.

Dose comes first.

The 2025 review reports the flip typically uses 4 to 6 units of botulinum toxin injected into the orbicularis oris, and the prospective study used 4 units.

There is no label dose to anchor those numbers: no US neurotoxin label includes the lips, so the lip flip is off-label.

The product matters for reading any before-and-after, including photos.

The measured study used onabotulinumtoxinA, the active ingredient in Botox, and no brand is approved for the lips.

Units are also product-specific — Botox Cosmetic's label states its units cannot be compared to or converted into units of any other botulinum toxin product — so a dose quoted in one brand's units does not translate into another's.

The flip repositions the lip you have rather than adding to it.

The evidence base is small, and results vary from person to person: a study of 17 women describes that group, not the range of individual before-and-afters.

The after also includes temporary function changes.

The review reported mild, transient side effects — difficulty whistling or drinking through a straw — resolving within weeks, and in the study, adverse events (temporary numbness, functional limitation) were mild and resolved within 30 days.

The mirror test separates the two.

A lip flip everts the upper lip by relaxing the orbicularis oris and adds no volume; lip filler adds volume.

If the after you want is a fuller lip, that is filler's before-and-after; if it is your own lip rolled slightly outward rather than filled, that is the flip's.

The regulatory picture runs the other way.

FDA regulates dermal fillers as medical device implants — not drugs — with approved uses in adults over 21 that include augmentation of the lips.

No US neurotoxin label includes the lips, so the flip is off-label for every brand: the treatment that changes volume has the FDA-listed lip use, and the one that changes position has none.

Duration is described differently too.

FDA says how long a filler lasts depends on the filler material and where it is injected, and that absorbable fillers are temporary and may need repeat treatment.

For the flip, we found no FDA-label or high-quality trial source for a duration — the commonly quoted 6 to 12 weeks figures come from clinic and consumer sites, not from the label or a controlled trial.

See the lip flip guide for what the studies do show, and the lip filler guide for filler's approved uses and materials.

The American Academy of Dermatology keeps a list of questions worth asking before any cosmetic procedure: Is the provider board-certified?

How many times have they done this exact procedure?

How often do they treat patients with your skin tone and type?

What results can you realistically expect?

What are the risks, recovery time, number of treatments and cost?

AAD also suggests asking for before-and-after photos of similar skin tones — directly relevant to the question this page answers.

Photos come with a rule, though: they document one other person's result, never a preview of yours.

FTC guidance treats before-and-after photos as implying typical results, and the sources behind them say results vary.

Two questions come straight from the lip-flip research.

Which toxin would they use, and how many units do they plan for your anatomy — there is no label dose for the lips, so this is where their experience shows.

And what is their plan if mouth function is affected afterward, since the studies report temporary trouble whistling or using a straw.

Anatomy knowledge is not optional on the label's own terms: the Botox Cosmetic label states that those administering it must understand the relevant neuromuscular and structural anatomy of the treated area.

A lip flip is off-label: there is no label recipe to follow.

CDC advises getting botulinum toxin injections only from a licensed, trained provider using product from an authorized source, and says even FDA-approved product given correctly is not risk-free.

Who may inject varies by state.

AmSpa, a medical spa trade association, says injecting botulinum toxin is the practice of medicine, so it must be done by a physician, an independent-practice nurse practitioner or another licensed professional acting within their scope, under rules that vary by state.

CDC also notes that your state might have a look-up tool to check whether a provider or setting has the appropriate license.

Bring the questions in the section above to any consultation, and check the license before you book.