Three Lip Augmentation Surgical Methods and Criteria for Eligibility

Information as of June 2026

Comparison of Incision/Filler/Fat Graft — There Is a Method Right for You

• 3 Key Methods
• Average Recovery Period 3-14 Days
• Duration 6 Months-Permanent

Types of Lip Augmentation, Key Differences You Need to Know Before Choosing

“I'll just get one filler injection” — This single assumption cuts your budget and satisfaction with results by more than 30%. Depending on the method, the duration of the effects of lip augmentation varies from 6 months to permanent, and the recovery period ranges from 3 days to 2 weeks. Lip augmentation surgical methods are broadly classified into three types: incisional surgery (V-Y advancement, vermilion advancement), filler injection (HA filler, PLLA filler), and fat grafting (micro-fat grafting). According to a 2023 announcement by the Korean Society of Aesthetic Plastic Surgery, fillers account for 68% of domestic lip augmentations, incisional surgery for 22%, and fat grafting for 10%. The criteria for selecting each method depend on current lip thickness, degree of asymmetry, preference for duration of effect, and acceptable downtime.

Incisional surgery is the primary choice if the lip thickness is thin (3mm or less), while staged filler injection is the primary choice if the left-right asymmetry is 2mm or more.

To accurately determine suitability for lip augmentation, a comprehensive evaluation of lip thickness (based on upper lip 8-10mm, lower lip 10-12mm), Cupid’s bow shape, tooth exposure (upper incisors exposed 2-3mm), and philtrum ratio (13-15mm from the bottom of the nose to the upper lip) is required.

Key If two or more of the following apply—lip thickness 3mm or less, loss of Cupid’s bow, or a reduction of 10% or more in upper lip volume—incisional surgery is the primary consideration.

Incisional Surgery — Cases requiring permanent effects

The standard for incisional lip augmentation is the V-Y advancement method, which involves making an incision on the inner side of the lip mucosa and rolling the erythema (red lip area) outward. The incision line is located on the inner lip mucosa and is not visible from the outside, and 5-0 or 6-0 absorbable sutures are used for closure.

The surgery time is 30-40 minutes for a unilateral procedure and approximately 1 hour when performed on both sides simultaneously. The procedure is performed under local or sedation anesthesia; cases involving only the upper lip account for 62%, while simultaneous procedures on both the upper and lower lips account for 38% (2022 data from the Korean Society of Plastic and Reconstructive Surgeons). Suitable candidates include congenitally thin lips with a thickness of 3mm or less, loss of lip volume due to aging (an average annual decrease of 0.5mm in thickness after the age of 40), and cases with low satisfaction even after repeated filler injections. If the lip width is less than 5mm, an enlargement of 2-3mm is possible via an incision. The recovery period takes 3-5 days for initial swelling, 7-10 days to return to daily activities, and 2-3 weeks for complete recovery. The sutures are naturally absorbed after 7-10 days, and the scar is located on the inner side of the mucosa and is not visible externally.

Clinical For 2 weeks after incision, excessive mouth opening (more than 3 cm) and hot foods (above 50 degrees) increase the risk of suture dehiscence by 3 times.

• Incision depth: Approx. 3-4 mm in the mucosal layer
• Suture: 5-0 Vicryl Rapide (Absorption period 7-10 days)
• Duration of effect: Permanent (Reoperation rate less than 5%)
• Upper lip thickness increase: Average 2.5-3.5 mm

Hyaluronic acid fillers — Most preferred non-surgical Method

Hyaluronic acid (HA)-based products are the standard for lip fillers, and representative FDA-approved products include Restylane Kysse (2020), Juvéderm Volbella (2016), and Belotero Balance (2011). In Korea, products approved by the Ministry of Food and Drug Safety, such as Yvoire, Cleviel, and Neuramis, are also widely used.

Lip-specific fillers provide a soft touch by having a HA cross-linking density 15-20% lower than general fillers, and minimize pain during the procedure by mixing in 0.3% lidocaine. The standard injection depth is 2-3 mm into the submucosal layer, and the injection volume is 0.5-0.8 cc for the upper lip and 0.7-1.0 cc for the lower lip. Suitable candidates are individuals in their 20s and 30s seeking correction of lip asymmetry (a difference of 1-3 mm between the left and right sides), correction of the Cupid's bow shape, and temporary volume enhancement. It is highly preferred by working professionals as immediate results can be confirmed compared to incisional surgery, and the downtime is short at 2-3 days. The duration of effect varies by product, ranging from 6 to 12 months; data reported for Restylane Kysse averages 9 months, while Juvéderm Volbella lasts 12 months. It can be immediately dissolved with hyaluronidase enzyme, allowing for correction within 72 hours in case of overcorrection.

Caution Excessive lip movement (kissing, using a straw) within 6 hours of the procedure increases the risk of filler migration, which may lead to asymmetrical results.

Product Name	HA Concentration	Duration of Effect	FDA Approval Year
Restylane Kysse	20mg/ml	9 months	2020
Juvéderm Volbella	15mg/ml	12 months	2016
Belotero Balance	22.5mg/ml	6-9 months	2011

Fat Grafting — A Balance of Permanent Volume and Naturalness

Lip fat grafting (micro-fat grafting) is a method of injecting autologous fat harvested from the abdomen or thighs into the lips after purification. The harvesting sites consist of the abdomen (67%) and inner thighs (28%), and the fat is purified using a centrifuge (3000 rpm, 3 minutes). The injection volume is set at 130–150% of the target amount, taking into account the engraftment rate (60–70%); the standard amounts are 1.5–2.0 cc for the upper lip and 2.0–2.5 cc for the lower lip. The injection is performed using a 23–25 gauge cannula for multi-layer dispersion between the submucosal and muscular layers. Suitable candidates include patients over 40 with age-related volume loss or those who prefer autologous tissue, as well as those facing significant financial burdens from repeated filler treatments. The effects are semi-permanent after fat engraftment, and lip volume fluctuates within a 3–5% range with changes in body weight. The recovery period involves edema lasting 5–7 days and bruising lasting 7–10 days, with full engraftment taking 3 months. Since volume stabilizes after a 30-40% reduction during the initial 3 months, the touch-up rate 3-6 months after the first procedure is 35%.

Tip If the fat harvesting site is the abdomen, there is a study showing that quitting smoking and stopping Vitamin E intake 2 weeks prior to the procedure increases the engraftment rate by 15%.

• Fat engraftment rate: Average 60-70%
• Initial overcorrection amount: 130-150% of the target
• Engraftment stabilization period: 3 months
• Rate of additional procedures: 35%

Criteria for determining suitability — Quarterly by age and lip condition

For those in their 20s, the purpose is temporary volume increase and contour correction, with 87% Fillers are the primary choice, and natural volume enhancement is preferred with a small injection of 0.5–0.8cc. If the goal is to emphasize the Cupid's bow and shorten the philtrum, a concentrated injection technique is applied to the central upper lip. For those in their 30s, the demand for correcting left-right asymmetry increases, with 42% combining fillers with Botox (for corners of the mouth). While fillers remain highly preferred due to downtime constraints caused by work life, the rate of fat grafting rises to 18% due to concerns regarding the duration of the effects. For those in their 40s and older, age-related volume loss and blurred lip contours are the main concerns, with a high selection rate for incisional surgery (35%) or fat grafting (28%). If lip thickness has decreased by 3mm or less, incisional surgery alone or a combination of incisional surgery and fillers is recommended. Incisional surgery is the primary consideration if two or more of the following apply: upper lip width less than 5mm, upper lip thickness 7mm or less, or loss of the Cupid's bow. Stepwise filler correction is effective when asymmetry is 2mm or more but the overall thickness is within the normal range (8-12mm). Key Points: The optimal method varies depending on your lip thickness, degree of asymmetry, and available downtime. Check out hospitals available for 1:1 consultation on K-Dia.

Recovery Period and Precautions — Differences by Method

With fillers, you can return to your daily life immediately after the procedure, but swelling and bruising may occur for the first 2-3 days. On the day of the procedure, hot foods (over 50 degrees), saunas, and excessive facial movements increase the risk of filler migration. For incisional surgery, dietary restrictions (liquid diet for 3 days, soft diet for 1 week) are required during the suture absorption period of 7-10 days. Additionally, mouth opening must be limited to 3 cm or less for 2 weeks to stabilize the suture site. You can return to work after an average of 10-14 days. For fat grafting, swelling lasts for 5-7 days, bruising for 7-10 days, and pain at the fat harvesting site is accompanied for 3-5 days. To increase the survival rate, quitting smoking, minimizing pressure, and maintaining your weight are essential for 2 weeks after the procedure. In all methods, drinking alcohol for 1 week after the procedure doubles the duration of swelling, and smoking lowers the survival rate by 20-30% due to impaired blood flow. If you are taking anticoagulants (aspirin, warfarin), you must consult with a specialist 7-10 days prior to the procedure to decide whether to discontinue them. Caution: Rapid weight loss (more than 3 kg within 2 weeks) after fat grafting can lower the survival rate by 15-20%. Maintaining your weight for 2 weeks before and after the procedure is important.

Key Comparison of 3 Lip Augmentation Methods

Incisional [Permanent]

• Effect: Permanent (Reoperation rate less than 5%)
• Recovery: 7-10 days (Full recovery 2-3 weeks)
• Cost: 2-4 million KRW
• Suitable: Thickness 3mm or less, 40s and older

First choice for those who want a permanent effect or find repeated filler injections burdensome

HA Filler [Non-surgical]

• Effect: 6-12 months (varies by product)
• Recovery: 2-3 days (immediate return to daily life)
• Cost: 400,000-800,000 KRW (per 1cc)
• Suitable: Asymmetry correction, 20s-30s

Preferred by office workers who need minimized downtime and immediate results

Fat Graft [Autologous Tissue]

• Effect: Semi-permanent (Engraftment rate 60-70%)
• Recovery: 7-10 days (Engraftment stabilization takes 3 months)
• Cost: 1.5-3 million won
• Suitable: Burden of repeated filler injections, 40s and older

Suitable for those who prefer autologous tissue and desire long-term cost savings

Common Misconceptions

Misconception Fillers last permanently after just one injection

Truth Hyaluronic acid fillers naturally decompose in the body, and their duration is 6-12 months. Since the mid-2000s, FDA approval for permanent fillers (such as Aquamid and Aquafilling) was revoked due to side effects including granulomas and foreign body reactions, and their use is currently not recommended in Korea either. If you want long-term effects, incision or fat grafting is suitable.

Misconception You can eat freely immediately after lip filler injection.

Truth Excessive lip movement (hot food, using a straw, intense facial expressions) within 6 hours of filler injection can cause the filler to shift from the injection site, resulting in asymmetrical results. On the day of the procedure, a lukewarm liquid diet is recommended, followed by soft foods for 2-3 days. It is also safe to avoid kissing or excessive lip contact for 48 hours.

Absolutely Prohibited Actions Before and After Lip Augmentation

• 7-10 days before the procedure: Stop taking anticoagulants such as aspirin and ibuprofen, and blood circulation supplements such as Vitamin E and Omega-3 (Increased risk of bleeding and bruising)
• On the day of the procedure: Absolutely no drinking or smoking (Swelling increases twofold, risk of infection)
• 6 hours after the procedure: Avoid hot foods (over 50 degrees), use straws, and excessive mouth opening (Risk of filler migration)
• 1 week after the procedure: Avoid exposure to saunas, steam rooms, and high-temperature environments (Persistent swelling, accelerates filler breakdown)
• 2 weeks after the incision: Mouth opening less than 3cm Restrictions, avoid hard foods (risk of sutures dehiscence)

Frequently Asked Questions

Can I go to work immediately after lip filler treatment?

You can return to your daily routine immediately after the filler procedure, but lip swelling and bruising may occur for the first 2-3 days. If you have important events (interviews, presentations, etc.), it is safer to schedule an appointment 3-5 days in advance.

How much is the cost difference between incisional lip augmentation and fillers?

Incisional surgery costs 2-4 million won (per session), while fillers cost 400,000-800,000 won (1cc, lasts 6-12 months). If fillers are repeated 3 times over 2 years, it costs 1.2-2.4 million won, so incisional surgery may be more cost-effective in the long run. However, individual differences exist, and consultation with a specialist is required. Do my lips change if my weight changes after fat grafting? Yes, the engrafted fat fluctuates within a range of 3-5% with changes in body weight. If you gain more than 5 kg rapidly, the lip volume may appear excessive, and if you lose weight rapidly, the volume may decrease. Maintaining your weight before and after the procedure is important. What are the side effects after lip augmentation? Fillers carry risks of bruising, swelling (2-7 days), asymmetry, and vascular embolism (rare but fatal). Incisional surgery carries the risk of infection, suture dehiscence, and scarring (inner mucosal), while fat grafting has been reported to result in engraftment failure, nodules, and asymmetry. For all methods, if swelling, pain, or fever persists for more than one week after the procedure, you must visit the hospital immediately. Can I have the filler removed immediately if I am not satisfied after injection? Hyaluronic acid fillers can be dissolved by 80-90% within 24-72 hours via the injection of hyaluronidase enzymes. However, temporary swelling may persist for 2-3 days after the enzyme injection, and it is safe to wait 1-2 weeks before re-injecting after dissolution. When can I kiss or wear makeup after lip augmentation? For fillers, it is possible after 48 hours, but it is safer to apply gentle makeup during the first week. Incisions are possible after suture removal (7-10 days), and makeup is possible 24 hours after fillers and 5-7 days after incisions. Please use hypoallergenic lipstick.

This content is for informational medical purposes only and does not replace personal medical advice or diagnosis. The appropriate method and effects of lip augmentation vary depending on an individual's lip thickness, degree of asymmetry, and health condition; therefore, you must make a decision after sufficient consultation with a specialist before the procedure. As all procedures carry the possibility of side effects, please familiarize yourself with safety information.

Find the Right Lip Augmentation Clinic for You at K-Dia