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I Got a "Lip Flip" Instead of Filler and I'm Never Going Back

The off-label Botox treatment is more subtle.

It would be easy to say the greatest thing about the growing crop of boutique medi-spas in L.A. is the sheer convenience of aesthetics-on-demand; the ability to dash in for a quick skin touch-up during your lunch hour. And while that's certainly true, I'd still like to give the edge to the fact that a highly personalized treatment—the kind that used to be reserved for some of the best dermatology practices in the city—has never been quite so accessible.

Consider Le Jolie, a boutique spa that sits on the edge of West Hollywood with all the trappings of a millennial hotspot: a neon sign, palm printed wallpaper, a sunny front deck. (Curious about their clientele? Just take a scroll through some of the bigger names on your IG feed.) But beyond its sheer Instagrammability, the reason why I’ve become a regular at Le Jolie is that it champions a deft, light-handed approach to layering treatments, from injectables to ultherapy to lasers. The results are subtle and highly personalized—the kind of finished product that looks less "I've had something done" and more "I woke up like this." ("Freshed-faced" is a phrase they use a lot here—a mantra that’s also an end goal.)

lip flip botox

Exhibit A: Rather than overloading patients on lip filler, co-founder Dr. Parvaneh Rafaeloff is a big fan of the "lip flip," a Botox treatment that helps relax the top lip and "flip" it out, revealing a less gummy smile. For me, it's also a decidedly less invasive approach to creating the illusion of fuller lips, since it kind of just zhuzh-es up my natural shape without adding a ton of extra volume.

Meet the Expert

Dr. Parvaneh Rafaeloff, MD, is the owner and medical director at Le Jolie Spa in Los Angeles, a notable destination for anti-aging skincare in Southern California. Previously, she performed clinical research at Cedars-Sinai Medical Center in L.A. and worked as a cosmetic surgeon.

But let's get a little more technical about it, shall we?

In general, Botox prevents the release of the neurotransmitter called acetylcholine, which nerves release in order to make muscles contract," says Dr. Dara Liotta.
"When [injecting] botox into a specific muscle, the effect is that the targeted muscle relaxes. Using botox to perform a botox lip flip can help relax a very small area of the orbicularis oris muscle (the muscle that surrounds the lips). Relaxing tension in this muscle can allow the lip to flip upwards, creating a poutier look."

"The lip flips upwards to create a poutier look. You can do the same with the muscle responsible for the gummy smile," Rafaeloff adds. In other words, you're working with lip volume that in my case, I didn’t even know I had—you’re just flipping the lip up to make it more visible. 

That said, the piece de resistance might actually be adding a smidge of filler for a highly personalized approach—perhaps along your vermillion line (the edge of your lip), or in your cupid’s bow, or for a little additional volume in your upper or lower lip. The cool thing is that both of these treatments can be applied at once. "Filler is used to create volume in a lip and to help enhance or change the shape of your lips to your liking,” adds Rafaeloff. “Botox just [targets] muscles that need relaxing.”

For the record, some practitioners might note that this particular use of Botox is technically off-label—that is, it hasn’t been studied or approved by the FDA. But that also just means finding a board-certified practitioner is a must, to ensure that you’re getting a safe (and quality) application.

One more thing to consider? Filler tends to be far pricier than Botox: While a Botox lip flip can run anywhere from roughly $50 to $500 (depending on how much you need), a lip filler treatment can start at anywhere from $500 to $1000. That makes this a cost-effective approach to lip enhancement, and with minimal downtime, too. (Typically, the results from the lip flip tend to kick in 5-7 days after your treatment, just like regular Botox.) That obviously changes when you add filler to the mix: Like Ross Geller, I bruise like a peach, and tend to feel sore for a couple of days post-treatment.

But it’s all worth it to me when it means getting a little touch-up that feels very me—and not even in a Facetuned, airbrushed kind of way. I prefer a je ne sais quoi; the kind of subtlety that can’t even be traced to my mouth. “Wow—you look so glowy,” said a coworker the day after my last appointment. "Fresh-faced." Mission accomplished.

Editor's note: While Dr. Rafaeloff is certainly qualified and licensed to perform injections, she isn't board-certified. For the safest experience and the best results, see a board-certified injector.

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