By Dr. Keswani, MD — Forever Medspa & Wellness Center
“Should I get a lip flip or filler?” I hear this question constantly, and it usually means the person has been given a confusing answer somewhere else. Here’s the honest version: they are two completely different treatments that do two completely different jobs. And there’s a third treatment — for the gummy smile — that almost nobody explains properly, even though it pairs beautifully with the flip.
How a lip flip actually works
Try saying “P” or “B” out loud. Feel how your lips curl inward? That curl hides some of the pink of your lip. The muscle that runs around your mouth is shaped like a J — and that J shape is more pronounced in younger people, which is honestly why the flip works better on younger lips.
A lip flip uses a very small dose of tox to relax just the front part of that muscle — the tip of the J. When that part can’t curl the lip inward anymore, the lip rolls slightly outward and more pink shows. Nothing is added. Your lip isn’t bigger. It just shows more of itself.
Why the dose has to stay small — and what that means for duration
Your lip muscle does real work all day: kissing, drinking through a straw, holding a cup to your mouth. Overdose the upper lip and those things get weak and awkward. So we deliberately put only a very small dose on a good-sized muscle — 2 to 5 units, and most people need just 2 to 3.
That small dose is also why the effect is short. A lip flip lasts about 4 to 8 weeks depending on the dose. That’s not a flaw in the treatment — it’s the trade-off that keeps your lips working normally. The results build gradually over those first weeks rather than appearing overnight.
A lower-lip flip is technically possible, but it’s less well tolerated — your lower lip is what holds cups and bottles while you drink. I’m cautious there.
So who should get a flip, and who should get filler?
Think of it this way:
- Lip filler is a gel that makes your lips genuinely bigger — same shape, more volume. If what you want is larger lips, filler is the answer. No amount of flipping gets you there.
- Lip flip changes how much pink shows, not the size. It’s subtle, it’s quick, and it’s a natural entry point for someone curious about lip treatments but not ready to commit to filler.
- Both together is completely reasonable. They don’t compete — they do different things.
My honest rule: tox is the entry point. Wanting genuinely bigger lips means filler.
The gummy smile fix nobody explains
Here’s the part most people have never had explained to them. A gummy smile — where a lot of gum shows when you smile — comes from a specific muscle with a long name: the levator labii superioris alaeque nasi. Its job is to pull your upper lip up when you smile, and in some people it pulls hard enough to expose the gums.
We treat it with small injections at the sides of the nose. It works when there’s enough gum show to work with, and it lasts a typical 3 to 5 months — longer than a lip flip, because the dosing situation is different.
Now here’s why the flip and the gummy smile treatment belong in the same conversation. A lip flip shows at rest — but the moment you smile, the lip curls in again. The gummy smile treatment covers the animated smile. Together, you get better lip show both at rest and while smiling. Two treatments, one complete result. That’s the explanation nobody gives.
A small bonus: bunny lines
While we’re near the nose — those horizontal lines that appear on the sides of the nose when you scrunch it are called bunny lines. They come from the upper part of the same muscle that drives the gummy smile, and a small dose treats them easily. It’s one of those small “fourth area” treatments, like lip lines or chin dimpling, that take minutes and make a real difference.
The bottom line
A flip changes how much lip you show. Filler changes how much lip you have. The gummy smile treatment handles what happens when you actually smile. None of these is “better” — it depends entirely on what’s bothering you, and the right answer is often a combination.
If you’re deciding between brands of tox for any of these, I’ve written a full guide on how to choose between Botox, Dysport, Xeomin, Letybo and Daxxify — the short version is there’s no wrong choice among the five.
Questions about whether a flip, filler, or the gummy smile treatment fits you? Text us at (201) 340-4809 and we’ll talk it through. You can book online at forevermedspanj.com/book/tox, and current offers are always on our Promotions page.
