1. Consultation and Assessment

Every treatment begins with a personalized consultation conducted by a certified aesthetic practitioner or cosmetic surgeon.

Goals of the consultation include:

Reviewing medical history, allergies, and medications.

Assessing lip shape, symmetry, and facial proportions.

Discussing the desired look — subtle enhancement or defined volume.

Explaining the filler type, permanence, and expected longevity.

Outlining potential risks and post-procedure expectations.

If the patient is a suitable candidate, the practitioner creates a customized treatment plan that defines filler quantity, injection sites, and technique.

2. Material Selection

Permanent lip fillers differ from temporary hyaluronic acid (HA) types. Common materials include:

PMMA (Polymethylmethacrylate microspheres) — a biocompatible synthetic polymer that stimulates collagen.

Silicone microdroplets — used in microdroplet technique for permanent results (off-label in some regions).

Fat transfer (lipofilling) — uses the patient’s own fat cells for natural integration.

The chosen material influences both the longevity and texture of results. For example, PMMA typically lasts 5–10 years, while fat grafting can last indefinitely with partial absorption.

3. Pre-Procedure Preparation

Once materials and methods are finalized, patients are given pre-care instructions such as:

Avoid alcohol, aspirin, or blood thinners for 48–72 hours.

Refrain from dental work or facial treatments before the session.

Arrive with clean, makeup-free skin.

A topical or local anesthetic is applied before injection to reduce discomfort.

4. The Injection Process

This is the core of the permanent lip filler procedure. It usually takes 30–60 minutes, depending on the technique used.

Step-by-step:

Marking and mapping: The practitioner outlines injection points to guide symmetry.

Sterilization: Lips and surrounding skin are thoroughly disinfected.

Anesthesia: Numbing cream or a local block is applied.

Injection:

Using a fine needle or microcannula, the filler is injected into targeted areas (vermilion border, Cupid’s bow, or body of the lips).

Small amounts are placed gradually to achieve the desired contour.

Molding: The filler is gently massaged into place for even distribution.

5. Immediate Aftercare

Post-procedure, swelling and mild bruising are common for 2–5 days.

Typical aftercare includes:

Applying cold compresses intermittently.

Avoiding heat exposure (sun, sauna, hot drinks).

Not massaging or pressing the lips unless instructed.

Staying hydrated and avoiding strenuous activity for 24–48 hours.

Patients are usually advised to avoid lipstick or gloss for the first 24 hours.

6. Healing and Follow-Up

Initial recovery:

Swelling peaks within the first 48 hours and gradually subsides over a week.

Lips may feel firm or uneven temporarily.

A follow-up appointment is typically scheduled 2–3 weeks after injection to evaluate symmetry, healing, and satisfaction. Touch-ups may be performed to fine-tune the final look.

7. Results and Longevity

Permanent fillers typically maintain results for 5 years or longer, depending on the material.

Fat transfer results can last indefinitely, but 30–40% of the grafted fat may be absorbed naturally within months.

Silicone or PMMA fillers form collagen over time, improving lip structure and firmness.

However, because results are long-lasting, careful initial placement is crucial to avoid overcorrection or unevenness.

8. Risks and Considerations

While generally safe under professional supervision, risks include:

Swelling, bruising, or nodules.

Infection or allergic reaction.

Asymmetry or migration.

Granuloma formation (rare).

Permanent fillers require expert handling and are not easily reversible like HA fillers. Therefore, thorough practitioner selection and pre-procedure consultation are essential.

9. Maintenance and Lifestyle

Keep lips moisturized with non-irritating balms.

Maintain regular check-ins with your provider every 6–12 months.

Avoid trauma or excessive sun exposure to prolong collagen support.

Follow a balanced diet and stay hydrated for natural lip resilience.

Some patients combine fillers with laser lip rejuvenation or microneedling to support texture and collagen balance.

10. Long-Term Monitoring

Since permanent fillers integrate into lip tissue, long-term follow-up helps ensure optimal results and early detection of any changes.

Practitioners may recommend:

Ultrasound imaging for filler tracking.

Annual evaluations to monitor collagen formation and lip volume.

Corrective treatments if migration or asymmetry occurs.