Botox Lip Flip: Is this really a thing?

Recently, a young lady asked me to do a Botox lip flip for her. The Botox lip flip is something that I was vaguely aware of, but hadn’t really studied because I didn’t think it would work. I know plenty of things that will make lips look better and just hadn’t ever felt the need to put this particular technique in my toolbox. That means it’s time to see if the Botox Lip Flip is really a thing!

Regular readers of my blog know that from time to time I will examine current beauty fads and trends from a scientific perspective in a recurring series I call, “Is this really a thing?” I’ve previously looked at things like collagen replacement, Vampire facelifts, and beauty shots (the kind you drink, not things like Botox).

Blog posts like this have rules. The rules are:

1. Approach with an open mind- I know a lot of stuff, but I don’t know everything.
2. Be fair- use actual claims from the actual product sellers.
3. Go to the medical literature and see what it says.

Without further delay, let’s examine the Botox Lip Flip!

I found an article about the Botox Lip Flip in Allure magazine from 2017. Regarding lips, the article says:

Filler adds volume, which makes the lip appear larger by literally making it bigger, says Liotta, while Botox^® relaxes muscles around the mouth, called the “orbicularis oris,” and rolls the lip outward (i.e. “flipping” it), creating the illusion of a bigger lip — without the added volume.

So the question here really seems to be, is it possible to roll out the upper lip using Botox^®? The medical literature is, unfortunately, silent about this. So let’s take a deep dive into how Botox^® works.

You all know that I think Botox^® is great (I also think that Xeomin is great but that’s a discussion for another time). I use lots and lots of it to make people look and feel good, but it also has many other uses like helping people who clench their jaw, people who sweat too much, or people who get migraines. For more on that, check out this post and this post from the archives.

Botox^® works because it interferes with how nerves interact with their targets. In my practice, we mostly take advantage of that by putting it in your facial muscles to make wrinkles go away.

If you’re an expert in the anatomy of the facial muscles, you can use Botox^® to alter someone’s appearance beyond just making wrinkles go away. I routinely give people a little bit of a brow lift (you can also drop someone’s brows if you don’t know what you’re doing). You can treat RBF by making the corners of the mouth come up a little. What’s RBF? Check out this post!

The way that those maneuvers work is that the structures involved have muscles that work in opposing ways.

This is a drawing of your facial muscles. Your eyebrow position is a function of the muscles that pull them up (red dots) versus the ones that pull them down (blue dots). To achieve a brow lift with Botox^®, you weaken the pull downers more than the pull uppers. This leaves the pull uppers relatively strong which will them pull the brows up!

The mouth has similar muscles that pull the corners of your mouth up (smilers) and down (pouters). You’ll notice that there’s a ring of muscle that goes around the lips themselves. You move that one when you pucker your lips or suck from a straw. Because it’s just a ring of muscle, there is no opposing muscle group to take advantage of- the Botox lip flip should be anatomically impossible!

Because it’s just a ring of muscle, there is no opposing muscle group to take advantage of- the Botox lip flip should be anatomically impossible!

So, the Botox lip flip shouldn’t be a thing. There are other ways, however, to make your lips stand out. Fillers work well, and the results can be dramatic without making you look like a duck.

Before and after photos of lip augmentation with Restylane^®

For patients with very down turned lips, we offer a surgical lip lift, but that’s a topic for another day! If you want to talk about options for your lips, come see me!