Plastic Surgeon Injects Botox in Lips to Prevent 'Fish Lips' Phenomenon

Nearly 9,000 lip augmentation procedures were performed in 2007, and the numbers continue to rise as more people pursue the 'Hollywood ideal.'  Angelina Jolie's lips are one of the most sought after pouts in 2008 according to plastic surgeons Richard Fleming and Toby Mayer who found that the majority of female patients equate Jolie's lips with perfection (Source:

Still, plumping up the lips with injectable fillers such as Restylane, Juvederm and other injectables doesn't guarantee the perfect pout.  Many women experience the phenomenon of 'fish lips' where the lips look out of proportion to the natural lip line.  Fish lips make the upper or lower lip literally disappear, and can look fairly artificial.

However, some plastic surgeons are attempting to reduce the risk of unnatural lips by using BOTOX - the same injectable used to reduce frown lines and wrinkles - to correct fish lips syndrome and create a more natural-looking and fuller appearance.

According to, BOTOX can be used to enhance the natural lip line and create the appearance of a smoother and more youthful pout.  When combined with Restylane and Juvederm, the lips can become smoother and free of wrinkles; the effects are a set of thicker and rounder lips that have just enough volume to pass off as natural.

Dr. Steven Pearlman, F.A.C.S., a New York plastic surgeon demonstrates how the Restylane + BOTOX procedure for lip augmentation works in this short video:


Further Reading

  • Miley Cyrus is undergoing a makeover, freshening up her look with a spiky new haircut and to the surprise of many fans, augmenting her lips. Recent pictures of Miley show her with much a much thicker and larger pout, which could be the result of a lip augmentation procedure. Lip plumping treatments are among the most popular minimally-invasive treatments and are usually performed with some type of filler. Restylane and Juvederm are some of the popular injectable used to enhance the lips, and many people believe these fillers produce the most natural appearance.

  • A new TV show in Australia called The Shire recently spotlighted plastic surgery and featured the stars of the show having now qualms about treatments. The show’s stars Sophie and Vernesa aren’t afraid to show off their fake breasts in revealing tops and dresses, and are both sporting the infamous lip-enhanced pouts. Vernesa admits that she’s been told not to have any more filler treatments in her lips to prevent her lips from touching her nose. She undergoes Botox for the first time on camera.

  • Khloe Kardashian made headlines recently after the paparazzi caught her with the infamous “trout pout” – the result of too many injectable fillers in the lips. Kim Kardashian’s younger sister appeared to have some very swollen and lumpy lips after leaving a Beverly Hills salon last week and many are suspecting that that star had cosmetic surgery. Celebrity plastic surgery doctor Dr. Anthony Youn did not treat Khloe Kardashian but believes that the star did have some type of injectable filler. He tells, “Khloe has a trout pout! The excessively plump appearance of her lips could be due to injections of a filler like Juvederm. Her upper lip is larger than her lower lip, causing her mouth to resemble a trout’s. Most injectable fillers last about 6 months in the lips, so given enough time we may see her lips shrink to a smaller and more typical size.” Another plastic surgery doctor, Dr. Michael Fiorellio who is based in New York City, made a similar conclusion. He suspects that Khloe had some type of filler treatment because, “Her lips look swollen and bruised. The product looks lumpy as well”. Dr. Fiorellio is suggesting that this Kardashian sister had either Juvederm or Restylane injections to make her lips appear larger and fuller. Injectable fillers are among the most popular types of non-invasive cosmetic enhancements around the country, and are an attractive option for women who want to add volume to their lips, fill out hollows in their cheeks, and diminish the appearance of wrinkles and lines. They’re also more affordable than having surgery and can be a convenient option for those who don’t want to deal with the long downtime and recovery process associate with a surgical procedure like lip implants or a facelift.