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Lip Filler and Lip Piercings

In 2022 alone 3.4 million patients in America sought out lip filler. This cosmetic procedure has rapidly become one of the most popular things to get done- and it’s no surprise. Filler can grant you the perfect, full pout. It can also restore volume for older clients who have lost some over time. It can even out features and improve our confidence and happiness with our faces. Lip filler at its essence is simply another form of body modification no different than piercings, tattoos, weight lifting, and plastic surgery. But what about when our body modifications overlap- when we have or want filler, but also have or want piercings? How does filler affect our piercings? Let’s look at it!

What is Lip Filler

To understand how our piercings are affected by filler we need to understand what filler is and how it works. Dermal fillers are gel-like substances injected under the skin to create fullness and volume, smooth skin and texture, or do both. Dermal fillers are regulated by the FDA and most are temporary. They are made of ingredients the body breaks down over time and thus need to be redone over time. Temporary fillers include

  • Hyaluronic acid, a sugar that is naturally found in the body

  • Calcium hydroxylapatite, a mineral and a major component of bone

  • Poly-L-lactic acid (PLLA), a biodegradable, synthetic material

"Generally speaking, dermal fillers fall into two main categories: hyaluronic acid filler, which is most commonly used for lip injections, and biostimulators," explains New York City-based board-certified dermatologist Macrene Alexiades M.D., adding that doctors tend to favor hyaluronic-acid based fillers because they are temporary, reversible and build upon the foundation of hyaluronic acid that is already found throughout the body. "When hyaluronic acid fillers are injected into the lips, they immediately work to attract water, which in turn, adds volume to the region where it was injected to give a fuller appearance.”

Even within these ingredients, there’s a huge range of fillers on the market that have different uses and different pros and cons. A good injector should work with a range of fillers and assess each client's needs to determine the filler that is best for them. Some people want to define the shape of their lips, others want more fullness, and others want a mixture of things. You may end up layering different fillers over time or finding one that doesn’t work for you and need to have it dissolved and replaced with a product better for your body. No two people are the same, and no two people's filler needs will be identical either.

When you go in for filler your injector will assess your anatomy and goals and suggest what works for you. You’ll get injections of the filler into your lip, and be pretty swollen and possibly bruised initially. Once that goes down you’ll be the proud owner of a new, plump pout. Depending on the filler you get you’ll need to go back every 6-16 months to get more as your body dissolves and absorbs the filler. This process of getting filled, the body breaking it down, and needing more, is the filler cycle.

What came first- the filler or the piercing?

Now that we loosely understand how filler works, we can look at its effects on piercings. The biggest question is- what should I do first? Get filler or get a piercing? And undoubtedly it is easier to have your piercing first. This is because of a few factors, the biggest being fillers’ ability to migrate. If you are looking into filler I’m sure you’ve already seen photos of filler horror stories- folks with migrated filler that gives them a signature pout and line of filler extending beyond the barriers of their lips. Finding an experienced injector is so important because filler migration is real and can have serious results.

Not only is migrated filler not the result most want, but it can be very tricky and expensive to fix, needing to see a skilled injector to have it dissolved and carefully refilled- often this is far more expensive than getting the filler in the first place.

When it comes to piercings we can cause migration if we pierce through filler. Yes- those overfilled and puffy lips? That can happen if we aren’t careful. So if a client already has filler and wants piercings, we need to wait till the end of the filler cycle (more on that later). Because of this, if it comes down to it, it’s better to already have a piercing and then get filler. But there are still some considerations in that case as well.

Getting Filler with Lip Piercings

If you already have piercings there are a few things to know before you get into getting filler.

-Research your injector: This goes without saying but you really need to make sure you are seeing a good injector you trust. But it is extra important when you have piercings to find an injector who understands how to work with them. When injections are done wrong or without care for piercings, they can cause piercings to become crooked, migrate, and even reject. A skilled injector will consider your piercings and inject very carefully to accommodate for them. When I had my injections done by Carolyn Barnes it was very important to me I was still able to wear my large collection of lip rings- she took the time to take measurements and see how my jewelry fit, and filled my lips to ensure everything fit well.

-Be prepared to remove jewelry for injections: When you go to get your injections I would wear your jewelry in so your injector can see how things sit and fit. However, to actually get your injections you’ll likely need to remove jewelry to ensure they can inject cleanly and evenly and get you your desired results. This is why having older and well-healed piercings is important. A vertical labret that is just recently healed may shrink and close in the time it takes to get injections. But one that’s a few years old and super well-established will have no problem being removed for injections and reinserted after.

-Feelin’ Swell: Lip fillers are going to swell. Sometimes this swelling can be pretty extreme. Some clients prefer to leave jewelry out till that swelling is gone. Others are concerned about piercings shrinking or closing so want to put jewelry back after their injections. Consult with your injector and piercer to see what the safest course of action is for you. If you are putting jewelry back in however you’ll likely need longer barbells to have room for that post-filler swelling. You should prepare and bring longer jewelry with you or see your piercer to help assist with installs to get the right pieces in. After, you’ll need to downsize once the swelling is gone. Post filler depending on the filler you may end up wearing a different length!

-Monitor with Care: No matter how experienced and careful your injector is, always monitor your piercings for the first month after getting any filler. Clean them like new piercings and keep an eye on them for any signs of irritation, migration, or issues. Most of the time they will be completely fine once the swelling is down but you can’t be too cautious- just be extra aware for that first month!

Getting Lip Piercings with Filler

If you already have filler and you want piercings, there are a few things to know before getting them.

-Wait for the end of your filler cycle: As we discussed above fillers work in a cycle. You get the filler, your body absorbs it, then you get more. If you already have filler and we pierce through it we can cause migration and issues, so we want to wait till the end of your filler cycle before doing a piercing. So for example if your filler needs to be redone every 6 months, at the 6 month mark you could get pierced, let that heal for a while, and then go get more filler. This does mean that your filler cycle will be interrupted for a few months while your piercing is healing but this is the safest bet. This is especially important if we are doing vertical lip piercings like vertical labrets or vertical philtrums. Even traditional laborers of philtrums can sometimes cause filler migration, if there is filler too close to the area we pierce, or if the swelling from the piercing causes some to migrate. Any oral piercings done during the active period of filler risk migration. These carry a much higher risk of filler migration than anything else. Beyond that, we would be piercing directly through filler so as it dissolves the piercings could end up crooked or shallow. I suggest waiting until the end of your cycle for any piercings, but especially vertical piercings.

-Be Honest with your piercer and injector: If you already have filler it’s very important to be honest with your piercer that you have this. I have had clients not mention they have filler and try to get pierced anyway- and then when that piercing wasn’t healing right and having major issues the truth about the filler came out. In that instance, we fortunately didn’t have any major migration but the piercing had a lot of irritation and ended up leaving worse scarring than necessary. If the client had been honest I would have waited to pierce and we could have avoided all of these issues. Also- be honest with your injector! Let them know you are planning a piercing and make sure to work that into your filler schedule.

-Research your piercer: Just like researching your injector is very important, so is researching your piercer. You want to make sure you are seeing someone with experience working on filled lips who knows how to safely work with them. Migrated filler can cost thousands and thousands of dollars to correct. Not worth it over a single piercing.

I personally have and love my lip filler- it’s made me feel confident, beautiful, and attractive. Just like all my piercings have made me feel the same! You can absolutely have both filler and piercings, it just takes some care to go about doing it in a way that is safe for your body. Please remember filler is a serious process that can have permanent long-term effects. Your body should be treated with care and respect by your injector and your piercer, and they should be doing things in your best interest, even when often that means having a lot of patience. I hope this blog helps anyone considering filler or lip piercings. Happy healing!

Lip Augmentation Using Hyaluronic Acid Filler and a 4-mm Needle: A Safer, More Natural and Predictable Approach J Clin Aesthet Dermatol. 2021;14(1):E61–E63.

by Lee Walker, BDS MFDS MJDF and Raul Cetto, MBBS, PhD, MRCS, DOHNS, PGDip (AestMed)

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