What You Need To Know About Breast Reduction Surgery


Dr. Phillip Chang M.D.


Dr. Phillip Chang M.D.

Everything You Need to Know About Lip Augmentation

From one of Northern Virginia's Premier Plastic Surgeons For the Cosmetic Appearance of Your Lips


The introduction of Juvederm and other cosmetic fillers has made possible a tidal wave of women asking asking to plump up their lips.  Young women will often ask to exaggerate the size of the average normal lip.  Older women will more often want less than will be required to restore the average normal lip.  In this article, I will present my strategy for how to approach creating beautiful lips that are customized for your desires.  I will describe the normal anatomy of the lip, the changes that come with age, the types of fillers that are available, and my technique for creating full sensual lips

Dr. Chang : Juvederm Lip Filler Leesburg, Virginia

Duck Face

The start of a new trend in lip augmentation

In 2014, Oxford Dictionary added DUCK FACE to its On-line dictionary.  According to the Oxford Dictionary, Duck Face is a noun describing “an exaggerated pouting expression in which the lips are thrust outward, typically made by a person posing for a photograph”. They go on an give an example of how the phrase was used.  “The pop star pursed her lips into a duck face in one shot” or “Don’t make that stupid duck face in your photos”

You can easily substitute the name Kylie Jenner into the first sentence and you might understand how or why the discussion of of bigger and poutier lips has come into the the popular conversation.  The sentence would then read, ” Kylie Jenner pursed her lips into a duck face” and the world responded.  Reality television, social media, and a beautiful woman with voluptuous duck lips created a movement.  All of a sudden, you couldn’t get away from beautiful women at bars or images on your instagram feed taking duck face selfies. Lips are soft, movable, and serve as the opening for food intake and in the articulation of sound and speech. Human lips are a tactile sensory organ, and can be an erogenous zone when used in kissing and other acts of intimacy.

Lip Size and Sexual Attraction

There is a lot of scientific evidence to suggest that within reason, bigger is better.  Intuitively, we all know that this makes sense.  The lips are after all, made for kissing.  Full lips represent youth and fertility.  They are filled with high concentrations of nerve endings that directly stimulate the erogenous zone in the brain.  Because of their high number of nerve endings, the lips are an erogenous zone. The lips therefore play a crucial role in kissing and other acts of intimacy.  

Scientific findings suggesting the erogenous importance of the lips include:  ( wikipedia )

  • Lips will engorge with sexual arousal
  • Studies show that men are more attracted to women with fuller lips
  • Studies show that women with higher levels of estrogen have larger eyes and fuller her lips; and are perceived as more attractive
  • Studies show that lipstick increases sexual arousal presumably because it makes the lip look more full
  • In many cultures of the world, a woman’s mouth and lips are veiled because of their representative association with the vulva, and because of their role as a woman’s secondary sexual organ.
  • Vaginal orgasm appears to be more prominent in women with a prominent tubercle in the upper lip

Strategy for Creating Beautiful Lips

My Strategy For Creating Beautiful Lips

Understanding normal lip anatomy is the the key to creating beautiful sensual lips.  Normal natural lips have distinct characteristics and landmarks that when violated or altered have the potential to create some pretty unnatural looks.  In reconstructive surgery, we plastic surgeons will use these same landmarks.  Patients will frequently come in to their lip consultation with concerns about how they have seen really ugly or weird lips on television and social media.  My response is that creating beautiful lips is both a skill and an art.  Not all injectors are plastic surgeons with a deep understanding of normal anatomic landmarks of the lip;  and not all injectors have a deep understanding of facial aesthetics as an art-form.  The following sections will outline my strategy in creating beautiful and sensual lips.

  • Understand normal lip anatomy
  • Understand the changes that develop with age
  • Understand the social trends particularly in young people
  • Discuss the consequences of unnatural requests
  • Understand my one stick lip augmentation technique
cosmetic lip anatomy

normal lip anatomic landmarks

Normal Lip Anatomy

You can’t really understand how to cosmetically alter the the lip without understanding its normal anatomy.  This is a thought I often have when I see a woman with a botched job from another office. This lack of understanding along with poor technique gives all plastic surgeons a bad name.  Rant is over.  Normal anatomy serves as guidelines.  In your consultation, we can decide to vary from these guidelines to suit your desires.

Normal attractive lips have the following properties:
  • The upper lip has a slight pout that curls the lip upwards.  
  • Cupids’s bow is a distinctive curved margins of the upper lip
  • The peaks of the cupid’s bow intersect with the descending philtral columns
  • There should be a fullness to the center of the upper lip extending to the base of the nose
  • The fullness to the upper lip is more above the lip than it is in the center
  • The fullness to the upper lip tapers as it extends to the corners of the lip
  • The lower lip is 50% fuller than the upper lip
  • The lower lip has 3 small tubercles of extra fullness

Normal changes in the Lip with Age

One of the primary changes that come with age is a generalized loss of volume.  The volume is lost not only in the pink substance of the lip but is lost above the upper lip in the philtrum between the cupid’s bow lip line and the base of the nose.  Cosmetic lip fillers can supplement the volume that is lost with age.  The loss of volume results in the following changes:

  • lips look less full and less sensual
  • loss of volume results in the development of vertical “smoker’s” lines  as the skin folds on itself
  • the upper lip  unfurls and curls inward toward the teeth ( the opposite of the pout )

Celebrity Lip Pout

adopted from Kylie Jenner's Instagram feed

In my experience, there is a tremendous difference between what a more mature woman thinks about lip augmentation and what a younger woman thinks about lip augmentation.  Older woman are mostly terrified about the thoughy of lip augmentation; Younger women are eager and will jump at the opportunity for lip augmentation.  This is a trend that was encouraged by Kylie Jenner, social media, and reality TV.

How to get rid of lip lines

The primary cause of lip lines is not smoking or excessive kissing.  It is because of volume loss with aging.  As the lip loses volume, the skin acts as an accordian and results in creases.  The creases will eventually become permanent as you lose more volume .  Deep permanent creases are extremely difficult to get rid of.  Cosmetic fillers will plump up the lip as will as spread out of the lip wrinkles.  Options include:

  • Cosmetic fillers such as Juvederm or fat transfer
  • Laser skin resurfacing if fillers are not sufficient
  • I hate Botox for this purpose as it Botox will flatten the lip

How to avoid big ugly lips

Getting a natural result is always the first priority in creating lips.  The lips are central to your face and signal beauty and sexuality.  Abnormal lips do not help the cause.  Here are the important elements to creating beautiful lips.

  • Understand and appreciate normal anatomic landmarks
  • Recreate normal anatomic landmarks if they are missing with age
  • Add volume not only to the pink lip pulp but to the philtrum above the lip line up to the nose
  • Understand normal social trends- today, the pout is king.  Larger might be more attractive, but only to a point.

Technique - one stick technique

I developed the one stick technique in 2001 after watching a live demonstration on lip injections.  The instructor used a very short needle and stuck the woman’s lip no less than 20 times.  I can guarantee that if I stuck your lip 20 times with a needle without filler, your lips would be huge and bruised.  My technique.

  • Numb up the lip with a nerve block or with numbing cream we formulate ourselves for effectiveness.  You don’t want the patient to move or be uncomfortable during this delicate process
  • The very thin but longer injection needle is placed at the corner of the upper lip  and threaded across the lip to include the philtrum, cupid’s bow, and pink pulp.  If the patient needs the majority of filling in the central 1/3 of the lip this is often the only needle stick.  
  • Fanning procedure is not usually performed in the lower lip.  However, because the lower lip is more uniformly full all the way across, a needle insertion might be required on the opposite side.

Lip Augmentation Example

Before Lip Augmentation

After Lip Augmentation

Before Lip Augmentation

Before Lip Augmentation (oblique close up)

Upper Lip Injection

Exam of Symmetry After Upper Lip Completed

Lower Lip Augmentation

After Lower Lip Injection

Evaluation of results compared to the instagram lip model

2 days after lip augmentation

2 days after lip augmentation

before and after lip augmentation

1 week after lip augmentation

What can you expect during your lip augmentation ( filler ) procedure

  • Step 1: Consultation and immediate treatment if the patient wants
  • Step 2: Pictures are taken
  • Step 3: Numbing cream is applied
  • Step 4: Injection is performed
  • Step 5: Ice and gentle massage for 1-3 days
  • Step 6: Return to normal daily activities the next day
  • Step 6: Swelling can last 2-3 weeks and sometimes longer
Why Dr. Chang and Aesthetica

Dr. Chang is a nationally recognized as one of the Best Plastic Surgeons

  • Voted Top Doctor and Best Plastic Surgeon in Northern Virginia
  • Lectures on Facial Aging and Mini Facelift Techniques
  • Published and contributor to New Beauty Magazine
  • Board Certified by the American Board of Plastic Surgeons


Lip Augmentation

Learn more about Lip Fillers in Northern Virginia

Getting a natural result is always the first priority in creating lips.  The lips are central to your face and signal beauty and sexuality.  Abnormal lips do not help the cause.  Here are the important elements to creating beautiful lips.

  • Understand and appreciate normal anatomic landmarks
  • Recreate normal anatomic landmarks if they are missing with age
  • Add volume not only to the pink lip pulp but to the philtrum above the lip line up to the nose
  • Understand normal social trends- today, the pout is king.  Larger might be more attractive, but only to a point.

Lip lines are due to the loss of volume that comes with age. If the lines have not become permanent creases, the simple addition of cosmetic fillers will plump out the lines.  

If the lip lines have become permanent creases, this the treatment options s are not as easy.  They will usually require a combination of cosmetic fillers and laser resurfacing treatments.

I hate using botox in the upper lip as some other doctors suggest.  Botox stops muscles from moving.  I think it is always a bad look.  

I’m not sure there is a single cosmetic filler that is the best.  I will use different fillers depending on the purpose of the treatment.  The most common cosmetic fillers for the lips include Juvederm, Voluma, and Volbella.  These are all forms of hyaluronic acid gels developed by Allergan.  Because they are hyaluronic gels, they are soft and resemble the soft tissue of the lips.  

Lip Lines – Patients that want lip lines to be treated usually lack a significant amount of volume in their lips including the philtrum, vermillion border, and the pink pulp.  My strategy is usually to use Voluma ( which lasts for up to 2 years ) in the philtrum above the lip and a combination of voluma and juvederm for the pink pulp.    If the lines are etched and permanent, then I might add Volbella, which is a very thin hyaluronic gel that is sometimes more capable of dispersing between the creases without causing bumps.

Pump Me up – Patients who want significant Kylie Jenner type pout will require more than one syringe of filler.  Typically, I will use Juvederm as it is a softer product than Voluma but doesn’t last as long.  If the patient is using Voluma in other parts of the face, I will add a little bit of Voluma to their treatment to add greater longevity to their results.

Lips have a lot of swelling after cosmetic fillers.  Think about how much swelling you have simply by biting your lips.  The swelling is variable and will depend on how much filler you had, technique ( longer with multiple stick techniques ) and how active you are.  In general, most of the swelling will be gone by 2-3 weeks but could be longer.  

Unfortunately, lip augmentation is a subjective process and there are no guarantees of your satisfaction.  In the event that you want more filling or if there is a need for any form of touch-up, you will be required to pay for the extra filler but at our discounted second syringe price.

Unfortunately, lip augmentation is a subjective process and there are no guarantees of your satisfaction.  In the event that you want more filling or if there is a need for any form of touch-up, you will be required to pay for the extra filler but at our discounted second syringe price.  Minor lumps and bumps are normal after lip fillers.  Most of these, while you might be able to feel them, you are usually not able to see them.  Larger issues may benefit from dissolving some of the filler.  This is performed at no cost but may dissolve the remaining filler.

While bruising is not common, visible bruising can occur in about one out of 10 patients.  I hope you are not the one.  The procedure obviously requires a needle and an injection.

The answer is absolutely yes.  All of the cosmetic nurses at Aesthetica have at least 6-10 years of experience and have been personally trained.  They have each seen more botox and cosmetic filler patients in a day than many dermatologists or primary care doctors in a month.  For the record, they also treat my friends and family.

Dr. Chang is a Board Certified Plastic Surgeon located in Leesburg, Virginia across from INOVA Loudoun Hospital.  

More Pages on Facial Rejuvenation Topics

Forehead and Temple Lift

Forehead and Temple Lift procedures are designed to elevate the brows.  Falling brows contribute to the heavy feeling in the upper eyelids which may also close off the eyelids

Nose Reshaping

Nose Reshaping

Nose reshaping is often called a nose job.  The medical term for nose job is a rhinoplasty.  The the nose can be reshaped surgically or may often be performed with facial fillers.  Common concerns include the nasal hump and a large nasal tip

Beautiful woman hiding plastic surgery

Facial Fillers

Facial fillers are injection products that can add volume to areas that are lost with aging.  Common options include Juvederm, Voluma, Sculptra, Radiesse, or your own fat for transfer.

Neck Liposuction

Neck Lift

Neck lift surgery elevates the neck.  Common concerns include the extra skin below the chin, the platysma muscle bands that split in the front of the neck, and neck fat.  The procedure is commonly, but does not have to be, performed with a facelift surgery

Are you ready for those sexy lips?

The desire to look younger and more attractive is a good thing and it is far more feasible and accessible now than ever before in history. Connect with us and Dr. Chang, the premier plastic surgeon in Northern Virginia today!

Hear From Actual Customers
The Reviews Are In

5 star rating
"Best plastic surgeon in Virginia - I was referred by friends who had breast augmentations with Dr. Chang. They were extremely happy. I just had my Mommy Makeover and I couldn't be more thrilled. He is no doubt the best plastic surgeon around!"​
"For a long time I had imagined what it would be like to have breast reduction surgery, but I always thought it was only other women who could do such a thing, not me. From the day of my consultation through a month post-surgery, I have had nothing but outstanding care and service by Dr. Chang, his staff, and the outpatient surgery clinic where I had the procedure."​
"I had a tummy tuck, breast lift and reduction, and liposuction and he performed these procedures beautifully. I now have a waist and flat tummy; two things I never dreamed could be possible."

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