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Dermal filler

Lip Enhancement is achieved by injecting hyaluronic acid into the lips and lines around the mouth to rejuvenate an aging lip. Lip enhancement is also used to treat asymmetry or increase the visible show/surface area and volume of the lips.
The hyaluronic acid fillers used for lip treatment are similar to the HA in your body tissues, there’s no need for a sensitivity or allergy test before the procedure.The HA used for cosmetic injections is a clear, sterile gel that has been crosslinked more times than our own HA in order to achieve duration.

How do I avoid getting a “Trout Pout” or “Duck Lips”?

The phenomenon known as “trout pout” or “duck lips” is caused by the aesthetic provider overfilling the lips at the vermillion border. This outcome is avoided through extensive training, lip injection experience, and by administering only the necessary amount of HA needed to obtain the treatment goal. A competent practitioner individualizes each treatment and injects the HA to provide an attractive and natural-looking result. When properly administered, a lip injection can do more than make the lips fuller and more voluptuous; it helps improve the symmetry, lip ratio, and the natural beauty of the client’s face.

What should I do before I come in for treatment?

Do not consume alcoholic beverages at least 24 hours prior to treatment as the risk of bruising is increased.

Avoid anti-inflammatory/blood thinning medications, if possible, for 3 days before treatment: aspirin, vitamin E, ginkgo biloba, ginseng, St. John’s Wort, turmeric, Omega 3/Fish Oil supplements, Ibuprofen, Motrin, Advil, and Aleve all have a blood thinning effect and can increase the risk of bruising after injections.  

Please contact your provider if you have a history of cold sores or “fever blisters” (HSV-1) so that medication can be prescribed 2 days prior to your appointment to minimize a recurrence.

How can I reduce swelling?

Tips to reduce swelling:

-Day 1 (post treatment)= Apply a cold compress for 5 min. every 30 min. for the first few hours if possible.

-Keep your head elevated as much as possible for the first 24 hours .

-Take Benadryl, as directed, at bedtime on the day of treatment – this will make you sleepy…no alcohol, no driving.

-Sleep at 45 degree angle – use pillows to prop yourself up.

-Day 2 = Use warm compress on and off to increase circulation and help the swelling move out.

-Arnica is a homeopathic remedy for bruising and swelling.  It may be used pre and post treatment.  It comes in a topical and oral form – both are sold at Whole Foods or can be purchased online.

Note: Swelling peaks usually peaks at 48 hours.

Am I a good candidate for lip filler?

The goal is to give you an even, attractive smile, and one that complements your facial structure. Lip augmentation isn’t about having comically large lips, as the procedure is often portrayed in the media. It’s about adding symmetry and volume to the lips.

You’re probably a good candidate for lip augmentation if you:

  • Want fuller, more attractive lips
  • Have uneven lips (a thin upper or bottom lip)
  • Have thin lips that disappear when you smile
  • Need fuller or shapelier lips to balance your facial symmetry

You are not a candidate if you are pregnant, breastfeeding, have a known allergy to lidocaine or HA.  

What Happens During a Lip Injection Procedure?

Lip augmentation with HA takes about 30 minutes on average. After a consultation to determine the amount of product needed, before and after pictures are taken. Next, a medical staff member will apply a topical numbing agent over the treatment area. The practitioner then uses a fine needle to inject the HA filler into lips to achieve your treatment goals.

Neurotoxin: (branded under the names Botox, Dysport, Xeomin, and Jeveau) can be used by injection to relax the orbicularis oris muscle right at the vermillion border (pink lip/skin border) allowing more pink show of the lip (known as a “lip flip”). It can also be used above the lip to lower the top lip eliminating a gummy smile. Botox is preferred for treatments around the mouth the lower face. Botox typically lasts 3 months in these areas.

Your Lip Treatment will be performed in Dr. Praful Ramineni‘s surgery center located in Washington, DC.

This has been an amazing experience from the consultation to post-surgery!!! I honestly can’t even express how happy & grateful I am with the results. Everyone….Dr. Ramineni and his whole team are impeccable, to say the least. A very thoughtful, professional, kind, and knowledgable team. I will 100% always refer anyone I know to this amazing team…Dr. Ramineni had a challenge when I came to see him with my issue but he 1000% went above & beyond to achieve perfection with my results. I can’t thank this team enough!! I genuinely want to thank you so much!

- Sally T.

Dr. Ramineni was recommended to me by my plastic surgeon as a masterful surgeon who could figure out why I was having complications. He diagnosed the problem correctly and fixed it. I am grateful for his openness, his honesty, and skill.

- Saiyyaed A.

Life-altering surgeon. He helped make my dreams come true with the most flawless surgery I’d been waiting my whole life to get. Healing and recovery has been almost disturbingly easy and pain-free. I could not recommend enough. Everyone there is so sweet as well!

- Katie C.

Dr. Praful Ramineni



Dr. Ramineni is the founder of District Plastic Surgery. He is board certified and has over 15 years of experience in plastic and reconstructive surgery. He started his career as one of the busiest surgeons at Medstar Washington Hospital Center with a focus on complex reconstructive surgery including cancer and trauma reconstruction, microsurgery and aesthetic surgery.

Dr. Praful Ramineni

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