Can you have lip fillers before orthodontic treatment?

Short answer: if orthodontic treatment is planned, I recommend postponing the decision on lip fillers until you see its result. The lips rest on the teeth, and when the position of the front teeth changes, the shape, fullness and profile of the lips change too. Research shows that when the front teeth are retracted the lips move back as well, and when the teeth come forward the lips can look fuller.

I am asked this question often, and for good reason: many people feel their lips are thin or asymmetric and want to fix this with an aesthetic procedure. But sometimes part of the problem lies not in the lips but in the teeth behind them.

The lips rest on the teeth

The lips are soft tissue and their shape depends largely on the support behind them. If the front teeth are tipped inwards, the lip can look thin and sunken. If the teeth stick out too far, the lips look strained and pushed forward, and closing the mouth takes extra effort. In both cases the root of the problem is not in the lip.

How orthodontics affects the lips

A systematic review comparing treatment with and without extractions showed that in the extraction group the lips moved back more and the profile became flatter. This shows how important the orthodontic plan is for decisions about the lips.

What problems fillers before treatment can cause

• After orthodontic treatment the lips may look fuller on their own and the filler becomes too much
• When the teeth are retracted, a filled lip may look unnatural
• A heavy lip can put extra pressure on the teeth
• Planning the profile and the smile becomes harder because the key measurements change

The right sequence

1. Orthodontic consultation, profile and smile photographs
2. Plan: where the front teeth will move and how this will affect the lips
3. Orthodontic treatment
4. Assessment of the result: how the lips look now
5. If needed, an aesthetic procedure by the relevant specialist

With this sequence it often turns out that an additional procedure is either no longer needed or much less is needed than originally planned.

What I look at in planning

• The profile: how the lips relate to the tip of the nose and the chin
• The angle and position of the front teeth
• Whether the lips close comfortably at rest
• How much tooth and gum shows when smiling
• Age-related changes: the lips thin and drop with age

This view is the basis of the Pitts philosophy: the plan starts not only from the teeth but from the face. More: what is the Pitts philosophy and can orthodontics change your face.

If you already have fillers

This is not an obstacle to orthodontic treatment. Just be sure to mention it at the consultation so that I can take the current state of the lips and the effect of the filler into account in planning.

What we look at together at the consultation

With a patient who comes with a question about the lips I first talk over the photographs. On the profile photo I draw an imaginary line from the tip of the nose to the tip of the chin and look at where the lips sit relative to this line. Then I assess the angle of the front teeth and the support they give the lips. After this analysis one of three situations usually becomes clear.

How long the wait is

Orthodontic treatment can take several months or several years, so some patients do not want to wait. That is understandable. But a hasty decision about the lips may need correcting later. Midway through treatment, once the main movement of the front teeth is finished, the lips can be reassessed and sometimes the decision can be made at that stage.

What the science says

• Systematic review and meta-analysis (2018): in treatment with extractions the lips move back more and the profile changes more than in treatment without extractions. In other words, the position of the front teeth directly affects how the lips look.

More about how the smile fits the face: smile and facial harmony. If you have questions, book a consultation.