Hyaluronic Acid Dermal Filler

Lip filler treatment is used to enhance lip volume, improve shape and symmetry, define the vermilion border, restore hydration, and soften the appearance of perioral lines. Results are individualized and may be subtle or more noticeable depending on anatomy and treatment goals.

I understand that lips are highly sensitive and vascular. Swelling may be more pronounced than in other facial areas. Temporary asymmetry is common during healing. Final results may take up to 2 weeks to fully settle. Multiple treatments may be required to achieve or maintain desired results. Overfilling is intentionally avoided.

Common side effects include swelling (sometimes significant in the first 24–72 hours), bruising, tenderness, tightness, temporary firmness or lumpiness, dryness, or peeling. These effects may last up to 10–14 days and typically resolve on their own.

Although uncommon, risks specific to lip filler include vascular occlusion leading to skin injury or tissue damage, ulceration or scabbing, asymmetry, contour irregularities, delayed inflammatory reactions, infection, and activation of cold sores (herpes simplex virus) in patients with prior history. Very rare but serious complications may include vision changes or tissue necrosis.

I understand that lip injections may trigger a cold sore outbreak if I have a history of herpes simplex virus (HSV). I have disclosed my HSV history to my provider, and preventative antiviral medication may be recommended if appropriate.

I understand that lip filler treatment can be uncomfortable and that anesthesia may be used to improve comfort. Anesthetic options may include topical numbing cream such as BLT cream, a compounded mixture containing benzocaine 10%, lidocaine 10%, and tetracaine 10%, and/or local anesthetic injection, including a dental-style ring block using lidocaine with epinephrine and sodium bicarbonate. I understand that anesthesia reduces discomfort but may not eliminate all sensation. Temporary numbness, tingling, or swelling may occur. Epinephrine-containing anesthetic may cause temporary paleness or pressure sensation. Rare risks include allergic reaction, bruising, or prolonged numbness. The type of anesthesia used will be selected based on my comfort, anatomy, and the clinical judgment of the provider.

I understand and agree to follow aftercare instructions, including avoiding strenuous activity, alcohol, and excessive heat for 48 hours; avoiding manipulation or massage of the lips unless instructed; using cold compresses gently for swelling; and avoiding makeup on the lips for at least 12 hours.

I understand that I must contact my provider immediately or seek emergency care if I experience severe or increasing lip pain, skin color changes (white, gray, dark purple), blistering, scabbing, open sores, pain spreading beyond the lips, vision changes, or neurologic symptoms.

I acknowledge that I have read and understand this lip filler consent addendum, have reviewed the general dermal filler consent, have had the opportunity to ask questions, and understand the benefits, risks, alternatives, and limitations of lip filler treatment. I voluntarily consent to lip filler treatment.