Lip fillers are injectable treatments using hyaluronic acid, a substance that occurs naturally in the body, adding volume, definition, and hydration to the lips.

• Consultation: Dr Karwal assesses your lip and facial anatomy, reviews your aesthetic goals, and determines the most appropriate treatment plan for your face.

• Medical Assessment: Your medical history is reviewed in full, including any previous filler treatments, allergies, or contraindications.

• Treatment Planning: A tailored plan is developed based on your anatomy and the result you are looking to achieve.

• Cleansing: The treatment area is thoroughly cleansed to remove any makeup, oils, or impurities.

• Anaesthetic Application: A strong topical anaesthetic cream is applied and left to take full effect before any injections begin.

• Treatment Mapping: Dr Karwal marks the areas to be treated, carefully planning placement for the most natural and precise result.

• Filler Injection: Hyaluronic acid filler is injected using a fine needle or cannula, selected based on the specific area being treated and the outcome required.

• Massage and Moulding: The product is gently massaged to ensure even distribution and natural contouring.

• Final Assessment: Dr Karwal and the patient review the immediate result together, with any minor adjustments made as needed.

• Aftercare: Detailed aftercare guidance is provided before you leave the clinic.

Lip fillers typically last 12-24 months, though this varies considerably between individuals. Some patients find their results last towards the shorter end of this range, whilst others enjoy longer-lasting results. The longevity depends on multiple factors including metabolism, lifestyle, and the amount injected.

No. At Karwal Aesthetics, we use only hyaluronic acid fillers, which are not permanent and break down naturally over time. Hyaluronic acid is also dissolvable with hyaluronidase, giving you the option to reverse results if needed.

However, not all clinics use the same products. Some fillers used elsewhere are not hyaluronic acid based and cannot be dissolved. We see a significant number of patients who have come to us from other clinics seeking ultrasound-guided dissolving, only for us to discover that the product used is non-dissolvable and therefore cannot be removed. This is more common than many people realise.

If you are considering lip filler anywhere, always ask your practitioner to confirm exactly which product they are using and whether it is hyaluronic acid based before your procedure. It is a simple question that could save you significant difficulty later.

Yes and no. You'll see an immediate change in your lip volume and shape, but this isn't your final result. Immediately after treatment, your lips will be swollen (sometimes significantly), which can mask the true result.

Your final, settled results will be visible approximately 2-4 weeks after treatment, once all swelling has subsided and the filler has fully integrated into the tissue.

Normal side effects include:

• Swelling (peaks at 24-48 hours, resolves within 1-2 weeks)

• Minor bruising

• Tenderness to touch

• Slight asymmetry during the swelling phase

• Small bumps that resolve as filler settles

Contact Dr Karwal if you experience:

• Severe pain

• Significant asymmetry that worsens rather than improves

• White or blanched areas (could indicate vascular compromise)

• Signs of infection (increasing redness, warmth, pus)

• Difficulty opening your mouth

• Any concerning symptoms

Filler migration refers to filler moving away from its intended placement site, often appearing as a blurred upper lip border, a shelf-like appearance above the vermilion border, or diffuse puffiness rather than defined lip shape. It is a real phenomenon and one that patients are increasingly aware of and concerned about.

Migration most commonly occurs when too much product is injected into an area that cannot accommodate it — often in a single sitting, and typically in less experienced hands. Overfilling beyond what the lip tissue can hold forces the product to move, which is where the blurred, shelf-like result comes from. It can also occur when product is placed too superficially, or when a high-viscosity filler is used where something softer is required. Patients who have had repeated lip filler over many years are at particular risk, as product can accumulate gradually over time.

At Karwal Aesthetics, migration risk is minimised through careful product selection, conservative volumes, and precise anatomical placement. Dr Karwal avoids overfilling and takes particular care with the vermilion border and the white roll of the lip — the areas most commonly associated with migration when technique is poor.

If you have existing filler that has migrated, or significant product from previous treatments, Dr Karwal may recommend dissolving all existing filler before placing anything new. Starting with a clean foundation allows for far more natural, precise, and defined results — and is always preferable to layering new product on top of displaced filler.

We will be honest with you — the lips are one of the most sensitive areas of the face, and lip filler is one of the more uncomfortable aesthetic treatments. We would rather set that expectation clearly than have you caught off guard in the treatment room.

That said, we do everything we can to make the experience as manageable as possible. A strong topical anaesthetic cream is applied before treatment and left to take full effect, which significantly reduces the initial discomfort. The fillers we use also contain lidocaine, a local anaesthetic, meaning that as the product is injected, the area becomes progressively more numb, making the latter part of the treatment considerably more comfortable than the first.

Most patients find it very tolerable once the numbing takes hold. If at any point you feel uncomfortable, simply let Dr Karwal know and he will pause.

Some swelling and tenderness in the first 24 to 72 hours is completely normal and expected. The lips are a highly vascular area and respond to injections accordingly. Mild bruising may also occur. The majority of swelling resolves within one to two weeks, revealing your true result.

In the days following treatment, avoid alcohol, strenuous exercise, excessive heat including saunas and steam rooms, hot drinks, and drinking through a straw. Avoid wearing lip liner or lipstick for 24 hours, and do not touch or massage the area unless advised to do so by Dr Karwal.

Arnica tablets or topical arnica cream can help reduce bruising. Staying well hydrated and eating a healthy diet in the days following treatment will also support recovery.