Lip Treatment: Top Lip or Bottom Lip First?

The decision about which lip to treat first, or whether to treat both lips simultaneously, is one of the more anatomy specific aspects of lip treatment assessment. At Core Aesthetics in Oakleigh, Corey Anderson, AHPRA registered nurse, makes this decision based on individual assessment of the lip anatomy, proportion and presenting concern rather than a default approach.

How Lip Proportion Works

Natural lip proportion varies significantly between individuals, but a common reference point places the lower lip as approximately one and a half times the projected volume of the upper. This ratio is not a target that every client should achieve through treatment, it is a reference that helps contextualise what “proportionate” means for the specific anatomy.

“Good information changes the quality of the decision.”

The relationship between the upper and lower lip in the context of the full face matters as much as the lips in isolation. The philtrum length, the Cupid’s bow shape, the width of the lips relative to the facial width and the relationship between the lips and the chin all affect what proportion looks natural for the individual face.

Upper Lip First: When and Why

The upper lip is the more frequently treated of the two, and for many clients it is the more relevant starting point. The upper lip tends to thin more visibly with age, losing both definition at the border and volume in the body of the lip. In clients where the upper to lower ratio has become disproportionate because the upper has reduced in volume, addressing the upper lip alone may be the most appropriate first step.

Upper lip treatment can address border definition, Cupid’s bow shape, lip column symmetry, the peak and curve of the upper lip border and subtle volume in the upper lip body. The upper lip is more technically complex than the lower because of the philtrum columns and the Cupid’s bow, which require more precise attention during assessment and treatment.

Lower Lip First: When and Why

Lower lip treatment alone may be appropriate where the lower lip is disproportionately thin relative to the upper, where the lower lip lacks projection in profile, or where the specific concern is the overall fullness of the lower lip rather than the border definition of the upper. In some clients, the upper lip is adequately full and the concern is specifically with the lower.

Treating Both Lips Simultaneously

For clients where the presenting concern is the overall volume, shape or proportion of the lips as a unit rather than a specific concern with one lip over the other, a small conservative addition to both lips on the same appointment may be the most appropriate approach. This allows a proportionate improvement across both lips while maintaining the overall lip to face balance.

The total volume placed remains conservative regardless of whether one or both lips are treated. The principle at Core Aesthetics is always to start conservatively and assess the settled result at a two week review before adding further treatment. Read more about lip treatment at Core Aestheticswhether lip treatment is worth it and lip treatment aftercare.

General Information Only. This article is general in nature and does not replace a consultation with a qualified health practitioner. Treatment outcomes, suitability and risks vary by individual. Any medical or prescription treatment options can only be discussed and provided where clinically appropriate following an individual assessment.

Safety, Suitability and Clinical Assessment

All aesthetic treatment procedures carry risk. The suitability assessment at consultation identifies any contraindications or relative risk factors specific to your circumstances, including medical history, current medications, previous procedures, and anatomical features that may affect the risk profile for a given treatment area. This information is reviewed before any treatment is planned.

For certain conditions and medications, injectable treatments are not appropriate, or require modification of technique or timing. For others, the treating practitioner may recommend that you consult with your primary healthcare provider before proceeding. These are clinical judgements that can only be made with accurate, complete medical history information, which is why the consultation history taking process is thorough.

Complication recognition and initial management are part of the clinical competency required of practitioners performing injectable treatments under AHPRA’s September 2025 guidelines for nonsurgical cosmetic procedures. The practitioner at Core Aesthetics holds current training in this area and maintains the relevant management supplies on site. Understanding that risk exists and is actively managed is more useful than assuming risk does not exist.

Review Appointments and Ongoing Care

A review appointment at four to six weeks is a standard part of every treatment cycle at Core Aesthetics. The review is not contingent on whether you have concerns, it is a clinical standard that applies to every patient. At review, the practitioner assesses the result across all treated areas, compares the outcome to the pretreatment clinical photographs, identifies any asymmetry or variation in response between sides, and determines whether any adjustment is appropriate within the same treatment cycle.

The review is also where longitudinal data about how your specific anatomy responds to treatment is recorded. Over multiple treatment cycles, this accumulated data allows the practitioner to refine the dosing and approach to better match your individual response pattern, which is one of the most significant advantages of maintaining a consistent treating practitioner rather than moving between clinics.

If you have any concerns in the period between your treatment and your review appointment, contact the clinic directly. The practitioner who treated you has the clinical context to respond accurately to any post treatment question, which is preferable to relying on general online information that may not reflect your specific situation.

What the Assessment Covers

The assessment at the consultation appointment is a face wide evaluation, not a focused review of only the area you have identified as a concern. This full face approach is deliberate: anatomical features interact with each other, and addressing one area in isolation, without understanding the broader facial context, can produce results that look disproportionate even when the individual area was technically treated well.

The practitioner evaluates facial symmetry, bone structure, soft tissue distribution, skin quality, and the dynamic movement patterns associated with each treatment area. The history taking covers your current medications, any previous injectable or surgical procedures, relevant health conditions, and any prior reactions or complications. From this assessment, the practitioner develops a treatment plan that reflects your specific anatomy and circumstances.

Results vary between individuals. What the assessment finds in one patient may be different from what it finds in another patient with a similar presenting concern, which is why templated treatment protocols are not used here. All treatments at Core Aesthetics are consultation based and individually assessed.

How Facial volume treatment Is Used as a Structural Tool

Facial volume treatment is often described in terms of volume, adding more to make something look bigger. This framing misrepresents how volume treatment functions in skilled clinical practice. Volume treatment is a structural tool. It can restore lost support in areas where facial volume has diminished with age. It can define a contour that was never clearly pronounced. And in some cases it can shift the proportional relationships between facial regions in a way that changes how the face reads overall.

Volume, in the sense of visible fullness, is sometimes a goal. But the mechanism is anatomical. Volume treatment placed in the right tissue plane, at the right depth, with an understanding of the surrounding anatomy, produces a different result than volume treatment placed superficially to fill a surface irregularity. This is why technique, placement, and clinical knowledge matter far more than product selection.

At Core Aesthetics, treatment decisions are based on a full facial assessment. Corey evaluates the face as a whole before deciding whether volume treatment is appropriate, where it would be most effective, and what volume would be consistent with a proportionate outcome. This assessment may lead to a recommendation not to treat, and that outcome is equally valid.

Understanding Facial Volume Loss and Why It Matters

The face changes with age through a combination of processes: bone resorption, fat pad redistribution, muscle changes, ligament laxity, and skin quality decline. These processes do not happen uniformly or at the same rate in different people. Two people of the same age may present very differently because of genetics, lifestyle, sun exposure, and individual anatomical variation.

Volume loss is one of the most clinically significant contributors to an aged appearance. When the structural support provided by subcutaneous fat and bone diminishes, the overlying skin is no longer held in place by the same framework. Features that once appeared well defined become less distinct. The relationship between facial thirds can shift. Hollowing in specific areas, the cheeks, the temples, the under eye region, creates shadows and contours that are often interpreted as tiredness or loss of vitality.

Understanding the underlying anatomy is essential to treating it appropriately. Volume treatment placed to address a surface concern without accounting for the structural deficit beneath it will produce a less effective and less enduring result. The consultation process at Core Aesthetics focuses on identifying the anatomical contributors to the concerns you have raised, not just addressing the surface appearance.

The Assessment Process Before Any Volume treatment

At Core Aesthetics, the consultation for facial volume treatment is a structured clinical appointment, not a sales conversation. Corey assesses the face in three dimensions, at rest, during movement, and from multiple angles. The goal is to understand the structural landscape of your face before deciding where, how much, and whether volume treatment is the right approach.

Key aspects of the volume treatment assessment include evaluating facial symmetry and identifying natural asymmetries that should be preserved or addressed; assessing the depth and distribution of any volume deficit; reviewing skin quality to determine how volume treatment would integrate; and discussing your goals in the context of what is anatomically achievable. For some concerns, volume treatment alone is sufficient. For others, a combination of treatments, or a different approach entirely, may be more appropriate.

You will leave the consultation with a written treatment plan that documents the assessment findings, the proposed approach, and the expected outcomes. Treatment is scheduled at a separate appointment, allowing time to consider the plan, ask further questions, and make an informed decision without any time pressure.

Dissolution, Complications, and Revision

Hyaluronic acid volume treatments are reversible. If a complication arises, if the result is unsatisfactory, or if a patient wishes to return to their baseline, hyaluronidase enzyme can be injected to dissolve the volume treatment. This is an important safety feature that distinguishes hyaluronic acid products from permanent or semi permanent volume treatments, which cannot be dissolved.

Dissolution does not always produce an immediate return to the pretreatment state. The process requires time, and in some cases more than one dissolution treatment. Swelling from the dissolution procedure can temporarily alter appearance. Corey will explain this clearly at consultation so that patients understand what reversal involves before they commit to treatment.

At Core Aesthetics, only hyaluronic acid formulations are used for facial volume treatment, the reversibility of these products is a deliberate clinical choice. Emergency protocols for vascular occlusion, the most serious potential complication of volume treatment, are maintained at the clinic. Patients are briefed on the signs of this complication and given emergency contact instructions as part of every treatment appointment.