Lip flip: Botox for the upper lip, what the label and the studies say

A lip flip uses botulinum toxin in the muscle around the mouth to turn the upper lip out slightly. It isn't a use on the Botox Cosmetic label.⁴

Here is what the studies we found say, what can go wrong and what to ask. It gives no dose and no injection plan. Whether to have it is for you and a clinician.

What it is

The lip flip is an injection of botulinum toxin into the muscle that circles the mouth, the orbicularis oris. It gives lip contour and fullness without adding volume.¹ That is the difference from lip filler, which adds volume. A 2026 study of 17 women found the lip flip lifted the upper lip through selective muscle relaxation, not through added volume.² Our lip filler page covers the other approach.

What the label says

The Botox Cosmetic label lists four uses in adults: glabellar lines, lateral canthal lines, forehead lines and platysma bands. The lips aren't among them, and the labels of the four other cosmetic brands don't list them either.⁴ A 2021 article from a surgical practice calls the lip flip one of the off-label uses of botulinum toxin that has expanded in recent years. The same article noted that little had been published on it.³ The plastic surgeons' society lists lip lines among the areas treated with botulinum toxin.⁵

What the studies say

A 2025 systematic review identified 48 articles and found seven that met its criteria. It reports consistent upper lip eversion and improved contour, with high patient satisfaction and minimal downtime.¹

A 2026 prospective study followed 17 women. It found a modest but significant increase in upper lip height at 15 days, and no change in lip volume. Patients reported high satisfaction.² The journal assigns it evidence level IV.²

Side effects

The review describes mild and transient side effects, such as difficulty whistling or drinking through a straw, that resolved within weeks.¹ In the 17-woman study, all adverse events were mild and transient, including temporary numbness and functional limitation, and resolved by themselves within 30 days.²

Every botulinum toxin label also carries a boxed warning. The effects can spread from the injection site and cause symptoms such as weakness, double vision, and trouble swallowing or breathing, reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening.⁴

The sources we read don't give how long a lip flip lasts, and we don't give a figure. Ask your provider what they expect.

Which licensed professionals may inject depends on your state. See our guide to choosing a Botox provider.

Here is what to bring to a consultation.

Cost

We don't give prices on this page. Our Botox cost guide covers how clinics quote per unit.

Common questions