Considering lip fillers? Here's what you need to know.

Gianna Palumbo always felt like her lips were too small for her face. When she saw photos of women with lip fillers on social media, she decided to have the injections done herself at the age of 20.

Ms. Palumbo, now 22, said people often compliment her lips — and when she thanks them, she also tells them where she had it done.

“I want to normalize it because wanting to improve something about your body is not a bad thing,” says Ms. Palumbo, who lives in Buffalo, New York.

Lip fillers, which inject hyaluronic acid to plump lips, have become more popular among younger patients like Ms. Palumbo. In a report of According to the American Academy of Facial Plastic and Reconstructive Surgery, nearly 75 percent of plastic surgeons surveyed said more and more people under 30 are requesting injectables such as lip fillers and other cosmetic procedures.

Some providers said they regularly see patients making specific requests based on images they've seen online, including from influencers who sometimes use photo or video filters to magnify their features. Celebrities like Kylie Jenner have also sparked interest in lip fillers in recent years.

“People get their education on social media,” says Dr. Ashley Amalfi, a Rochester plastic surgeon and chair of the American Society of Plastic Surgeons' social media subcommittee. To combat misinformation and provide context, she and her practice post on Instagram and TikTok about fillers and other procedures, and encourages other surgeons to do the same.

If you're thinking about getting lip filler, here's what medical professionals want you to know.

Choose your provider wisely and ask for advice.

Start with a consultation to share your goals and concerns and discover what a healthcare provider can do in a safe and natural-looking way.

Look for a board-certified one plastic surgeon or facial plastic surgeona dermatologist or a medical professional who works directly under their supervision, experts said.

“If you go to a doctor's office, chances are they are well trained and use good products,” says Dr. Theda Kontis, a facial plastic surgeon in Baltimore and former president of the American Academy of Facial Plastic and Reconstructive. Surgery. “When you go to a hotel room or a spa, you don't know what they're using,” or whether a trained medical professional is readily available if needed.

Think about what you want and why.

Providers said patients should avoid getting fillers that mimic the beauty standards they see on social media because they may not be safe, feasible or natural-looking for their faces.

Dr. Amalfi said she always starts conservatively, with just one syringe of filler, or even half a syringe, with the option of adding more later. She does this to create a natural effect and ensure that patients feel comfortable with the change. She and other experts emphasized making sure patients really want to benefit from fillers and have realistic expectations about results.

For example, suppose a patient feels that her lips are not symmetrical. “If I see that and I agree with their assessment, and I believe I can make them happy, then I will do it,” said Dr. Kontis. But if they have very thin lips and want to look like Angelina Jolie, she said, “That's just not going to happen.”

Know what to expect.

During the procedure, a healthcare provider will apply a numbing cream and then give several injections of hyaluronic acid to shape the lip. Even with anesthesia, the procedure can be painful, said Dr. Kontis. Sometimes doctors also give anesthetic injections into the mouth, like a dentist does.

Afterwards, your lips may be swollen and bruised; an ice pack can help reduce these symptoms. It takes about two weeks for the filler to settle.

If you don't like the results, a provider can dissolve the filler with another injection. Otherwise, your lips should return to their normal size in about six to twelve months. If you've been getting fillers for years, Dr. Kontis, your body will build collagen in response, potentially increasing the “normal size” of your lips.

Research the health risks.

The biggest risk of the procedure is that the injector accidentally hits a blood vessel. This can lead to loss of blood supply to that area and tissue death. “In experienced hands this is not likely to happen,” said Dr. Kontis.

Doctors do not recommend fillers for patients who are pregnant or breastfeeding, anyone with open sores such as acne or burns, and patients who have had allergic reactions to filler products.

In addition, people with a history of cold sores or cold sores may need an antiviral medication after the procedure, as the injections can cause flare-ups, said Dr. Kontis.

Some beauty companies and social media users have taken to advertising hyaluronic 'pens' – which push hyaluronic acid into the skin under high pressure – as needle-free alternatives to injections. But the The Food and Drug Administration has warned about this use of these unregulated products, noting that they can cause infections, scarring and other serious complications.