Lip filler swelling: what is normal

The lip is mobile tissue with a generous blood supply and very little to hold fluid in place. Any injection causes a small inflammatory response, and in the lip that response has room to spread.

Some of the early swelling is also the product itself drawing in water — hyaluronic acid is hydrophilic by design, which is part of how it works. That component settles over the first week or two as the product integrates.

Day one: significant swelling, frequently uneven. Lips can look considerably larger than what you asked for, and it is normal to feel alarmed.

Day two: often the peak, and usually the worst it will look. Many people describe day two as worse than day one.

Days three to four: swelling drops noticeably and the shape starts to emerge.

Day seven: close to the final result.

Day fourteen: settled. This is the point at which the result should be judged, and when we review together.

Very common, and usually a reflection of uneven swelling rather than uneven placement. One side often swells more than the other for no reason anyone can identify.

It is genuinely not possible to assess symmetry properly until things have settled, which is why I will not adjust anything before two weeks even if you ask me to. Adjusting a swollen lip means adjusting to a shape that will not exist in a fortnight.

A cool compress in the first 24 hours, applied gently and not pressed. Sleeping with your head slightly elevated on the first night. Staying hydrated.

Avoiding alcohol, strenuous exercise, saunas, steam rooms and very hot drinks for the first day or two — all of them increase blood flow to the area.

Antihistamines help some people, as a proportion of early swelling is histamine-driven. Arnica is popular; the evidence is weak but it is harmless. Check with me before taking anything alongside other medication.

Avoid anti-inflammatory painkillers like ibuprofen in the first 24 hours if you can, as they can increase bruising.

The single most useful rule: swelling improves. If yours is getting worse after day two, that is not the normal course.

Ring me straight away for severe or increasing pain rather than settling pain, blanching or white patches on or around the lips, skin turning dusky, blue or mottled, or pain out of proportion to how things look. Those can indicate a vascular occlusion, which is rare, is an emergency, and is very treatable when caught early.

Also ring for fever, spreading redness or discharge, which suggest infection, or for a cold sore developing.

I would far rather see you and find nothing than have you wait it out overnight because you did not want to make a fuss.

Do not book lip filler within two weeks of a wedding, holiday, photograph or significant event. Three weeks is more comfortable.

If you have never had it before, consider booking when you have a couple of quiet days afterwards. Not because you cannot function — you can — but because looking in the mirror on day two is easier without an audience.