Lip filler

What is the controversy behind Butterfly Lips?

27 June 2024


Russian Lips. Image credit.


First it was the style of Russian Lips that were trending for lip augmentation. Now “Keyhole Lips” and “Butterfly Lips” are making their rounds on the internet; with celebrities and influencers such as Katy Price and Lauren Goodger showcasing their plumped up lips with surgical tapes.


The overtly plumped lips with steri-strips make for interesting content for TikTok and Instagram- but “Butterfly Lips” are gaining attention among medical practitioners for entirely different reasons. Some doctors are calling out on “Butterfly Lips” as being more unsafe than traditional lip fillers injections, which are already inherently risky treatments. Here’s the lowdown on the evolution of lip filler trends; and all you need to know about “Keyhole Lips” and the controversy behind this lip filling treatment.


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Lip Care: Do’s and Don’ts for Healthy Lips



Lauren Goodger sharing her butterfly lips treatment and lip taping. 




Butterfly Lips:

Butterfly lips, also known as “butterfly kisses,” involve a lip augmentation technique for achieving a fuller and plumper pout, particularly in the centre of the upper and lower lips. Lip fillers are injected into the lips in a vertical manner to increase the height and projection of the lips, akin to the wings of a butterfly.


Surgical tapes or steri-strips are placed on the lips and around the mouth; to evert the lips and supposedly, reduce the migration of lip fillers.


In scenarios where the patient has already had lip fillers; the pre-existing lip fillers are first broken down by the injection of an enzyme called hyaluronidase. Also known as hyalase, this enzyme melts away any remaining dermal fillers in the lips. Injection of the lip fillers to create the butterfly look follows next.


Related blogpost:

How to Dissolve & Remove Fillers with Hyaluronidase


Kylie Jenner spotting the Keyhole pout/ Keyhole lips


Keyhole lips

Keyhole lips Not to be confused with butterfly lips, is a different look from lip fillers known as keyhole lips. Keyhole lips were popular for a while, before butterfly lips started trending.


For keyhole lips, the lip augmentation technique creates a small indentation or “keyhole” in the center of the upper lip. This shape resembles an inverted letter “V”, with the edges of the lips remaining fuller, framing a thinner center. This look created by keyhole lips augmentation technique causes a larger pout.


Lip filler moustache happens when dermal fillers migrate out of the lips.



Lip filler injections are not to be taken lightly; as it is a procedure that is fraught with risks. Some of the risks include prolonged swelling, bruising, overfilled lips (sometimes called fish lips or trout pout), lip filler migration (aka filler moustache). The more worrying complications of lip fillers are necrosis, angioedema, granuloma and reactivation of Herpes infections.



Lip augmentation with lip fillers may have gained traction in decades with celebrities such as Kylie Jenner who have made overtly plumped lips mainstream. But achieving butterfly lips through lip filler injections is particularly controversial for these reasons:



Lip taping does not prevent filler migration

The steps involved in augmentation with lip fillers to create the butterfly lip look create the impression that this technique is safer- steri-strips or surgical tapes to evert the lips. According to practitioners hold the lip filler in place to prevent filler migration, presumably by creating a physical barrier. This view is misleading.


The risk of migration of lip fillers is dependent on the amount of and type of fillers used; as well as injection depth and technique. Patient factors such as activities that add pressure on the lips can increase this risk of migration of lip fillers from their original placement. This practice of lip taping for butterfly lips however, is not backed by evidence. Understanding of lip anatomy will also prove contrary- that lip taping does not reduce the risk of lip filler migration.


Image of lip necrosis due to botched lip filler injection; image credit BBC


Safety concerns and side effects of lip taping

One of the milder side effects of lip taping to evert the lips is the dryness of the oral mucosa. Patients who reactively lick their lips to moisten this mucosa could worsen this dryness and irritation due to presence of enzymes in saliva. More lip care tips for healthy lips in this post.


Secondly, lip tapes placed tightly can cause pressure sores. This along with the irritation of the lips due to the eversion caused by the lip tapes; can mask signs of complications as patients may attribute the pain, discomfort and discoloration of lip necrosis to the lip taping.


Unrealistic facial proportions and beauty standards

Butterfly lips and keyhole lips are an exaggeration of the natural appearance of the lips. Achieving this visual requires injecting lip fillers to the point of overfilling the lips. There may be fans of this aesthetic, but your doctor here does not approve of unnatural, exaggerated and overfilled faces.



The duration of lip fillers will differ on the type of dermal fillers used. Most lip fillers should last for 9-12 months.


Kylie Jenner’s transformation; and her very striking lip enhancement.



Other non-surgical alternatives to lip augmentation include:

• Botox Lip Flip

In the Botox Lip Flip, botulinum toxin is injected into the muscles around the mouth (orbicularis oris muscles) to relax the muscle and flips the corners of the lip upwards. The lip flip gives the illusion of slightly fuller lips without actually adding volume into the lip. The results with the Botox Lip Flip are also more subtle than lip fillers. You can learn about other interesting uses of Botox in Not Just for Wrinkles: 5 Surprising Uses for Botox.


• Lip Plumpers

Lip plumpers are products that contain ingredients that increase blood flow to the lips. This increase in blood flow causes a temporary swelling of the lips to make them look fuller. These ingredients may include menthol, pepper and ginger extracts and so these lip plumpers may have a slightly stingy and irritating feel to the lips. This means that one of the side effects of using these lip plumpers is a red and sore lip for some users who have sensitive lips.


Conclusion on Butterfly Lips, Keyhole lips and lip taping

Butterfly lip and keyhole lips may be the flavour of the month when it comes to lip augmentation; but the practice of lip taping in these treatments remains controversial. Lip taping does not reduce the risks of lip fillers; and may instead delay the notice of the complications with lip filler injections



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