The standard of care is to avoid using Radiesse in the lips because of the possibility of nodule (lump) formation. To be clear, the lips refer here to the red-colored lips, referred to as the vermillion lip. An off-label use of Radiesse is the use in the cutaneous, or skin-colored lip, above the red lip and under thenose, used in a horizontal fashion in sparing amounts. A concern though is migration via movement of muscle during speech, smiling and eating, that might force the product down and into the vermillion lip. The nodules reported in the literature, seem to be in the vermillion of the lip when the red lip was injected to augment its volume or in the vermillion border to create definition and minimize the bleeding of lipstick into these vertical wrinkles. More study needs to be done to follow the consequences of this cutaneous lip augmentation. I do not recommend it unless there is thorough discussion between you and your doctor and you understand the risks. For now, the unequivocal treatment of choice for lip augmentation is the hyaluronic acids such as Juvederm or Restylane.
