Peri-Oral Lines (Lip Flip) Anti-Wrinkle Injection Policy

Published:

November 4, 2025

1. Purpose

Provide a safe, evidence-based framework for administering botulinum toxin type A (BoNT-A) to the orbicularis oris for softening peri-oral lines and subtle upper-lip eversion ('lip flip'), in accordance with Australian cosmetic-medicine governance and international consensus. ¹

2. Scope

Applies to AHPRA-registered practitioners performing or supervising anti-wrinkle injections to the peri-oral region, specifically the orbicularis oris muscle, to treat dynamic vertical lip lines or enhance lip eversion. ¹

3. Governance (Australia)

Requires a face-to-face prescriber consultation, compliance with TGA restrictions on prescription medicine advertising, and full clinical documentation consistent with NSQHS medication-safety standards. ¹

4. Regional Anatomy & Injection Mapping

The orbicularis oris forms a circular sphincter around the mouth. Consensus technique: 4–6 injection points to the upper and/or lower lip border (approximately 1–2 U per site), placed superficially at the vermilion border to relax dynamic movement without impairing oral competence. ⁴

5. Dosing (Guideline Based)

Typical total dose: 4–8 U for the upper lip (optional 2–4 U lower lip). Adjust dosing by muscle strength, lip thickness, and patient goals. Follow accepted international dosing guidance and Australian regulatory standards. ⁵

6. Contraindications

Defer treatment in pregnancy, breastfeeding, local infection, or significant neuromuscular disorders. Review medical history, allergy status, and medications before injection. ²

7. Informed Consent & Risks

Discuss expected results (gentle lip eversion, not augmentation), risk of temporary speech difficulty, drooling, or smile asymmetry if over-treated, and the need for repeat dosing every 3–4 months. ¹

8. Post-Treatment Care

Avoid touching or massaging lips for 24 h, and avoid strenuous exercise or heat for 24–48 h. Reassess after 2 weeks to evaluate symmetry and functional movement. ²

9. Adverse Events & Management

Over-relaxation may cause mild difficulty in puckering or pronouncing certain sounds — usually transient. Bruising or swelling is self-limiting; apply cold compress and reassure patient. ⁶

10. Documentation & Audit

Record prescriber, injector, product, batch, expiry, total dose, injection sites, consent, and outcome photos. Maintain annual audits and at least 20 hours CPD in cosmetic injectables. ³

Sources

AHPRA 2025, Guidelines for Cosmetic Medical and Surgical Procedures, Canberra., viewed 04 November 2025, https://www.medicalboard.gov.au ↩
Queensland Health 2024, Beginner’s Guide to Cosmetic Injectables, Brisbane., viewed 04 November 2025, https://www.health.qld.gov.au ↩
Australian Commission on Safety and Quality in Health Care (ACSQHC) 2023, NSQHS Standards – Medication Safety, Sydney., viewed 04 November 2025, https://www.safetyandquality.gov.au ↩
American Society for Dermatologic Surgery (ASDS) 2022, Resident Training Guide: Dose, Dilution and Injection Technique for Botulinum Toxin Type A in Cosmetic Practice, ASDS Education Series., viewed 04 November 2025, https://www.asds.net ↩
AbbVie Medical Information 2024, Highlights of Prescribing Information – Botulinum Toxin Type A for Cosmetic Use (Facial Lines and Peri-Oral Regions), US Label Reference., viewed 04 November 2025, https://www.abbvie.com ↩
The Lip Flip Technique: J Drugs Dermatol. 2022;21(1):71–76. doi:10.36849/JDD.6344R1., The Lip Flip Technique: J Drugs Dermatol. 2022;21(1):71–76. doi:10.36849/JDD.6344R1., viewed 04 November 2025, https://jddonline.com/articles/the-lip-flip-for-beautification-and-rejuvenation-of-the-lips-S1545961622P0071X ↩

Disclaimer for Newcastle Cosmetic Doctor Policies & Procedures

The policies and procedures contained within this document are the exclusive property of Newcastle Cosmetic Doctor and are provided for internal clinical governance and educational purposes only. These materials represent the internal operational framework, safety standards, and evidence-based protocols developed and implemented by Dr. Bart John Scanlon and the Newcastle Cosmetic Doctor team. They are designed specifically for use within Newcastle Cosmetic Doctor and reflect our clinic’s own professional standards, risk assessments, and compliance obligations under Australian law and regulatory authorities. External individuals, practitioners, or organisations must not copy, reproduce, distribute, or rely upon these materials, in whole or in part, for their own clinical, commercial, or educational use without prior written consent from Newcastle Cosmetic Doctor. These materials do not constitute medical, legal, or professional advice and are not intended to be adopted as official protocols or procedures by any other entity. Any external use or adaptation must be independently reviewed and modified to meet the relevant laws, guidelines, and standards applicable to the user’s own jurisdiction, scope of practice, and facility operations. Newcastle Cosmetic Doctor and Dr. Bart Scanlon accept no liability for any loss, injury, or damage arising from the unauthorised use, reliance upon, or misinterpretation of this material.