Legal Disclaimer

This guide provides general information about cosmetic perioral (“smoker’s lines”) filler for adults aged eighteen years and over and does not replace individual medical advice, diagnosis, or treatment.^{1 9}

Any decision to have perioral filler should follow a consultation with a suitably qualified health practitioner, including discussion of risks, benefits, alternatives, and the option not to proceed.^{2 10}

Perioral filler uses prescription-only medicines regulated under the Health Practitioner Regulation National Law and the Therapeutic Goods Act and related instruments.^{1 3}

This document is written to align with AHPRA advertising guidelines and TGA health-service advertising rules by avoiding medicine names, inducements, testimonials, discounts, or guaranteed claims.^{1 3}

1. Scope of this guide

This guide covers cosmetic use of hyaluronic-acid-based injectable gels and micro-droplet techniques around the mouth to soften vertical perioral lines (“smoker’s lines”) in adults.^{2 7}

It does not cover reconstructive procedures, laser resurfacing, chemical peels, surgery, or any treatment during pregnancy or breastfeeding, which require individualised medical assessment.^{2 9}

The content is neutral patient education about a regulated health service, not promotion of a specific product or clinic, and is consistent with AHPRA and TGA expectations for non-promotional health information.^{1 3}

2. What is perioral line (“smoker’s lines”) filler?

2.1 Plain-language description

Perioral line filler is a cosmetic injectable procedure where very small amounts of hyaluronic acid gel are placed around the lips to soften vertical lines that appear above and below the mouth.^{2 9}

These lines are often caused by repetitive lip movement, sun damage, natural collagen loss, genetics, and in some cases past smoking, although they can occur in non-smokers as well.^{9 10}

Treatment aims to gently support and hydrate the skin so that lines appear less etched and lipstick bleeding is reduced, while keeping the lip border and movement as natural as possible.^{2 9}

2.2 Regulatory context in Australia

Perioral filler uses Schedule 4 prescription-only medicines which must not be advertised to the public by product or brand name and may only be used following lawful prescribing processes.^{1 3}

TGA guidance explains that advertising of health services can describe cosmetic injection services in general terms but must not directly or indirectly promote specific prescription-only injectables, or use coded terms or inducements.^{3 4 12}

AHPRA’s cosmetic-procedure guidelines and related Medical Board documents set expectations for consultation, assessment, consent, psychological screening, and cooling-off periods for non-surgical cosmetic procedures such as perioral filler.^{2 10 11}

2.3 Clinical pearl

If perioral filler is marketed as a “wrinkle delete” or “age-proof lips”, that language is not in line with how Australian regulators expect cosmetic procedures to be described.

3. How does hyaluronic acid filler work in the perioral area?

3.1 Superficial support and hydration

Perioral filler typically uses softer, low-volume hyaluronic acid in micro-droplets or fine threads placed just below the skin surface or slightly deeper where lines are etched.^{2 7}

By adding small amounts of support and drawing water into the area, the filler can help the skin look smoother and more hydrated, which may reduce the appearance of fine vertical lines.^{3 7}

This approach relies on many small, carefully placed injections rather than large boluses, aiming to preserve natural lip function and avoid over-projection.^{2 7}

3.2 Anatomy and technique

The perioral region includes the orbicularis oris muscle (which moves the lips), cutaneous lip, labial arteries and veins, and highly mobile skin.^{7 10}

Because of the movement and vascularity, experienced injectors use low-volume, low-pressure techniques with either fine needles or micro-cannulas to reduce the risk of lumps, vascular compromise, and disrupted lip movement.^{2 10}

Australian cosmetic-procedure guidelines recommend that only trained, registered practitioners perform perioral injections due to the complexity of the area and the importance of maintaining functional mouth movement.^{2 10}

3.3 Clinical pearl

Fine-line improvement relies on many tiny placements and good skin quality; large volumes in this area almost always look unnatural.

4. What results should patients expect?

4.1 Visual changes

Perioral filler can help soften fine vertical lines, reduce lipstick bleed, and smooth the skin around the lips, giving a more hydrated and refined appearance.^{2 9}

The goal is subtle improvement — lines may still be visible, but they are less etched and less likely to catch light or makeup sharply.^{2 9}

4.2 Time course

Visible swelling and small raised areas at injection sites are common immediately after treatment and can make the area look more uneven or bumpy for a few days.^{6 7}

Most patients see a more realistic result after one to two weeks when swelling has settled, and final blending is usually assessed around four weeks.^{7 15}

4.3 Realistic expectations

Perioral filler does not erase lines caused by long-standing sun damage or repeated expression, and it does not stop lips or skin from moving and folding during speech.^{2 9}

Results are best when patients expect softening and improvement, not complete removal of every line.^{2 10}

4.4 Clinical pearl

Some residual lines are normal and necessary so you can still smile, talk, and use your lips without stiffness.

5. How long does perioral filler last?

5.1 Typical duration

Perioral filler is temporary; hyaluronic acid is gradually degraded over time.^{3 7}

Because the area moves frequently with speaking, eating, and facial expression, many patients notice results lasting around six to twelve months.^{8 9}

5.2 Factors influencing longevity

Longevity varies depending on expression habits, smoking status, sun exposure, product choice, injection depth, age, and skin quality.^{2 7}

People with very active mouths or heavy sun exposure may metabolise filler faster and see results fade more quickly.^{7 10}

5.3 Wearing off

As the filler degrades, the added support reduces gradually, and the skin returns toward its previous texture over months rather than days.^{3 7}

Correctly performed perioral filler has not been shown to worsen the natural ageing process once it wears off.^{9 10}

5.4 Clinical pearl

Think of perioral filler as part of ongoing maintenance, alongside sun protection and skincare — not as a one-off “permanent fix”.

6. Is perioral filler painful?

6.1 Sensation during treatment

The skin around the mouth is sensitive, and injections can cause stinging, pressure, or a pinprick sensation.^{7 10}

Many patients describe the procedure as mildly to moderately uncomfortable, but tolerable with appropriate numbing measures.^{7 10}

6.2 Comfort strategies

Clinics typically use topical anaesthetic creams, cool packs, distraction techniques, and fillers containing local anaesthetic to improve comfort.^{3 4}

Additional local anaesthetic methods may be considered based on practitioner scope and patient needs.^{2 10}

6.3 Tenderness after treatment

Tenderness, tightness, or a sore feeling around the mouth corners and upper lip is common for a few days after injections.^{6 7}

These symptoms usually settle with time and can often be managed with simple measures such as cool compresses and appropriate analgesia if recommended by the practitioner.^{7 15}

6.4 Clinical pearl

If pain feels sharp, worsening, or is accompanied by colour changes, you should contact the clinic urgently.

7. What are the risks and side effects of perioral filler?

7.1 Expected short-term effects

Short-term effects such as swelling, bruising, mild redness, or small raised injection sites are common and usually improve within several days.^{6 7}

Early lumpiness or unevenness is often due to swelling and normally softens as the area heals.^{7 15}

7.2 Less common issues

Less common issues include persistent nodules, irregular texture, or prolonged swelling that may require review and sometimes adjustment.^{2 7}

Management may include observation, gentle massage instructions, or dissolving focal areas of filler when appropriate.^{3 13}

7.3 Serious but rare complications

Rare but serious complications include vascular compromise, infection, or significant interference with lip function if filler is placed too deeply or in incorrect planes.^{3 10}

Clinics must have emergency protocols, access to hyaluronidase, and comply with NSW Health infection-control and skin-penetration standards, including appropriate cleaning and sterile technique.^{2 5 6}

7.4 Clinical pearl

Because perioral lines sit near vessels and mobile muscles, conservative treatment by an experienced, medically led provider is critical.

8. Who is a suitable candidate for perioral filler?

8.1 Potentially suitable adults

Perioral filler may be considered for adults bothered by vertical lines around the mouth, lipstick bleed, or a crêpey perioral texture who seek modest smoothing.^{2 9}

Ideal candidates have realistic expectations, good overall oral health, and an understanding that filler is one part of a broader anti-ageing strategy.^{2 10}

8.2 When treatment may be delayed or avoided

Treatment may be unsuitable in people with active infections, severe dermatitis or cold sores around the mouth, uncontrolled systemic illness, or during pregnancy or breastfeeding.^{2 9}

Extensive sun damage, heavy smoking, or severe skin laxity may limit improvement from filler alone, and alternative or combination treatments may be more appropriate.^{2 10}

8.3 Psychological and ethical considerations

Australian cosmetic guidelines highlight the importance of psychological screening, realistic expectations, and voluntary consent for all cosmetic procedures.^{2 10}

Practitioners should decline or defer treatment if a patient is seeking perfection, has significant body image concerns, or is under strong external pressure to change their appearance.^{9 10}

8.4 Clinical pearl

Patients who view perioral filler as a small improvement — not a cure for ageing — are more likely to have results that align with their expectations.

9. What is recovery like and what aftercare is recommended?

9.1 Early recovery (first 72 hours)

Most people resume light activities quickly, but swelling, small lumps, and bruising around the upper and lower lip are common in the first few days.^{6 7}

The area may appear uneven when moving or speaking, which usually improves as swelling and bruising resolve.^{7 15}

9.2 First 2–4 weeks

Within one to two weeks, swelling generally settles, and the filler begins to soften, resulting in a smoother perioral area.^{7 8}

By approximately four weeks, results are usually stable enough to review contour, symmetry, and patient satisfaction, and to plan any further treatment if indicated.^{7 15}

9.3 Typical aftercare advice

Aftercare advice commonly includes avoiding strenuous exercise, saunas, steam rooms, hot yoga, and significant alcohol intake for at least 24–48 hours to minimise swelling and bruising.^{3 14}

Patients are usually advised not to undergo strong facial massages, peels, or laser treatments around the perioral area for at least two weeks, and to avoid pressing or picking at injection sites.^{5 6}

9.4 Clinical pearl

Healing can look uneven in the first one to two weeks — allow the full four weeks before deciding whether you like the result.

10. Common myths and misconceptions about perioral filler

“Perioral filler removes all smoker’s lines forever.”

Even with filler, movement-related lines and sun damage will still show; the aim is softening, not erasing.^{2 9}

“Only smokers get smoker’s lines.”

Non-smokers can develop vertical lip lines from sun exposure, genetics, and repetitive movement.^{9 10}

“More filler around the mouth always looks better.”

Large volumes can make the area look stiff or overdone; multiple tiny injections with conservative volume are usually safer and more natural.^{2 7}

“Perioral filler is the same as lip filler.”

Although both use hyaluronic acid, the technique, depth, and goals for perioral lines differ from volumising the lips themselves.^{2 10}

10.1 Clinical pearl

Filler is one tool for perioral ageing — lifestyle, sun protection, and skincare remain essential.

Sources

1. Ahpra (2024), Guidelines for advertising a regulated health service (Advertising hub — guidance document), Australian Health Practitioner Regulation Agency. (Viewed 2025), https://www.ahpra.gov.au/Resources/Advertising-hub/Advertising-guidelines-and-other-guidance/Advertising-guidelines.aspx ↩
2. Medical Board of Australia & Ahpra (2023), Guidelines for medical practitioners who perform cosmetic surgery and procedures (cosmetic surgery and procedures guidelines), Medical Board of Australia. (Viewed 2025), https://www.medicalboard.gov.au/Codes-Guidelines-Policies/Cosmetic-medical-and-surgical-procedures-guidelines.aspx ↩
3. Therapeutic Goods Administration (2025), Advertising health services & cosmetic injections: Frequently asked questions and answers (specialised advertising issues and topics), Australian Government Department of Health and Aged Care. (Viewed 2025), https://www.tga.gov.au/products/regulations-all-products/advertising/specialised-advertising-issues-and-topics/advertising-health-services-and-cosmetic-injections-frequently-asked-questions-and-answers ↩
4. Therapeutic Goods Administration (2024), Advertising a health service (online guidance on advertising health services involving therapeutic goods, including cosmetic injectables), Australian Government Department of Health and Aged Care. (Viewed 2025), https://www.tga.gov.au/resources/guidance/advertising-health-service ↩
5. NSW Health (2025), Beauty, body art and skin penetration industries (fact sheet — Public Health Act 2010 and Public Health Regulation 2022), NSW Government. (Viewed 2025), https://www.health.nsw.gov.au/environment/factsheets/Pages/beauty-treatment.aspx ↩
6. NSW Health (2023–2025), Skin penetration — information and resources (overview and infection-control requirements for skin penetration procedures), NSW Government. (Viewed 2025), https://www.health.nsw.gov.au/environment/skinpenetration/Pages/default.aspx ↩
7. Australian Commission on Safety and Quality in Health Care (ACSQHC) (2021), National Safety and Quality Health Service (NSQHS) Standards, 2nd ed. — Clinical Governance Standard, ACSQHC, Sydney. (Viewed 2025), https://www.safetyandquality.gov.au/standards/nsqhs-standards ↩
8. Australian Commission on Safety and Quality in Health Care (ACSQHC) (2017–2023), NSQHS Standards — Partnering with Consumers Standard: overview and fact sheets, ACSQHC, Sydney. (Viewed 2025), https://www.safetyandquality.gov.au/standards/nsqhs-standards/partnering-consumers-standard ↩
9. RACGP 2022, Submission to Medical Board consultation – Regulation of medical practitioners who provide cosmetic medical and surgical procedures, Royal Australian College of General Practitioners. (Viewed 2025), https://www.racgp.org.au/advocacy/reports-and-submissions/view-all-reports-and-submissions/2022-reports-and-submissions/submission-to-medical-board-consultation-regulatio ↩
10. Medical Board of Australia (2023), FAQs – New standard and guidelines for cosmetic surgery and procedures, Medical Board of Australia. (Viewed 2025), https://www.medicalboard.gov.au/Codes-Guidelines-Policies/FAQ/FAQ-New-standard-and-guidelines-for-cosmetic-surgery-and-procedures.aspx ↩
11. Ahpra (2023–2025), Cosmetic procedure advertising requirements (cosmetic advertising topic pages), Australian Health Practitioner Regulation Agency. (Viewed 2025), https://www.ahpra.gov.au/Resources/Cosmetic-surgery-hub/Cosmetic-procedure-advertising-guidelines.aspx ↩
12. Therapeutic Goods Administration (TGA) (2024), Health service advertising and cosmetic injectables — key messages for advertisers (topic guidance), Australian Government Department of Health and Aged Care. (Viewed 2025), https://www.tga.gov.au/products/regulations-all-products/advertising/specialised-advertising-issues-and-topics/advertising-health-services-and-cosmetic-injections-frequently-asked-questions-and-answers ↩