Background: Lip filler enhancement has fast become one of the most popular minimally invasive cosmetic procedures. Motivations for “overtreatment” with lip fillers are poorly understood.

Objectives: The aim of this study was to explore female motivations for and experiences of procedures that achieve an aesthetic of distorted lip anatomy.

Methods: Twenty-four females who had undergone lip filler procedures resulting in strikingly distorted lip anatomy, determined by the Harris classification of filler spread, took part in semistructured interviews about their motivations, experiences,and perceptions related to lip fillers. A qualitative thematic analysis was carried out.

Results: Four major themes are discussed: (1) the normalization of lip fillers, (2) perceptual drift which is mediated by exposure to repetitive images of larger lips on social media, (3) perceived financial and social benefits of larger lips, and (4) the relation between mental health and seeking repeated lip filler procedures.

Conclusions: Motivations for seeking lip fillers vary, but most subjects described social media impacting perceived aesthetic norms. A process of perceptual drift occurs whereby mental schema encoding expectations of “natural” facial anatomy can adapt through repeated exposure to enhanced images. The results can inform aesthetic practitioners and policymakers seeking to understand and support those seeking minimally invasive cosmetic procedures.

This article contains supplemental material located online at www.aestheticsurgeryjournal.com.

David Veale MD, MPhil, FRCPsych, FBPsS, Hon FBABCP

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