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Steven J. Pearlman, MD, FACS Dual Board Certified in Facial Plastic Surgery

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Beautiful lips with Restylane and Juvederm filler in New York

Beautiful Lips: Bigger is not better, it’s all about shape – the Cupid’s Bow 

New York, NY. I have been fortunate to be featured in the media for two of the most expressive features on the face over the past 2 weeks: lips and eyebrows. This week I will discuss what makes lips beautiful and what doesn’t. On May 4th, Hollywood Life revealed Megan Fox’s new lips. Way overdone, as are a number of other celebrities. While some may look good, most unfortunately don’t; such as Melanie Griffith, Elizabeth Hurley, Priscilla Presley and a host of others.  When it comes to lips, bigger is not necessarily better. I was quoted about classic beauty when natural lips ruled. Clara Bow, Gloria Swanson and Carol Lombard all demonstrated well formed upper lips with a cupid’s bow, the true power of beauty. Their lower lips were an appropriate 1 ½ to 2 times the size of their upper lips as it still should be for celebs and patients alike.


As we age, a number of things occur to the lips. They deflate; the cupid’s bow of the upper lip flattens and the lip loses the nice bow shape. The border of the lip loses the nice ridge that defines the lips. To properly restore lip shape, only a half cc of hyaluronic acid filler is necessary, either Restylane or Juvederm. I place the filler just like you do your lipstick. First the lip liner: filler is injected along the border of the lips to re-define the rim and restore Cupid ’s bow. Next the lipstick to fill in the lips: the rest of the filler is placed within the substance of the lips to create fullness to create a soft, subtle pillow. For younger patients seeking bigger lips, I go up to 1 cc. This can be done tastefully for small lips and still look beautiful. The “Cupid’s Bow Lip” technique of mine for lip enhancement was featured in Vogue August 2008.

Actual Before and after lips I enhanced using Restylane, this is what lips should look like: 

Tip of the week: lips can be enhanced using the “Cupid’s Bow Technique” yet still look natural, unlike too many celebrities out there.

Steven J. Pearlman, MD, FACS

Pucker up with the new “CUPID’S BOW LIP” treatment

Instead of aiming arrows, I try to hit the love mark with cosmetic injectables.

Gravity eventually takes a toll on every part of the body, even the lips. As we get older, the upper lip loses its firmness and definition. As a result, the Cupid’s bow, a sign of youth and beauty, is lost leaving an undefined, flat line in its place.

Thinning of the lips becomes evident from generation to generation. I did a comparison of 4 generations of lips right in my own family; from my baby girl to my wife to her mother and my wife’s grandmother. What I can see is the loss of shape firmness (the medical term is turgor) as well as volume of the upper lip. By the eldest generation the upper lip becomes flat with vertical lines.

CUPID’S BOW LIP is performed by using a half cc, or touchup size of Restylane or a half a syringe of Juvederm. The filler is used to create new shape to the lips. To the contrary, to create larger lips, I use a full syringe or 1cc of filler. However if overdone, as is seen way too often, patients can look puffy and get an awful “trout pout.” Additionally, I use a tiny amount of Botox to smooth the vertical lines above the lip as well as relax the muscle in this area.

I am looking to re-introduce the power of glamour. Celebrities have long been the inspiration for what patients look for. However, the latest trends have been to make lips too large. They look great on Angelina Jolie, but how many other celebs have lips that are way too big, plus upper lips that are twice the size of their lower lips? For truely aesthetic lips, the lower lip should be at least 1 1/2 times the size of the upper lip.

So who do I look to emulate? I create more coy, flirtatious lips. This more refined and natural look references the Holywood glamour of yesteryear when starlets like Gloria Swanson, Carole Lombard and Greta Garbo were the defining power of beauty.




Below are a few examples of lips that I have created using this technique, after photos are on the bottom.


a VERY happy patient

a VERY happy patient

Both upper and lower lips
Both upper and lower lips


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