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Russian Lip Filler Technique

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Dr. Schwarzburg was the 1st cosmetic surgeon to introduce the Russian lip technique to NYC.

The Russian lip technique was a result of years of refining and advancing the classic lip injections. This allowed Dr. Schwarzburg to create an innovative approach that is based on a solid foundation with new unsurpassed benefits including:

  • Vertical enhancement of lip height, which leads to taller and fuller lips without an overdone or ducky look;
  • The revolutionary retrograde tenting injection that vertically stretches the lip rather than creating an outward projecting lip;
  • The pillar approach of the Russian lip filler method with filler acting as a supporting strut.

Since the introduction of the Russian lip filler technique in early 2020, Dr. Schwarzburg treated thousands of patients who could never imagine having lips that look natural, plump and vertically enhanced.

Because of the steep learning slope needed to master this advanced method only very few physicians in New York truly understand how to achieve desired results with Russian lip filler technique

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Dr Schwarzburg MD

Using Tissue Tenting In The Russian Lip Technique:


Russian technique has become one of the most sought-after lip-filling techniques in NYC, due to its natural look, shape and outline. A flawlessly contoured lip seen on celebrity favorites such as Kylie Jenner, is something that everyone desires and is completely possible using this advanced lip filler application. 

A short list of why the Russian lip filler technique is so popular is listed below:

  • Inherently natural look – Adding fullness to the lips without making them look “ducky” was a challenge before Dr. Schwarzburg adopted the Russian lip augmentation method. It makes the lips appear taller and flatter with more emphasis on the Cupid’s bow.
  • Treating thin and narrow lips – It is essentially impossible to treat hereditary thin and narrow lips with any technique other than the Russian lip filler technique. Since the goal is to expose more of the red body of the lip, a biocompatible “rod” has to be inserted to allow an increase in its height. The standard horizontal and deep subdermal lip filler placements classically only added volume without providing definition along the vertical aspect of the lip.  
  • Russian doll lips – This form of lip augmentation almost exclusively uses hyaluronic acid based fillers, which are known for their ability to restore volume and hydration in mature lips. The natural doll-like plumpness that comes as a result of the Russian lip injection approach is often preferred by patients who want to rejuvenate their lips, for a softer, less projective result.
  • Symmetry – Most patients have some degree of asymmetry, which is completely natural. The Russian lip technique focuses primarily on the cupid’s bow and the outer edge of the lip, also known as the vermillion border, two areas that are key when it comes to the symmetry of one’s lip shape.
  • Ideal philtrum length – The philtrum describes the ridge located between the base of the nose and the cupid’s bow and is often forgotten about when it comes to traditional lip fillers. Because the Russian Lip technique enhances the lip vertically, it has the ability to shorten a long philtrum, giving the face a less awkward appearance and the lips a “Russian doll” look.
  • Smoothing facial wrinkles – Perioral lines, also known as smoker’s lines, commonly form around the lips as long deep lines because of aging, sun damage, and dehydration. Because of the focus on the vertical enhancement of the lip, it indirectly addresses these fine wrinkles along the way.
  • Preventing aging lips – As we age, our bodies naturally lose facial volume and produce less collagen and hyaluronic acid, leaving our lips looking thin, wrinkly, and dry. A fear faced by many is that a lip filler will create a noticeably unnatural and overdone appearance. The Russian lip technique can be used as a preventative measure in younger patients to maintain fullness and hydration in the lips without looking fake. 
  • Built-in natural results – A major deterrent that prevents patients from even considering getting lip fillers, is that their lip augmentation could end up looking “ducky”, over-protruded, and just simply fake. The Russian lip technique has the critical advantage of enhancing both the body and the vermillion border of the lips, and yet completely avoiding the outward protrusion seen in classic lip augmentation techniques.


Dr. Schwarzburg, who is a New York City based cosmetic surgeon, explains that the procedure does not require much planning, and can be performed on the same day as your consultation. However, if you do have time to plan ahead, you can take the following steps into consideration.

  • Consultation – Having the opportunity to consult with Dr. Schwarzburg at his Manhattan private practice is a great way to confirm that you are a candidate for the Russian lip filler treatment and to get to know your provider, making the entire experience more comfortable.
  • Schedule appropriately – Keep in mind that swelling and bruising are common side effects with any dermal filler, meaning that your treatment should be planned around important upcoming events, such as weddings or birthdays.
  • Blood thinners – Blood thinners such as aspirin, ibuprofen and naproxen, as well as herbal supplements including Ginkgo Biloba, ginseng, flax oil, cod liver oil, fish oil, vitamin A, and vitamin E, can cause excessive bruising. Avoid these 3 – 5 days prior to your lip treatment.
  • Alcohol – Avoid alcohol 1-2 days prior to your treatment, as it can lead to increased bruising and swelling.
  • Cold sores – Let your doctor know if you have had, or have cold sores. You will likely be advised to take Valtrex one day prior to your treatment to avoid exacerbation during the injection process.

The Technical Aspect Of Russian Lip Injection:


Russian lip filler procedure at Skinly Aesthetics is stress-free and easy on your body. From start to finish you will be treated in a relaxing and friendly environment with achieving your lip goals being the top priority. The following sequence of events makes up your Russian lip filler experience at Skinly Aesthetics:

  • During your consultation with Dr. Schwarzburg at his NYC outpatient clinic you will discuss a series of important details that will determine your candidacy for this innovative and transformative lip filler procedure. The consultation will include your overall aesthetic goals, questions and concerns, medical history, and any allergies that can affect your outcomes.
  • Multiple pre-treatment high-resolution pictures are then taken as a reference point to compare your before and after Russian lip filler results;
  • The lips are then numbed using a potent topical lidocaine cream, which stays on for 15 – 20 minutes;
  • The lips are then cleaned and sanitized to prepare them for injections;
  • Once the lips have been carefully marked for injection, a dense and rigid hyaluronic acid-based filler such as Juvederm Voluma is injected vertically into various regions of the lip, using a tiny hollow needle (20 mm, 31 Gauge), through the entry points along the vermilion border. The injection areas include Cupid’s bow in the center of the upper lip; body of the lip; and oral commissures (corners of the mouth) via a retrograde serial puncture technique; 
  • With each injection, the needle is drawn upward in the top lip, and downward in the bottom lip, using a tenting tension technique, to balance the shape of the Cupid’s bow with a natural-looking fullness in the center of the bottom lip;
  • Once the injection process is complete, the lips are carefully massaged and molded to create a natural and flawless look of the heart-shaped lips;
  • An ice pack is provided to minimize swelling and potential bruising and you are discharged home.





    Injectables can be uncomfortable sometimes, which is for the most part inevitable. However, a strong topical lidocaine cream is applied 15 – 20 minutes prior to your injection, in order to ease discomfort. 

    In addition, this unique method requires more superficial injection (only 1 – 2 mm deep), meaning that it will not reach quite as deep as traditional lip filling techniques, making it slightly more tolerable than average lip fillers. 

    All hyaluronic acid fillers contain lidocaine, making the injection process even more tolerable. In cases of extremely low pain thresholds, Dr. Schwarzburg will perform an intraoral nerve block to completely take away any pain sensation.


    The ideal candidate for Russian lip injections is an overall healthy patient who would like to make adjustments to the size and shape of their lip, achieving an attractive pout while avoiding the outward protrusion and “ducky” appearance of a traditional lip filler.

    NYC-based cosmetic dermatologist Dr. Schwarzburg notes that maintaining realistic expectations about the procedure and the outcomes is critical.


    It is a good idea to refrain from getting your lips injected if:

    • You are pregnant; 
    • Have an active oral infection, such as herpes or canker sores or any other type of the oral wound; 
    • Have a known allergy to dermal filler components. 
    • Have unrealistic expectations and are looking for dramatic results that are not compatible with your functional anatomy.


    Russian lip filler injections carry few risks and side effects when performed by an experienced and skilled board-certified surgeon. 

    The following are the most commonly experienced side effects:

    • Transient swelling and ecchymosis for 1-4 days alleviated with ice packs;
    • Temporary skin irritation and lip tenderness that are treated with over-the-counter painkillers;
    • Cold sore reactivation secondary to stress and anxiety, which is immediately treated with a short course of Valtrex;
    • Intense inflammatory response leading to the formation of small nodules, knots and lumps that are easily managed with a targeted injection of Hylenex;
    • Filler migration, where the gel particles move through the lip tissues secondary to poor placement technique or not following the post care instructions; 
    • Bacterial lip infections are very rare and are treated with a short course of antibiotics without any consequences.

    The difference between an experienced board-certified physician and an inexperienced or unqualified injector is their ability to safely identify and handle any of the above complications. Be sure to contact Dr. Schwarzburg if you experience any of the above-mentioned complications so that they can be swiftly resolved.


    There is no significant medical or social downtime associated with Russian lip filler injections. Because of Dr. Schwarzburg’s unique non-surgical approach, you would only expect minor and short-lasting inconveniences including lip swelling and minor bruising that don’t affect your normal activities since there are no stitches or cutting involved. Cold therapy by applying ice packs relieves those inconveniences. 


    Minor side effects do occur with any medical treatment involving needles. To expedite the recovery you are encouraged to do the following: 

    • Apply ice packs right after your Russian lip filler treatment and throughout the first 24 hours. The purpose of the ice pack is to constrict the blood vessels, which reduces blood flow to the recently injected lips. Reduction of blood flow reduces production of inflammatory signals and leads to less swelling and pain;
    • Stay away from hot environments such as saunas and steamy showers for 48 hours as they promote blood flow to the traumatized lip area and increase post-procedural swelling and bruising;
    • Wait 30 minutes before you apply makeup so that the little needle wounds completely seal to ensure that there is no bacterial contamination;
    • Avoid rubbing or massaging your lips to prevent filler migration;
    • There is anecdotal evidence that applying aloe vera and arnica cream helps with minor bruises;
    • Increase your water intake and limit sodium and alcohol consumption to promote better healing and minimize the degree of swelling.


    The results of Russian doll injections are instantaneous and the lips will immediately become augmented and contoured, though the final results and shape will not be obtained until the swelling and bruising have subsided, within 1-4 days post Russian lip treatment.

    During the first few days your lips may look asymmetric and disproportionately large due to swelling and/or bruising. Keep in mind that this is part of the process and will resolve once the swelling and bruising have gone down.


    Depending on the type of filler and your personal response to it, your newly augmented lips should last you anywhere from 6 to 12 months.

    The longevity of the dermal filler used for your Russian-style lip augmentation depends on multiple factors including the following:

    • Filler type definitely plays a role as the degree of cross-linking influences intrinsic degradation. There are many advanced cross-linking technologies, some better than others.
    • Your intrinsic metabolic rate as your body can burn through hyaluronic acid as fast as it burns through the calories they consume. 
    • Lifestyle is another consideration, since patients engaged in highly intense physical activities tend to metabolize fillers faster.


    The cost of Russian lip filler ranges $700-$1500 for a single treatment in NYC. 

    The price of Russian technique lip augmentation depends on the following factors:

    • Credentials of your provider – The treatment is both complex and difficult and requires an exemplary level of training and expertise and should only be performed by board-certified injectors;
    • The number of fillers used – Most patients get 1ml of dermal filler for their augmentation, but others may get up to 3 ml of dermal fillers depending on their anatomy;
    • The type and brand of the filler influences the cost as some fillers cost more than others, due to composition, quality, and longevity.
    • Various promotions that medspas may have or if other treatments are combined with your Russian filler treatment

    Skill, experience level, and your injector’s credentials overshadow cost considerations and concerns, as many clinics offer this complex procedure without actually having the experience or skill to beautifully execute it and achieve the coveted results. This is why a board-certified physician with extraordinary skill set, will often charge more than a registered nurse whose expertise is sometimes harder to assess.


    Not every doctor in NYC is capable of performing this advanced procedure and the more training and experience your doctor has the better. 

    You don’t want to end up with botched lips because you got a huge discount with an unknown and inexperienced injector. 

    Because the Russian lip filer approach involves very superficial filler placement, incorrectly performed injections invariably produce conspicuous lumps and bumps that cause extreme distress and frustration for patients leading to significant interruptions in personal and professional lives. 

    Dr. Schwarzburg was the first doctor in NYC to perform the Russian lip technique and possesses the critical knowledge and expertise to make the entire process seamless with excellent aesthetic results!


    The Russian lip filler technique is exceptionally well suited for patients with thin lips and Dr. Schwarzburg devised his unique protocol to help patients with genetically thin lips achieve their dream lip shape:

    • Average-size lips easily accommodate 1-2 syringes of dermal fillers to achieve great Russian lip results;
    • Thin lips are classically very dense and not very pliable – for dermal fillers to exert their effects the lip skin must be sufficiently stretched out to accommodate the filler product;
    • Injecting a full 1ml syringe during a single session of Russian lip technique for very thin lips inevitably leads to poor outcomes with lip filler migrating to the top of the lip and creating a fake and unpleasing look known as “top shelf” or “mustache” lip;
    • The Russian lip technique for thin lips necessitates sequential stretching of the lips over the period of a few weeks with half syringes of dermal filler to ensure the attractive and pleasant results that the technique is known for;
    • Dr. Schwarzburg prefers to inject 0.5 ml of high G prime filler every 2-3 weeks in patients with thin lips until the desired shape and form of the coveted Russian doll lip contour is achieved.
    before and after of russian rose lip injection with restylane filler
    Russian technique lip augmentation before and after


    Just like most other lip fillers, the Russian lip style utilizes hyaluronic acid dermal fillers to enhance the volume and structural definition of the lips. However, there are some major differences in the injection technique and the results, when comparing this innovative lip augmentation method to the standard lip filler injection process.

    Russian lip Injection vs Classic lip injection:

    • While traditional lip fillers are injected horizontally, often resulting in a “sausage effect”, the Russian lip injection is performed vertically, to uniformly increase the size and the vertical dimension of the lip from top to bottom instead of right to left;
    • Because this method requires more entry points than the standard lip filler technique, the procedure itself takes slightly longer (30 – 45 minutes), while a regular lip filler takes 15 – 30 minutes;
    • The entry points are directly on the vermilion border (lip border), which is a more sensitive area, requiring a strong anesthetic to make the injection process minimally painful;
    • The filler is placed into the superficial subdermal plane, only 1 – 2 mm deep to effectively stretch the overlying skin. This is called lip tenting, in which the filler acts as a strut to maintain the necessary degree of tension in the newly created shape. These kinds of results can not be accomplished with a standard lip-filling technique. 
    • The superficial subdermal plane is relatively avascular, meaning that it doesn’t have too many blood vessels, such as superior and inferior labial arteries and veins that can be inadvertently punctured and lead to bruising, hematomas and skin discoloration.

    Russian lip impressive results:

    While traditional lip augmentation results are often wider, the Russian lip results in a taller, coveted heart-shaped lip creating the Russian doll lip effect. There’s more focus on the central part and body of the lip, accentuating the cupid’s bow and drawing the eye to the mid-lip, rather than the outer corners of the lip, which can otherwise result in a “trout pout”.


    As we age, collagen production decreases and the effects of gravity become more pronounced. In the lips the philtrum length increases and philtrum columns fade away. These age-related visual lip deficiencies present a unique opportunity for non-surgical lip correction via the Russian lip injection approach. When the Russian lip filler technique is properly executed, the philtrum distance decreases and the philtrum columns are re-created resulting in dramatic rejuvenation and reversal of age-related deficits, achieving desirable “heart-shaped” lips. 

    We all know that application of makeup allows to accentuate Cupid’s bow for the luminous, attractive and sexy pout. If you are longing for that look without spending a lot of time and labor on makeup, then achieving this appearance is possible through expertly placed Russian doll lip filler technique.


    There are several types of fillers that can be used for the Russian lip tenting technique. 

    The filler acts as a reinforcing rod and allows the lip to remain vertically stretched out or tented for a prolonged period of time. For this process to be successful and long-lasting, the filler must possess certain biomechanical properties. 

    The most crucial feature is the ability to resist internal compression force, which tends to collapse the lip as it gravitates to its native non-injected state. Hyaluronic acid fillers with a high G prime factor allow the gel material to remain rigid and inflexible and maintain the characteristic contour of the Russian lip technique.


    One of the most commonly used fillers that Dr. Schwarzburg prefers to use at his medspa in NYC is Allergan’s Juvederm Voluma and Teosyal’s RHA 4, as they are the densest and the most rigid fillers available on the market. 

    Dr. Schwarzburg advises against using softer fillers such as Restylane Kysse, as they are softer, more subtle fillers without the ability to withstand high internal pressure loads. Depending on the original shape and anatomy of the patient’s lips, Dr. Schwarzburg custom selects the filler that he finds most appropriate for each individual.


    Russian doll lips can be combined with a number of treatments to enhance the overall appearance of your upper, middle and lower face.

    • Any of the neuromodulators can be used for a Botox lip flip which involves the injection of 5 – 10 units into the vermillion border, right above the lip to flip the lip upward;
    • Jawline contouring and PDO threads are often combined with this lip contouring method to shape the overall lower face;
    • Many patients in New York combine under eye filler and cheek fillers with their Russian lip filler to rejuvenate more than just their lips, but to also regain an overall youthful and cosmetically appealing facial contour that has been diminished through age and the weight of gravity.


    One of the major medical advantages of this lip tenting injection is the minimally invasive nature of this process without the use of a scalpel, general anesthesia, stitches and long recovery. From an aesthetic perspective, Russian lip filler provides results that are virtually impossible to achieve with standard lip injections. 

    The following considerations must be kept in mind to safely and consistently achieve great and impeccable results with the Russian lip technique:

    • The standard lip injection techniques invariably result in excessive augmentation of the vermilion border and that classically creates a “ducky” and fake appearance that is easily recognized and is not aesthetically appealing;
    • Instead of creating outward protrusion with classic approach, the Russian lip is shaped vertically, resulting in a beautiful and natural-looking heart-shaped lip. From a side profile, there will be no “ducky” appearance, but a natural fullness;
    • Russian lip style creative and unique non-surgical lip augmentation attains natural-looking fullness, but with flattened and heightened lip shape. 
    • The superficial placement of the filler presents a unique set of challenges that only the most experienced injectors are able to successfully overcome. If the injection process deviates from a highly specific protocol, the visible asymmetry with lumps is all but guaranteed. 
    Russian technique lip filler augmentation results with Juvederm filler
    before and after results utilizing Russian lip technique following injection of 1.5ml of Juvederm Ultra filler


    Dr. Schwarzburg is one of the select physicians in NYC that has mastered the Russian lip technique. As such, his patients are consistently satisfied with their new lip fillers, leaving them with a natural look, with lips that truly stand out in the best way possible. 

    The Russian Lip Technique is highly rated on RealSelf, a reputable source with a 95% approval rate, in which patients across the globe leave their feedback about plastic and cosmetic surgeries. On average, patients who have received Russian Lip are extremely happy with their outcome in terms of the comfortable injection process, minimal downtime and side effects, and natural yet outstanding results. 

    With the common fear of ending up with fake or ducky-looking lips, the Russian Lip Technique is worth it for anyone of any age looking for a beautifully contoured lip, without looking overdone. Based on all of the above, the common consensus is yes – the Russian Lip Technique is worth it!


    Finding a reputable facility to properly perform the Russian lip injection technique can be difficult, especially in a large city like NYC where hundreds of medical spas offer the Russian lip technique. Many medspas advertise the Russian lip technique, though it is rarely done properly as it requires extensive training, experience, and a vast understanding of the anatomical structure of the lips. 

    To avoid overdone look and other adverse side effects associated with the Russian lip technique it is best to seek out a board-certified cosmetic physician who specializes in minimally invasive treatments and cosmetic injectables, like Dr. Schwarzburg in NYC. 

    Skinly Aesthetics is only a few blocks away from New York’s iconic Central Park, and is surrounded by Michelin-star restaurants such as JoJo by Jean-George, right across the street. The Bloomingdale’s department store on 59th street and Lexington Avenue and other fashion and beauty stores are only a short walk away.


    Skinly Aesthetics Medical Spa, owned and operated by board-certified cosmetic physician Dr. Schwarzburg, located on the Upper East Side of Manhattan as well as various locations spread out in Downtown New York, Midtown West, Chelsea, Soho and West Village, offers the best Russian lip fillers in NYC.

    To schedule your appointment with Dr. Schwarzburg at his Upper East Side office in Manhattan please call 212-774-4264 or email:

    Explore treatment options tailored just for you. Schedule your consultation right now.

    Consult with Dr. Schwarzburg

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      I had a great experience and great results. With only one section my eyes bag problem are gone, I tried a few different treatments before and nothing worked. I scheduled… read more

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    • My experience getting my lips done was amazing. The staff were very welcome and very professional. I love the way my lips turned out. I would definitely recommend Skinly Aesthetics… read more

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      I’ve been Dr. Schwarzburg’s returning patient for over a year! I love how he has improved my body, he is committed and perfectionist! The facility is sparkling clean and modern!! I… read more

    • Dr. Schwarzburg is a very polite and knowledgeable doctor. He had done my tear trough and check filler. He also does my sisters as well. She swears by him, and… read more

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      Cheers from CATALINA – Great spa and great services; As well as awesome treatments they offer! Dr Schwartzburg is a really funny guy and has a great sense of humor! -CATALINA

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    • I’m new to medical aesthetics, and it was long overdue. I was always scared of needles and any change to my face, but the time has finally arrived, when I… read more

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      This place is the best! The staff is super nice and my lips look amazing! Will definitely be back!

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    • Incredibly pleasant office and staff. Cannot recommend the doctor enough. He is super knowledgeable, honest, kind and most importantly, talented!

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      This is one and only place I would ever go to for any injectables. Dr. Schwarzburg was very thorough with his assessment and had fully explained to me what I… read more

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    • Unparalleled experience with lip fillers at Skinly. Dr. Schwarzburg used his custom technique to create a beautiful upper, which nobody was able to do before that. It looks 100% natural… read more

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      I was very impressed with my filler experience at Skinly. I just turned 40 and noticed how my face sank overnight. All of my friends have been doing this for… read more

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      Such a great experience! I highly recommend this place. Everyone is so friendly, and listened to my needs/gave me exactly what I asked for. I’ll be returning! Excellent, 5/5.

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