A Plastic Surgeon Gives His Take on Kylie Jenner's Lip Fillers: Are They Safe?

Dr. Matthew Schulman tells PEOPLE all about the procedure

Kylie Jenner’s lips are no longer sealed.

The star, 17, came clean in a Keeping Up with the Kardashians sneak peek this week, admitting her plump pout is cosmetically enhanced.

Zendaya and Giuliana Rancic

WUF/Splash News Online

“I have temporary lip fillers,” she said. “It’s just an insecurity of mine, and it’s what I wanted to do.”

PEOPLE spoke to New York City plastic surgeon Dr. Matthew Schulman — who has not treated Kylie — to learn more about the procedure.

As it turns out, those temporary fillers are the most common type of lip augmentation and arguably the safest.

“She got exactly what most people would get,” Schulman said, adding that it would have cost the reality star anywhere from $750 to $950 and, as a minor, she would have needed a parent’s permission.

Still, Schulman, who is also an assistant professor at the Mount Sinai School of Medicine, said he’d be hesitant to operate on anyone as young as Kylie.

“I don’t think there’s a safety concern,” he explained. “I think the bigger concern with her being 17 is more of a psychological concern: whether she’s old enough or mature enough to undergo body transformation.”

Read on to learn Schulman’s answers to all your burning questions about lip plumping — and the dangers of the so-called “Kylie Jenner Challenge.”

Kylie said she got “temporary lip fillers.” What exactly does that mean?
When we talk about the most commonly used fillers for the lips, we’re usually talking about things like Restylane and Juvederm. Those are all temporary fillers, meaning they’re going to last about six to nine months. Those materials are in a category of fillers called hyaluronic acids, so it’s basically a sugar gel, and the body breaks it down. Now, she says temporary fillers probably to distinguish from permanent fillers like silicone injections.

Do they require maintenance?
If she wants to maintain the look she has, she has to keep doing it every six months or nine months. When the temporary filler wears off, her lips go back to normal. You’re not committing to maintenance forever — she can continue to do it or she can stop doing it, and her lips won’t be damaged in the long term.

What are the advantages and disadvantages of hyaluronic acids versus more permanent methods like fat injections and implants?
Hyaluronic acids are very predictable. When they’re in the lips, they’re very soft; they won’t feel like a hard material inside your lip. They are temporary, and the nice thing about it, too, is if there’s a problem or if it was injected improperly where there’s a lump or something doesn’t look right, there is a medication that can dissolve that material. So that’s a nice feature. There’s sort of a safety feature to that.

The other way to plump the lips would be fat. Fat in theory is permanent, but fat is also very unpredictable. The fat tends to move a little bit and form lumps in the lips, especially because the lips are an area that is constantly moving. Also, you can lose up to 50 percent of the fat that’s injected, so you need to put in a lot of fat in order for you to get the result that you want. And also with fat, you have to harvest the fat. You have to go through the process of a little bit of a liposuction procedure. In general for the lips, you only need a few cc’s of fat, so it’s just a little bit, just a small syringe. That can be easily suctioned, even from someone that’s very skinny, in their hip or their butt or their stomach. But there’s always the risk of having a problem where that fat is harvested from.

The third way is with lip implants. I actually like them a lot with the right patient. They’re silicone implants that are put in. The advantage is that they’re permanent, they don’t need any maintenance. The newest type of implants that are used today, because they’re smooth silicone, they can be removed if there’s a problem. So unlike old materials like so-called Goretex or Alloderm, the new silicone implants for lips can easily be removed if there’s an issue. That’s the implant that Farrah Abraham was undergoing, but she never got past the injection of the local anesthetic. She had some sort of allergic reaction to the medication.

How common are temporary lip injections?
It’s the vast majority. Probably 90 percent of patients that come to me for lip augmentation are choosing one of the hyaluronic acid fillers, which I think is the appropriate choice. Now, the other 10 percent, in my practice, are choosing implants. In my patients who are getting implants, I often require that they have a temporary filler like hyaluronic acid injected first, so that they can see what they look like for the next six months or so and be certain they like what their lips look like when they’re larger, before they go ahead and commit to a lip implant.

Are there any safety concerns when undergoing the filler procedure?
It’s very safe. I mean, it’s essentially a sugar gel, so the risk of having an allergic reaction is as close to zero as you can get. The bigger risk is risks associated with the actual injection process: bruising, swelling, having lumps or bumps or unevenness from improper injection technique. Those can be a problem. Luckily, those issues are very temporary, that will either resolve on their own with a little bit of time, or they can be treated with some of the medication called hyaluronidase, which is a medication that will dissolve that material.

The only other extremely rare complication which would be very, very serious is inadvertently injecting the material into a blood vessel. So if that material is accidentally injected into a small blood vessel, that material can travel through the blood vessel and can cause a blockage or a clot in that area. It’s extremely rare, because as you can imagine the blood vessels in that area are super small, so it would be almost impossible to put a needle inside one of those vessels, inject a little bit of material that would travel through the vessel. It’s more of a concern when the filler is used in other areas of the face, like around the corner of the nose or between the eyebrows.

RELATED LINK: Kylie Jenner Admits Her Lips Aren’t Natural — See the Video!

Kylie is 17. Do patients under 18 typically need parental permission?
Yes. The laws may vary state to state, but it’s pretty well accepted that a minor cannot be seen by a doctor, be evaluated by a doctor or be treated by a doctor without parental permission. There must have been someone, presumably her mother, who was with her and would have needed to sign authorization for the treatment.

The FDA suggests certain fillers for only people 21 and up. Is this enforced?
That’s true. For a lot of the medical devices or medications, the FDA approval is based on exactly how they did the FDA studies, so a lot of medications or devices or injectables are not FDA-approved for under 21 years old, not because there’s a safety concern, but because they didn’t have enough people in the test group that were below that age to definitively say it’s safe. That’s the labeling, so technically if I use a filler on someone who’s under 21 it’s considered an off-label use. It doesn’t mean I can’t do it, but I need to disclose to the patient that it’s FDA-approved for people who are over 21; you are under 21; so you understand this is being used in an off-label manner.

What is the youngest age of a patient you’ve given this type of procedure?
For fillers in the lips, I’ve never treated anyone below 18. There may be some situations where I would do it, if I have a teenager who has a scar or a facial deformity. There are people out there who have had accidents and sometimes there’s a scar on their lip, sometimes there’s an asymmetry of their lip because of that accident. Then, I would have absolutely no problem injecting some filler in that area to try make it look more normal or more cosmetically pleasing to the teenager.

In terms of just a straightforward, cosmetic lip augmentation, I wouldn’t treat anybody under 18.

RELATED LINK: We Tried It: Lip Plumping Every Possible Way, from Easy to Crazy

Kylie inadvertently inspired (and does not endorse) a trend where teens are sucking shot glasses over their lips. That’s not safe … right?
No, essentially what they’re doing is causing trauma to their lip, which is making their lip larger because they’re causing injury. They’re causing bleeding, swelling, tissue damage. Just like if you were smacked in the lip and your lip got swollen and big and puffy, that’s what they’re doing. They’re causing injury. It’s 100 percent unsafe, it can cause broken blood vessels around the lips that can stain the skin and be permanent, and it can also cause bleeding within the lip itself, which can lead to scarring, and scarring can lead to thickening of the lip with lumps and bumps and real permanent cosmetic deformity.

For young fans who want to look like Kylie, is there anything you would recommend that’s more natural, like plumping lip gloss?
There are some products out there that can plump lips naturally, so capsaicin-containing products. Capsaicin is that active ingredient in hot peppers, which is what you’re going to find in any of these lip-plumping cosmetics.

So that can certainly work, but again, I get concerned when, for good or bad, people try to emulate the Kardashians. I think that this trend of 14- or 15-year-old girls trying to achieve lips like Kylie is just a dangerous, slippery slope. I think it just encourages them to have body-image issues.

Obviously I’m a cosmetic plastic surgeon, so this is what I do, I change people’s bodies and give them what they want. But I think that the person needs to be old enough and mature enough to understand there’s a difference between self-esteem and how they feel about themselves and how they look.

It’s a little dangerous, because what’s going to happen is they’re going to move on to something else, and then they’re going to want to have their lips filled, and that’s not going to last, and then they’re going to want implants. Sixteen-, 17-year-old girls are not always psychologically mature enough to handle that.

What do you think of Kylie getting injections at 17? Do you understand the process better now? Sound off below.

–Michele Corriston

RELATED VIDEO: Forget the Kylie Jenner Challenge, Here’s How You Really Get the Perfect Pout

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