The number of lip augmentation procedures performed continues to rise exponentially. The author provides a detailed discussion of the rise of this popular treatment with an overview of how injectable materials have evolved; from paraffin, liquid silicone and bovine collagen. The author briefly describes the anthropological history of the lip and the cultural significance of this anatomical region in terms of female facial attractiveness being closely linked to the shape of the lips. Characteristics of lips most suitable for injectable augmentation are discussed, along with principles of assessment and the importance of establishing realistic expectation. The author describes the ethical challenge of an increasingly younger patient group seeking lip augmentation, fuelled by social media, in particular a reported link between male self-esteem and social media. This paper reinforces that the aesthetic clinician is under no obligation to treat patients who are assessed as being unsuitable and that patients may be seeking treatment to resolve issues of self-esteem and quality of life. An insightful piece which captures the journey and current considerations in assessing and treating patients seeking lip augmentation with dermal fillers.