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Objectives: We will not talk about mild side effects, such as bleeding, swelling, lip asymmetry, and reactivation of herpes simplex, which are common for all lip augmentation techniques. Our goal is to determine the safe and effective way for the most popular technique, Russian Lips and describe complications and ultrasound picture of this conditions. 1. HA filler misplacing above the lips ("Homer Simpson Lips") 2. Bumps /lumps 3. Delayed Granulomas/Nodules Introduction: Fillers are one of the most frequently used beautifying products, with lips being the first and most popular area for correction. Young doctors, nurses, and dentists usually start their professional way with this facial area. We will not talk about mild side effects, such as bleeding, swelling, lip asymmetry, and reactivation of herpes simplex, which are common for all lip augmentation techniques. Our goal is to determine the safe and effective way for the most popular technique, Russian Lips. Here's what we need to know about Russian Lips. Materials / method:   The Complications:   1. HA filler misplacing above the lips ("Homer Simpson Lips"): multiple superficial vertical injections can cause migration of the product after a few months. The treatment is to inject hyaluronidase with ultrasound detection of dermal filler. 2.Bumps/lumps: Multiple superficial injections cause the Tyndall effect and visualization of the dermal filler, particularly in the mucosal area. 3.Delayed Granulomas/Nodules: A rarely cited late complication of lip augmentation. The enveloped filler material may resist degradation and remain sequestered in the macrophages. Results: Tips and tricks 1.The treatment is to inject hyaluronidase with ultrasound detection of dermal filler. 2. Treat M-shaped lips and patients with gingival smile with BoNT before augmentation with dermal fillers. 3.Choose dynamic . Choose dynamic products and don't inject too much volume. 4. Be careful with the depth of injections. Use thin 30G-31G needles and always pay attention to the injection layers and the amount of product. 5. Don't mix different brands of dermal fillers in the same area if the last session was less than six months ago. Conclusion: Filler injection for soft tissue augmentation is a satisfactory procedure with very modest results despite high expectations. However, as the number of indications and performance increases, the number of complications also increases. It is important for physicians to know facial anatomy and high-risk regions. The experts of filler injection must be familiar with each filler material, the injection techniques, and the potential complications. We summarized rare complications after lip augmentation that can help clinicians avoid these problems successfully.