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The Large Lips are one of the nine items that can be purchased from the Item Shop in the Game Boy Advance game Wario Land 4. The Large Lips can be bought off the Item Shopkeeper for ten Frog Medals (depending on the game mode, it could cost more). All items from the Item Shop are there to assist Wario in defeating a challenging boss by doing pre-damage at the battle's beginning. When purchased, the Item Shopkeeper will follow Wario to the boss room. Her head will then transform and be replaced with a large pair of lips, which will then kiss the boss. The Item Shopkeeper will then transform back into her old self and then exit the room, leaving Wario to fight a weakened Boss. Damage varies depending on the boss, but it is most effective against Aerodent, dealing 14 damage.
Large Lips also appears in volume 28 of Super Mario-Kun. The Item Shopkeeper uses this move against Aerodent, massively damaging it, just as in the game.