Lips have always been considered one of the more expressive and sensual features of the face. However, prior to the 1990′s, cosmetic lip enhancement, also known as lip augmentation, was largely ignored. Now there is a huge demand to produce lips that are plumper, smoother and shapelier.
Lip enhancement procedures are designed to change the shape of the lip or increase the fullness of the lips. Both the upper and lower lips can be enhanced. For the upper lip, lift procedures can be used to shorten a long upper lip.
Whether you have always had thin lips, or you want to restore your lips to the fullness and shape they had in your youth, a lip augmentation procedure may produce the look you’re seeking.
If you are unhappy or self-conscious about the appearance of your lips, these enhancement procedures provide options for you to change your appearance and improve your self-confidence.
The initial consultation will begin at our office in St. Louis, Missouri, with a complete medical history and exam. You should tell Dr. Jones if you have had any previous operations or injections to your lips, if you have a history of cold sores or herpes, or if you have had collagen injections in the past. You will be asked to look into a mirror and point out those areas of your lips and mouth that you would like to see improved. You should be very frank in discussing what you hope to achieve with surgery. Bring pictures out of magazines to show Dr. Jones what you like and don’t like. This will help us understand your expectations and determine whether they can realistically be achieved. Other options available to you will be discussed along with risks and limitations. The costs of the treatment will be explained. Your photograph will be taken.
Drooping of the corners of the mouth can be addressed by lifting these areas by direct skin removal. Permanent tattoos applied to the lip and/or the borders of the lip can be used to give the appearance of a fuller lip. Cosmetic dentists can use tooth bonding techniques to push the lips forward, giving them the appearance of being fuller.
Risks and Limitations Serious complications from lip enhancement procedures are rare. However, as with any surgical procedure, there are risks of bleeding and infection. If synthetic material is used, such as SoftForm, there is a risk that the material can be visible under the tissue and that it can become exposed, requiring the material to be removed. Fat grafts, collagen sheets and collagen injections can be somewhat unpredictable and are susceptible to being absorbed by the body over several months. When graft materials are placed initially, it is common for the lips to be firm. This improves over several weeks.
There are a number of techniques used for lip enhancement, each with its own advantages and limitations. These techniques include:
Lip enhancement procedures can be performed safely in an office-based surgical suite, an outpatient surgery center, or a hospital. The surgery can be performed under general anesthesia-in which case you are completely asleep-or local anesthesia with sedation, in which case you remain awake, but drowsy and relaxed. You will not feel pain, but you may notice some gentle tugging. Most commonly the procedures are done in the office using local anesthesia. The procedures last 45 minutes to two hours, depending on the procedure. If the procedure is done in the office under local anesthesia, you may drive yourself home afterwards.
This procedure involves injecting the lip with a “filler material.” Restylane is the newest filler approved for lip enhancement. This is a non-animal stabilized hyaluronic acid gel. Hyaluronic acid is a natural substance already present in your body. Human-derived collagen (Cymetra), which is manufactured, and fat, which is taken from your own body, are the most commonly used substances. All of these fillers may be absorbed and have to be repeated.
Radiance is a long-lasting 3-5 year soft tissue filler currently FDA-approved to treat human vocal cord paralysis. Made from calcium hydroxyiapatite, an element found in bone and teeth, Radiance is created in tiny spheres for injection into soft tissue. The spheres gradually dissolve away into bone or fat and are then filled in by collagen cells, subsequently enhancing the correction. Not requiring any skin tests, Radiance has no reported side effects.
Restylane The skin around the lips is initially treated with a cream to anesthetize the skin, followed by placing local anesthesia around the mouth. Restylane is injected into the upper and/or lower lips with a very fine needle. It can also be combined with the marking of the vermilion border by injecting the gel along the lip line. Redefining this edge leads to a more youthful and appealing look.
The skin around the lips is initially treated with a cream to anesthetize the skin, followed by placing local anesthesia around the mouth. The fat is removed from an area of excess, usually the abdomen (the donor site). After local anesthesia is placed in the donor area, the fat is extracted through a 1/4 inch incision placed in an inconspicuous area. The fat is harvested, prepared and then injected in the lip using a small needle. Often patients choose to have other areas of their face enhanced with the harvested fat, such as the deep cheek folds.
Dr. Jones prefers to use a human-derived collagen that is screened and processed to avoid the spread of disease. The chance of allergic reactions to this type of collagen is less than that of collagen obtained from cow skin. The collagen is injected into the lip just like fat.
Grafts are larger amounts of material that are placed through incisions made on the inside corners of the mouth. The lips are made numb with local anesthesia. The material is threaded under the lip to the other side to give a uniform enlargement. The incisions are closed with a couple of dissolvable sutures.
AlloDerm is a human-derived, processed sheet of collagen. It is rolled on itself and threaded along the length of the lip. It is easy to use and produces an excellent uniform fullness in the lip. However, the permanence of the material is variable and may need to be replaced in six to 12 months.
Many tissues from your own body-including skin, muscle and collagen (known as fascia)-can be placed in the lips to produce additional fullness. All grafts have a chance of being absorbed, but some of the tissue and fullness usually persists. A repeat procedure may be necessary.
V-Y Advancement Flap-The lining on the inside of the lip is incised and advanced onto the surface of the lip to produce a more permanent, soft lip augmentation. The stitches on the inside of the lip dissolve in five to seven days. Numbness in the lip diminishes over several weeks.
Lip Lifts, Indirect Lift (upper lip only)-This technique is used to address an overly long lip, one that is frequently associated with aging. The upper lip is shortened and lifted by removing skin at the base of the nose. This produces a more prominent lip and also displays more of the upper teeth.
Lip Tuck-On either the upper or lower lip, skin at the border of the lip-the “white roll”-is removed. This pulls the red part of the lip, the vermilion, outward, making the lip look fuller and more attractive.
Any procedure on the lips will produce temporary swelling and discomfort. Cold compresses used for 10 minutes every hour while awake for the first two to three days will minimize the swelling. You will be prescribed oral pain medication as needed and possibly antibiotics and anti-viral medication. You should minimize talking and chewing during the first three days until the swelling starts to improve. You can continue with your usual activities four to five days after the procedure. Swelling may persist for a few weeks.
Some of the techniques offer more permanent lip enhancement than others. If you’re not sure you will like the new look, a temporary treatment allows you to experiment before proceeding with a more permanent solution. In general, the scars from the incisions fade and are rarely visible.