Lip augmentation procedures are commonly done as office procedures using injectable fillers such as Juvederm. They can also be done as an adjunct to other cosmetic surgery procedures, such as a facelift. Younger patients can enhance or improve their natural lip shape while older patients restore the volume that has been lost with age. As lips age and shrink, they tend to roll in and develop vertical lines. The upper lip may fall, and the corners of the mouth sag. Restoring volume to the lip can often make a significant improvement and does not have to be overdone. In cases where the upper lip has dropped to cover the upper teeth, a lip lift may be considered, often combined with a filler or fat.
Although Juvederm contains an anesthetic, we also use topical anesthetic and can do anesthetic blocks for management of the discomfort if necessary. Since lip augmentation is usually a brief office-based procedure with minimal down-time, we often combine it with other nonsurgical facial cosmetic procedures such as Botox injection. In the lips, Juvederm lasts 6 months or more for most patients.
Fat transfer is another option. This involves using your own fat to augment your lip volume. This is more of a cosmetic surgical procedure, and although it can be done in the office using local anesthesia, it is more commonly done in the operating room, and usually in concert with other procedures such as facelift and fat injection to other areas of the face.
Properly harvested and injected, fat transfer is a permanent procedure, albeit with some caveats. There is always some unpredictability with regard to how much of the fat lives or “takes”. With fat injection, particularly in the lips, there is a degree of unpredictability and additional fat injections are often necessary to achieve a complete and lasting result.
I do not do lip implants of any kind. In my opinion, they are not a good idea. I have seen and taken care of too many complications from them. Some of the complications I have seen include infection, extrusion, scarring, and lip distortion. If you currently have lip implants and have any concerns about them, please make a consultation with me. It is better to remove the lip implants and consider alternatives before a problem arises.
Facial rejuvenation surgery often involves a lip enhancement procedure to restore some of the lip shrinkage that comes with age. I often encourage this to balance the other rejuvenating effects of a facelift and blepharoplasty for example. To rejuvenate the rest of the face and leave the lips thin from age could create a disharmony. Although fillers could be used for this, I usually suggest a more permanent solution, such as fat injection or SMAS augmentation, as anesthesia is already being used for the other facial surgery. The SMAS is a layer of tissue within the cheek that is elevated during a facelift and supports the lift. Some of the SMAS is trimmed, and this can be threaded through the lips for a nice subtle lip augmentation.
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