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Lip Augmentation

Lip Augmentation, Implants, and Enhancement

Many people desire to have fuller lips. Unfortunately, poorly performed lip augmentation can result in a ‘duck bill’ appearance. There are many options for lip enhancement which are both surgical and non-surgical. A detailed lip analysis is often necessary to determine which procedure might be best to achieve a desired look. The upper lip should extend just slightly more than the lower lip. A small amount of the central incisors can be seen in normal repose though it is not necessary. It is important to look at all aspects of the lips when evaluating facial rejuvenation in that area. Just adding filler to the lips may not address the actual cause of the aesthetic concern.

Non-surgical options for lip augmentation

While there are no facial fillers approved by the US FDA for use in the lips, many have been used for quite some time safely in an off label manner. Care must be taken as not all fillers can be used in the lips. For some product lines with different size particles, only one of the products should be injected into the lips. The biggest risk of injection into the lips is formation of lumps. Though no studies have been conducted, anecdotal evidence suggests that temporary fillers do not last as long in the lips as in other areas. As a permanent solution to temporary fillers, autologous fat transfer can be made to the lips as well.

Lip Enhancement with Fat

As a permanent alternative to temporary fillers, fat can be taken from a person’s abdomen or thigh and transferred to the lips. The procedure can be undertaken in the office with only local anesthesia. A certain amount of the fat may not take, but the results are otherwise permanent.

Surgical Options for augmentation with lip implants

Several implants have been created to use in lip augmentation. Expanded polytetrafluoroethylene(ePTFE) comes in various sizes and several formulations. Some of the formulations have varying size diameter holes in the material which allow for tissue ingrowth. Dermal scaffolding such as the human dermis tradenamed Alloderm® or porcine dermis tradenamed Surgisis®, can be implanted into the lips. Experimental data indicates that the implant provides scaffolding for natural growth of tissue.

Surgical Procedures for lip enhancement

For patients with excess skin of the sides of the lips, a procedure known as a corner of the mouth lift can be performed to help decrease the sad appearance from the down turned commissures. In a corner of the mouth lip, a small triangle of skin is removed from the corner of the mouth on both sides. A small scar is created but usually well hidden.

In patients with a lack of red show of the lip, lip lifts or mucosal advancement augmentation procedures can be undertaken. Lip lift procedures involve making an incision at the base of the nose and removing a strip of skin of the upper lip. The skin is then closed with sutures, pulling up the red part of the lip. A scar is created but usually well hidden at the base of the nose. Patients with narrow nasal bases are not good candidates for lip lift procedures.

Mucosal advancement procedures involve making incisions on the inside of the lip and lifting up the entire visible red area of the lip as well as the red area on the inside of the lip. The mucosa is then pulled forward, allowing more of it to be seen on the outside of the lip.

There is not one procedure for lip augmentation which will address every patient’s needs. The lip can be quite a complex structure and in order to avoid the ‘duck bill’ look, it is imperative to have a good assessment before undergoing any treatment.