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Lip Augmentation

Full lips with an accentuated border have often been associated with beauty and youth. Lip augmentation is a solution for people who want to enhance narrow lips or otherwise rejuvenate lips that have become wrinkled with age. Cosmetic lip augmentation consists of the enhancement and reshaping of otherwise normal lips to improve their appearance in relation to the patient's facial structures. Successful lip augmentation is highly dependent on the skill of the provider, with that skill stemming from many years of experience injecting the lips of many types of patients. Moreover, the surgeon must master the various injection techniques.

Lip augmentation (see the image below) consists of the reshaping and/or enlargement of the visible portion of the lip, the vermillion. Alteration of the shape of the Cupid's bow and of the relation between the vermillion and the skin underlying the nasal columella also fall within the category of lip augmentation

Also important is to consider the relationship between lip height and incisor show in the anatomic analysis. Evaluate possible maxillary hypoplasia and protrusion and consider the patient's occlusion status

Contraindications

Contraindications for cosmetic lip augmentation include facial nerve disorders, recurrent herpes simplex lesions, diabetes, severe hypertension, history of multiple allergies, and/or autoimmune disorders.

Lip augmentation can be achieved with

Autologous fat recently has become a more popular choice of filler. The distinct advantage of fat as a volume augmenter is that the results obtained are long-lasting (in some cases, permanent), depending on the amount of tissue injected and the location treated. Moreover, the risk of allergic reactions is avoided since the fat used is autologous tissue. Fat is obtained from the patient's donor site under local anesthesia; prepared with saline wash, decantation, or centrifugation; and then injected in the lips. As much as 30% of the injected fat can persist after transplantation with appropriate technique, and, in some patients, almost complete survival of the graft has been reported.

Autologous dermis, dermal fat, tendon, and fascia grafts are obtained from the patient, shaped, and implanted. In some patients, the grafts may be obtained from skin resected during local procedures such as lip lift or advancement, de-epithelialized, and then grafted. Once the tissue is harvested and shaped, it is threaded through a tunnel within the lip. A curved tendon passer facilitates this procedure. They provide a natural autologous option for both primary and revisional lip augmentation.

Hyaluronic Acid (Restylane, Juvederm) is a natural substance found in our bodies. It is well suited to plump thin lips and it may also be appropriate for some surface wrinkles around lips. Artificial fillers can also be used for lip augmentation. Sometimes augmentation of the lips requires multiple injections to distribute the filler for enhanced lip fullness and to raise or define a cupid's bow (the middle portion of the lip), which has the upturn or vermillion border the red part of your lips.

Lip Reduction

Larger-than-average lips may appear out of proportion with other facial features and can interfere with eating, drinking and speaking. If you feel that your lips are too large, lip reduction surgery may be worth considering.

Lip reduction surgery can permanently reduce lip size. This plastic surgery procedure may be performed alone or in combination with other facial cosmetic plastic surgery procedures, such as chin augmentation, jaw augmentation or rhinoplasty.

The procedure involves "removing skin from the lips along the dry-wet border of the vermillion" and using stitches to create a new lip line. The result is a smaller, thinner pout. Surgical reduction of the lip can be achieved by incisions placed on the inside of the lip (the moist red part) which is not ordinarily visible. The red part of the lip is then rolled to the inside of the mouth to make the lips appear smaller.

Risks of Lip Augmentation/ Reduction Surgery

Although it is considered safe, lip surgery does boast certain risks. General surgery risks include anesthesia complications, bleeding and infection. Additional lip surgery risks include:

  • Asymmetry
  • Numbness (usually temporary)
  • Lumps and excess scar tissue in lips
  • Dissatisfaction with the cosmetic results

Lip reduction results are permanent, but if you find that your lips are too thin after your surgery, lip augmentation may be performed to correct this outcome.

Lip Augmentation/ Reduction Recovery

Immediately following your lip surgery, your lips may feel sore and tight. During the next few days, you may feel some mild to moderate pain. Your surgeon can prescribe painkillers to help with this discomfort. Swelling and bruising are also to be expected after lip surgery. You should apply ice bags to the lips to limit pain and swelling.

You will have to refrain from vigorous exercise until your surgeon gives you the OK. Your surgeon will likely instruct you to sleep on your back with two pillows to keep your head elevated. If you have stitches, you'll need to avoid touching them with your tongue, as this can increase your risk of an infection.

Because the incisions are placed inside the mouth, eating may be challenging at first. Avoid foods with a high acid content — such as oranges and tomatoes — as they may irritate your wounds. Soft, pureed foods may be best immediately following your lip reduction surgery. Your surgeon may ask you to rinse with an antiseptic mouthwash throughout the day to help prevent infection. Excessive pain, redness or pus around the incision sites may be signs of infection. If these occur, contact your surgeon immediately.

Your sutures will likely be removed within a week to 10 days following surgery, by which time most of your swelling should have subsided.

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