Full lips and a wrinkle-free mouth are hallmarks of a youthful face. As we age, our lips naturally lose their volume, becoming thinner and less defined. There are also people who were born with lip abnormalities or whose lips have become deformed later in life for one reason or another. Lip Enhancement, also known as lip augmentation is a procedure that improves the shape and fullness of the lips.
Lip enhancement procedures
There is a large choice of available lip enhancement procedures, however for convenience they can be looked at as a group.
Temporary lip augmentation
Many substances have been used to provide temporary lip augmentation. These substances are typically injected under the white line. This is the white hair-free line which outlines the vermilion (red mucosa) of the lip and is distinct from the normal lip. This produces a “pouting lip”.
Lip Enlargement is very frequently performed by employing non-permanent natural dermal fillers such as such as Restylane and Juvéderm to help achieve a more alluring look and to restore the lips back to their former youthful appearance with greater balance and volume. These advanced fillers are composed of Hyaluronic Acid which is naturally found in the body. Hyaluronic Acid aids in maintaining the structure and thickness of the skin but it is slowly depleted through the aging process.
Since all these substances dissolve over time, they must be topped up every 3 to 9 months.
Permanent implantation by injection
Permanently injected substances have a tendency to be somewhat firmer than normal lip tissue and can sometimes produce lumpy results. There are however a number of products becoming available.
The disadvantage of permanent implantation is of course its permanence. If a patient were to change their mind about their lip enlargement in the future, such materials would be difficult to remove.
Some patients might also find the permanent implantation to be firmer than normal soft tissue. The usual test is whether kissing and biting into an apple appears normal. There may be some patients that might notice a difference.
In carrying out the implantation, usually small amounts are injected at a time, since it is easier to add more than to take it away.
Augmentation employing fat is usually considered to be temporary. This procedure has the advantage of employing the patient’s own tissue and therefore there will be no allergic reaction. The fat is collected either as part of some other liposuction procedure or harvested specially for the purpose of lip augmentation. Usually the fat is taken from the abdomen or the buttocks. It can be stored in the fridge for later use for many months.
Injection of fat however does cause a greater degree of temporary swelling than does the injection of other substances.
Permanent lip augmentation using the patient’s own tissue
The deeper layer of the skin, known as the “dermis” has been employed as a graft for many years, but recently it has also become popular in lip enlargement. The tissue is typically harvested as a by-product of another operation where it would normally otherwise be discarded: e.g. abdominal reduction, breast reduction, facelift, etc.
In this procedure the epidermis (outer skin) is removed and the shaped dermis is threaded through from one side of the lip to the other. Since the patient’s own tissue is being used, the advantage is that this tissue normally takes well as a graft, thus avoiding the potential for an allergic reaction. However there is still the possibility that the graft may not take fully, and there will be some thinning of the dermis with age. Nevertheless, good results can be achieved.
This is also a bigger procedure, producing more swelling for longer (typically one to three weeks). And as in any operation, it can can also create complications involving infection and bleeding. As an alternative to employing dermis tissue, fascia tissue (the covering of muscle) can also be used. This can either be the “temporalis fascia”, taken from the covering of the temporalis muscle under the scalp at the temple, or from elsewhere.
It should be noted that lip augmentation by injection or graft is limited by the amount of vermilion or mucosa of the lip that is available. Some older people have very limited amounts of vermilion.
Surgical advancement of the vermilion
The mucosa of the inner side of the lip can be advanced downwards to create a fuller lip or even advanced downwards and round so as to replace normal skin. This last operation will however destroy the normal white line.
However such reconstructive procedures are mainly employed in the treatment of congenital deformities and deformities acquired through injury or disease.
Which lip enhancement procedure is the best?
There are many procedures that can be used to enhance the lips. Besides its use in treating lips that are considered to be too small and thin, a lip enhancement procedure can also be performed to address any of the following conditions:
- Poorly defined lips or “Cupid’s bow”
- Thin or flat lips
- Fat lips
- No upper lip
- No lower lip
- Lopsided or asymmetrical lips
When the lips are too large or asymmetrical, a surgical lift enhancement procedure may also be needed. Excessively large lips may also be treated by liposuction. However the surgical option should be considered as permanent since it will dramatically alter the lips’ structure and in the majority of cases simple non-surgical enhancement using dermal fillers is all that is required.