The more mature patient typically notices a loss of volume and thus projection and softness change as lines and wrinkles develop when the filling(lip anatomy-fat, muscle, skin) decreases with age, use, and sun damage.
Currently, there are various options to address these changes.
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Q. What are the surgical and nonsurgical choices to enhance my lips?
- Nonsurgical options primarily include the hyaluronic fillers (Juvederm Ultra XC, Restylane, Perlane, Belotero) which can be injected typically after local anesthesia of the lips to enhance both the fullness or bulk of the lip as well as the finer features including the junction of the pink lip and facial skin to define the cupid’s bow of the upper lip and white roll junction of both lips while camouflaging many of the vertical lines where lipstick runs. Combination of fillers for bulk versus delicate enhancement are also used.
- Surgical options can vary from fat transfer(which can be done under local but many patients combine this with other facial surgery where they are asleep for the primary procedure. Fat transfer (autogenous fat grafting) includes liposuction fat from sites such as the tummy, thighs, etc. and using your own fat (live cells with growth factors and small percent of stem cells) within the lips.
- Patients who are pleased with results of fillers can then consider using their own skin-fat graft( taken from hidden sites(e.g. Lower abdomen, excess skin in front of ear, etc) which is then placed inside the lip through two small internal incisions(not visible) as essentially a permanent filler. This procedure is more commonly done under anesthesia.
Q. How long do the lip augmentation options last?
- The nonsurgical fillers typically last from 6-8 months and do require touch ups. After multiple treatments many patients note longer term improvements up to a year.
- Fat transfers depend on immediate postop care by the patient. These are live cells which can be damaged if direct pressure or excessive movement occurs especially during the first few weeks. Typically what is there after four months (your body has grown blood vessels into and the fat is now part of you) is permanent. Obviously, if you lose or gain weight it can be lost in these areas as well.
- Solid skin-fat grafts placed within the lips are more or less a permanent change.
Q. Can my lips be made to look like a celebrity or movie star I find attractive?
- No. Your lips can be enhanced to optimize what your natural anatomy is. Lips can be rotated out to show more pink, the white roll(area above pink of lip) can be contoured to define better and eliminate lipstick bleed(lipstick filling in lines or wrinkles) to a great extent. Your lips can be smoothed and improved but will always be based on your natural anatomy.