Lip Augmentation

Other Associated Terms: Lip Enhancement, Lip Lift.

lip_augmentation

Overview:

Like the other features of our face, lips make up a significant part of our appearance. Our faces convey our emotions and form an essential role in communication with others. Lips can present a smile, a frown or a kiss and can also determine whether or not we look vibrant or aged. Some popular media stars are actually famous for their full lips, which gives them a distinctive, desirable image.

Those of us who also desire fuller lips, either to enhance our appearance or ward off the effects of lost volume due to aging, may wish to consider lip augmentation. The purpose of this procedure is to give more volume and to contour the shape of the lips in order to give them more aesthetic appeal.

Benefits:

Lip Augmentation benefits are directly related to one’s self-image and sense of self-confidence. Lips that are thin, aged or not in proportion can be altered to give a more pleasing, youthful look through injectable fillers or implants. For women, plump lips are a projected bio-signal (biological) of fertility and youth since the thinning of the lips, as aging progresses, is due to lowering estrogen (hormone) levels.

This signal is perceived by men at a subconscious level. Just another reason why full, plump lips are so pleasantly noticeable in our society.

In general, lip augmentation can give back one’s youthful appearance or give lips that are naturally thin, additional volume that they never had. Since lip augmentation is a quick and simple procedure, recovery times and risks/complications are held to a minimum.

Patient Characteristics:

The ideal candidate for lip augmentation is someone who is in good health, both physically and psychologically, and who has realistic expectations of the final results. The purpose of seeking lip augmentation may be to; provide more facial symmetry, increase self-esteem, restore volume lost due to aging and enhance facial appearance. Your own personal reasons for wanting this procedure should be discussed with your doctor during your consultation.

Filler/Material Types:

There are different fillers and implant materials available for lip augmentation. These include the following:

AlloDerm® can be used for lip enhancement and is similar to Dermalogen. The material for AlloDerm™ is obtained from the skin (dermis) of a recently deceased donor and then processed into sheets. The benefit is that it provides a safe, easily molded filler that is very compatible with lip augmentation procedures. Like collagen, the effects are temporary and additional procedures will be indicated.

Artecoll® is mostly collagen, which is a protein found in mammals. Our collagen’s thinning results in wrinkles as we age. Seventy five percent of Artecoll® is collagen (bovine) while the remaining twenty five percent consists of Plexiglas (plastic) beads, in suspension. The benefit is that it is a more permanent filler than regular collagen or fat injections. A drawback would be the possibility of an allergic reaction to collagen – so preliminary tests need to be performed, prior to its use.

Autologen is collagen that is taken from your own body and processed for injection. Since the material is taken from your own body, the chance of rejection is eliminated. However, the process requires more than one visit to the doctor, for the procedure, and the results are temporary, since the material is reabsorbed into the body.

Bovine Collagen is taken from cows with the benefit of lasting from only four to twelve weeks. This will give the patient a preview of what a lip augmentation will look like and allows for a decision that may involve more permanent fillers at a later date. There is a risk of an allergic reaction which necessitates an initial test for this possibility.

CosmoDerm®/CosmoPlast® are fillers made from human skin that is grown in a laboratory. The fillers also contain lidocaine which reduces physical discomfort. Since the materials are laboratory produced, no allergic tests are needed. CosmoPlast® is used in lip augmentation (sometimes along with other products) and CosmoDerm® is used for fine lines. The downside is that the products only last from three to six months.

Dermalogen (see AlloDerm®)

Hylaform® is made up of hyaluronic acid and harvested from deceased donors (see AlloDerm®)

Radiesse® (Radiance) is a calcium based filler that has the advantage of lasting an average of 2 years (some report 3-5 years). However, while Radiesse® is FDA approved, Radiance® has FDA approval pending for cosmetic use. Downsides include that fact that removal can be difficult, should it become necessary. It is also more expensive than collagen and can cause lumps – particularly in the lips.

Caution: Make sure that you seek an experienced doctor and that the product used is genuine  Radiance (or Radiance FN) – not spurious hydroxylapatite powder mixtures or Coaptite®.

Restylane® is an injectable gel containing hyaluronic acid (which is found naturally in humans). This material provides for less chance of rejection and is absorbed into the body within approximately 6 months.

Juvéderm® is an injectable gel made of hyaluronic acid that has the added benefit of lasting longer than other temporary injectables (up to a year). Like Restylane®, here is also little chance of allergic reactions.

Fascia is connective tissue that can come from either your own body or that of a deceased human donor. After the material is obtained, it can be surgically implanted and may last up to one year before being reabsorbed.

Fat Injection (See Autologen)

Fat Grafting (See Fascia) – some of the material may stay permanently but the amount is unpredictable.

A local flap procedure will bring a strip of skin from inside the mouth and use it to augment the lips. The downside is that it a more advanced procedure and requires sutures (stitches) that are placed inside the mouth and on the site where the lips are enhanced. The results will last for about a year, before the skin is reabsorbed into the body

Permanent results can be achieved with implants made of synthetic materials such as soft ePTFE, Gore-Tex® and SoftForm. In the case of Gore-Tex®, the material is porous and will allow tissue to grow into the implant – which will make it part of the actual structure of the lip.

Fillers that are not FDA approved or are not for use in the United States:

Amazingel (aka Amazing Gel or Amazingel – Single Injection Wrinkle Remover): A polyacrylamide implant that is at risk for infections (even years after injections). Available in Asia and illegally brought into the United States via Mexico.

Aquamid – made by a Danish company but not officially available in the United States. It is composed of hydrophilic polyacrylamide and can be 300 – 400 times its weight when in water. It does not have FDA approval.

Argiform (Argyform) – made in Russia, it is a polyacrylamide gel made of 95% polyacrylamide with the remainder composed of water. Not FDA approved.

Bio-Alcamid or BioAlcamid – A permanent injectable hydrophilic polyalkylamide gel. Available in Mexico but not in the United States.

Bioplastique – This is an implant (injectable) made of solid microspheres of silicon that are suspended in a gel material that is neither soft nor hard – but similar to cartilage. It is not approved by the FDA for use in the United States.

Biopolimero – A silicon oil product that is found in South America and in United States towns that are near the Mexican border. The use of this material is discouraged by U.S. cosmetic surgeons.

DermaLive® (and DermaDeep®) is a newer product that combines tiny particles of acrylic hydrogel and hyaluronic acid. It works by building up collagen around the particles, which gives it its’ volume. This product is not approved in the United States due to complications that have been reported.

Evolution – is made of (positively) charged microspheres that are suspended in a gel (polyacrylamide). The material is advertised to last 2-3 years or longer but is not available in the United States. It can be found in Asia, Africa, Europe, U.K. and Australia.

Kopolymer 4E – A semi-permanent filler that is not available in the United States but can be found in towns near the Mexican border.

Metacrill – made of polymethylethacrylate microspheres suspended in a cellulose material. The results can be permanent with the possible formation of granulomas. Not available in the United States but can be found in towns near the Mexican border.

Outline – see Evolution.

Profill (Profil) – contains polyoxyethylene, amino acids, vitamins and mineral salts. This material comes in the form of a liquid that turns into a gel upon implant. Not FDA approved.

Silicon Injections – are not FDA approved for cosmetic use (but are approved for other uses in the body, such as in retinal detachment treatment and the material is intended to be removed later). The most common approved silicon products for use in the human body are Adatosil 5000 and Silikon 1000 (ask to see the label on the vial)

Procedures:

Injectable filler lip augmentation procedures are simple and don’t take much time – usually lasting approximately a half hour. The injections are performed as an outpatient procedure in the doctor’s office or medical center and the patient will go home the same day. The procedure is also relatively painless once a local anesthetic is given (either topical or injection).

The procedures, themselves, will vary depending on the type of filler used. Some variations that can be expected are:

Collagen injections require a skin test that will check for a possible allergic reaction. This allergy test will be performed several weeks before the scheduled injections.

For fat injections, anesthesia will be applied to both recipient and material donor sites. The fat that will be used is drawn off with either a suction device (cannula) that is similar to the one used in liposuction or with a syringe. The fat will then be sent to the lab for processing and injection into the recipient site (lips).

No allergic skin test is required for Restylane®. A thin needle will be used to inject the material in tiny quantities inside the lower and upper lips to add shape and to increase lip volume.

Surgical lip implantation is also a relatively simple procedure that can take as little as an hour to complete. Local anesthesia is used and the surgeon will initially make small incisions at the corners of the mouth and possible other locations on the lips. The material will be used in sheets and threaded through a thin, small tunnel that has been created. The implant is trimmed to precise dimensions and the incisions are then sutured closed.

Recovery:

Recovery from any procedure will usually hinge on factors such as the patient’s health and the actual procedure that was used. Injection procedures tend to have few side effects that only last for a couple of days. In some cases, though, there can be some swelling and/or bruising that can last up to a couple of weeks (depending on the injection type).

Surgical implants, however, take a bit longer and you should allow for at least two weeks for recovery. During the recovery period, you can expect some mild discomfort for up to two days and some bruising/swelling for up to a week.

You will be instructed not to sleep on your stomach and to avoid strenuous activities for up to three days. You will need to keep your lips clean (infection avoidance) and limit laughing/smiling for the first week after surgery. Also, you should limit talking and chewing for the first 48 hours after surgery while applying ice packs periodically.

Recovery with flaps and grafts procedures will take one to two weeks. Lip stiffness may be experienced for 2-3 months with occasional drooling for the first 2 weeks.

Risks Associated with Lip Augmentation:

While standard risks apply with any procedure, specific risks can be inherent with certain materials and/or techniques used in lip augmentation. These should be discussed with your doctor prior to making the decision to have a particular procedure.

For injectable materials, the risks will usually depend on the reaction of the patient to the filler material. Some examples are:

Collagen risks will usually involve the possibility of an allergic reaction. This is why an allergy test is performed prior to the injection. However, a negative allergy test result is still no guarantee that a reaction will not occur.

Fat injections, while not carrying a risk of allergic reactions, may still have other rare complications, such as infection (which can be treated with antibiotics).

Restylane® may present some temporary side effects, such as tenderness, moderate discomfort bruising or redness.

With implant surgery, there can be the standard risks such as bleeding, numbness, asymmetry and a possible reaction to the anesthesia. Material from the implant may also migrate to a different location and protrude. Rejection is also a possibility with any foreign substance.

As stated before, you should discuss potential risks associated with your particular procedure with your doctor.

Procedure Costs:

Injectable Lip Augmentation utilizing materials, such as collagen and Hylaform®, produce results that will usually last about six months. The average cost of injectable procedures run about $330 a session. However, you should consider result maintenance when factoring total expenses. Since the results are temporary, multiple procedures will be necessary throughout the years.

Fat Transfer Lip Augmentation procedures range from $2500 – $4500. Although the procedure is more expensive than other injectables, there is an advantage due to low allergic reaction risks and extended life of the results.

Permanent Lip Implants have the advantage of not being absorbed into the body – but they are still reversible. Gore-Tex® lip implants, for example, average $1,500 – $3,500. It’s important, though, to discuss all costs with your surgeon to understand all costs associated with your procedure (to include anesthesia, tests and miscellaneous expenses).

Things to Discuss with Your Surgeon During Your Consultation:

During your consultation, there will be several topics that you may wish to discuss with your doctor. The discussion should include the details of what you would like to see, in your results (you need to be specific). This will help establish a base-line for reasonable expectations. Numerous before and after photos should be viewed and you should determine the extent of the doctor’s experience in the procedure you’re seeking.

Ask questions regarding risks and determine the percentage of that doctor’s patients who experience these complications. You need to let your doctor know your detailed medical history (especially allergies, medications you’re taking and any history of pronounced scarring).

Total costs should be discussed and since the procedure, most likely, will not be covered by medical insurance financing options, if necessary, should be reviewed. The specifics of the procedure should be discussed as well as recovery procedures.

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