Natural Lip Augmentation
The lips play a central role in enhancing facial beauty and attractiveness. Across cultures, full lips are considered to be an attractive feature and universally desired. Anthropologic studies, suggests that the presence of full lips are suggestive of youth, sexuality, fertility and overall attractiveness. Given the cross cultural favorability of fuller lips it is no wonder women and men of all ages desire to have this feature.
Who are the candidates?
There are two basic categories for lip augmentation:
Cosmetic Lip Augmentation. These patients are typically in their 20s and 30s and are motivated to enhance their lips by creating a fuller, sexier, and more pouty lips.
Lip Rejuvenation: This group of patients are typically in their 40s and beyond and have noticed that their lips are thinner than before and they are seeing a loss of the border between the red lip and white (called the vermillion border). Additionally, there may be fine lines beginning to form in the upper lip. This often causes lip stick to bleed into these lines as a result of both of these changes. The goal here is to restore the contours and shape of their youthful lips.
The steps and techniques are different in when treating each of these groups, however, the basic principles are the same when creating a natural looking lip.
The Principles to Creating Natural Lip Augmentation
The principles are simple:
Do not over-fill.
Respect the unique nature and anatomy of each lip.
Use aesthetic judgment and artistry to create an attractive lip that enhances their beauty.
Be meticulous and obsessive to achieve symmetry and balance.
Be very discriminating about what you inject into the lips (don't experiment with new products or technologies).
What can be used to augment the lips?
There are many different techniques and products used to augment the lips. My personal choice is guided by efficacy and safety. As a result, I generally use Juvederm Ultra or Fat.
Juvederm Ultra is a filler consisting of hyaluronic acid (HA). HA is a natural product found throughout our bodies. The consistency of this particular product is soft and smooth and when injected properly it feels and looks very natural. The typical volumes used are between a ½ to 2 syringes. It lasts about 6 months in most cases. The lips appear swollen at first but with a few days the swelling starts to settle. It can take a full 2 weeks until all the swelling has settled. As a general rule, the lips may appear a bit unnatural or even asymmetric during the first 2 weeks and it is tempting to touch them up. However, as a rule, I never touch them up until a full 2 weeks has passed. This is because most of the issues resolve once the swelling settles. The procedure is essentially painless. We use a strong topical anesthetic on the lips and the newer products have Lidocaine in them so the injections hurt much less than in the past. Also, this newer technique avoids the need for a dental block, which many patients do not like.
Fat Injection is also commonly performed in our practice. The advantage in the aging lip is that it you can achieve a subtle and permanent result. The disadvantage is that the swelling required to achieve an effective result can take between 3-4 weeks to settle. In the end, however, the lips look very natural.>
Like everything we do in medicine and surgery, there are potential complications. In the case of lip augmentation, most of the products I mention about are safely injected without intrinsic problems. However, as a result of poor technique, lack of experience, and an overall lack of knowledge what a naturally full lip looks like, the poor cosmetic result that may occur as a result can be difficult for some patients. Many of our impressions of what cosmetic lip augmentation looks like is not favorable. However, it is important to note that poor or unnatural results occur because of the individual injecting the lip and not simply because the lips were injected. This is why it is important to be selective about who injects your lips. As a National Trainer and Lecturer for Allergan (makers of Juvederm, Botox, and Latisse), I have personally trained dozens of nurses and physicians throughout San Diego on proper and aesthetically sound injection methods.
Another concerning trend is toward injecting permanent products that are not FDA approved. Unfortunately, patients often get these products placed in foreign countries like Mexico or South America. To correct some of these problems, the patients then require a lip reduction. This requires a surgical removal of the permanent and often over-filled product in order to return the lip to a more balanced and natural appearance.
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