The lips are a prominent landmark on any woman's face, and women have enhanced the appearance of the lips since time immemorial with lipstick and other makeup.
Now, improved techniques allow us to safely and reliably enhance the lips beyond what is possible with makeup.
The pink part of the lip is called the "vermillion," and it goes from the "white line" where the vermillion meets the skin, back to the "red line" between the skin-like vermillion on the outside of the lip and the moister pink mucosa on the inside of the lip.
Of course, the lips are very sensitive, so some sort of anesthetic is often used. The common fillers are generally mixed with a local anesthetic to reduce the discomfort of injection.
Topical anesthetics can also be applied, but generally take an hour or so to be most effective. These work best when applied by the patient between an hour and an hour and a half before her appointment.
Perhaps the most effective anesthetic is usually called a "dental block," because it makes the whole lip area numb, even though dentists would never place local anesthetic that way (they are more interested in numbing the teeth than the lips!)
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Depending on your needs and goals the following approaches can be taken:
The most common approach to lip enhancement uses fillers, because they are readily available, safe, and very effective. While some patients want a very dramatic result with substantial enlargement, which is certainly possible, others want a more natural result.
In any case, the artistic touch is critical when doing lip enhancement will fillers. It is also important to understand the internal anatomy of the lips, including the location of the blood vessels, to reduce the chance of problems.
The most subtle lip enhancement, and the most common, involves putting a controlled amount of filler along the margin of the vermillion (the pink part of the lip, as opposed to the skin on the outside and the mucosa on the inside).
Further lip enhancement can be done by placing a larger amount of filler within the vermillion itself.
I always do the lip injections very slowly, especially if you have not had them before, so that we do not "overshoot" and produce more lip enhancement than you want.
While modern fillers are much longer lasting, and some of the filler probably remains for about a year and a half, many patients will want to add additional filler after about nine months or so, as it goes down slowly over time.
PERMALIP™ LIP Implants
An excellent option for a woman who wants a more permanent lip enhancement is to use the PermaLip™ silicone rubber lip implant. This is a surgical procedure that Dr. Nachbar does in the office under local anesthetic.
The PermaLip implants come in various sizes, both different lengths and different thicknesses. The length will be determined by measurement of the length of the lip, but the thickness is determined by the amount of lip enlargement desired. Sometimes, if the upper lip needs more enlargement than the lower lip, different thickness implants can be used in each lip.
After the area is anesthetized with local anesthetic and cleaned, a small incision is made on each of the two corners of the mouth. The pocket is created in the lip using a dissector, and once the tunnel has been made, the soft silicone PermaLip implant is pulled into place with a surgical tendon passer. Both the upper and lower lips can be treated through a single incision at each end of the lips.
There is more swelling and recovery with lip implants than with injections, but once this has healed, patients have told me that the implants are very soft and comfortable, and that neither they nor their partners can feel the implants when kissing.
I generally recommend that women use injectable fillers for their first lip enhancement, so they can decide how much they like the enhancement with a solution that does not make a permanent change. However, when they want a more permanent solution, the PermaLip implant can be used.
Should the woman later decide she wants to remove the implant, it can be done through a small incision just inside the center of the lip.
It is also possible to get additional lip enhancement using fillers after the PermaLip implant is placed.
FAT TRANSFER AND LIP LIFT
Other options for surgical lip enhancement include Fat Transfer and Lip Lift.
Fat transfer involves taking a small amount of fat from another part of the body and injecting it into the lips as a fat graft. Then, the surrounding tissue sends blood vessels into the transferred fat to keep it alive after the transfer.
The percentage of fat that will survive is variable, but most patients get at least some long-lasting lip enhancement with this technique. You can improve your chances by minimizing movement of your lips in the first week or two following the transfer.
Fat transfer does produce much more swelling, for one to two weeks, than filler injection, but can produce a longer-lasting result.
A Lip Lift procedure can also be done to enhance the appearance of the lips. There are several possible techniques, but one technique removes some skin from just below the nose, to pull the skin upward and thus turn more of the pink vermillion forward. This can be combined with other techniques which increase the volume of the lips.
what to expect
While the result from injection of off-the-shelf filler is immediate, with only a little swelling, generally for just a few hours, PermaLip lip implant, fat transfer, and lip lift involve more swelling and recovery.
Plan Your Procedure
If you would like to enhance the appearance of your lips, no matter your age, please call Dr. Nachbar at Scottsdale Plastic Surgery, for a complementary consultation so we can discuss your goals and guide you toward your best solution.