Kiss and Tell: The Secrets Behind Lip Augmentation

Dr. Kamakshi R. Zeidler and Dr. Amelia K. Hausauer of Aesthetx, the premier practice in the Silicon Valley for aesthetic medicine, offer their insight on lip augmentation and the many options available.

When looking at the cover of the latest fashion and beauty magazines, it is hard to miss those full, voluptuous lips pouting back at you. What is the secret to these beautiful pillows?

Many choose to undergo lip enhancement treatments to refine the shape of thin or flat lips, restore volume to aging or thin lips, improve symmetry between upper and lower lips, or smooth out vertical lines around the lips. Lip enhancement options range from surgical to non-surgical procedures and quite frankly, all of the choices may seem overwhelming at first. To help sort all the options, first ask yourself “how long do I want my full lips to last?” Based on this answer, your lip enhancement can be broken down into two categories: semi-permanent (non-surgical) or permanent (surgical) solutions.

Non-Surgical Treatments: Quick Way to Plump and Refine Lips

The most common semi-permanent solution is lip augmentation with fillers, which are injected into the upper and lower lips to precise sculpt, plump or even out asymmetries. Fillers are a wonderful way to customize treatment, adding as much or little as desired over a series of sessions as needed to maintain the appropriate proportion and desired overall look. We recommend using hyaluronic acid fillers such as Juvederm Ultra, Vobella or Restylane products to achieve the softest effect. Hyaluronic acid is a major component of the deeper layers of the skin, so it is well tolerated and highly customizable. Some of these products are actually FDA-approved for lip enhancement, while others are not but have volumes of medical literature to support their safety and efficacy. Prior to this in-office procedure, it is important to have an in-depth discussion to understand what each patient wants to achieve. The next step is to assess the lips and determine which areas need finessing, keeping in mind of course, the overall balance and shape with your face.  At Aesthetx, we rely on different products to provide different effects. For example, Juvederm (off-label) creates a beautiful rolled border that offers structure and minimizes lipstick bleed without giving an overly pumped-up or heavy look. Vobella, by contrast, is “lipgloss in a syringe” as it smooths interior lip lines and provides a hydrated, but not volumized appearance. Belotero is perfect for treating pencil thin lines around the mouth without adding bulk or thickening the skin of the lip. Other non-hyaluronic fillers like Radiesse and Sculptra should not be used in the lips, because they cause bumps and nodules.

The benefit of lip fillers are several. Injection is quick and only takes approximately fifteen to thirty minutes to complete. Patients can return to work or home immediately following the injection with minimal downtime. The biggest drawback is risk of a bruise. There is a low possibility of allergic reaction, since hyaluronic acid is a natural component of the skin. Additionally, the amount of fillers used can be adjusted precisely and exactly, and hyaluronic acid fillers are dissolvable, so there is room for tweaking and building as desired. Since these are a semi-permanent solution, patients do need to return six to twelve months later for repeat treatment or touch-up.

Surgical Treatments: Leveraging Fat and Tissue

For more durable options, there are several surgical procedures to boost and shape. The process of adding your own fat, called autologous fat grafting, is one treatment for those who want to use only their own natural body tissue. During this procedure, fat is removed from one part of the patient’s body, such as the abdomen or back with liposuction, gently cleaned, then injected into the lips. The benefit? Fat looks and feels very natural, the risk of a potential allergic reaction is close to zero and no incisions are needed. The downside is that there is a lot of swelling, so most patients need to wait about a week before feeling their lips are ready for prime time. Fat also provides a subtle result. Due to its soft consistency, it does not change the shape of the lips. So for those looking for more dramatic shape changes, fat can sometimes be disappointing. Because the fat cells are injected in part into the lip muscle, over time, the transplanted fat cells can shrink in size, making some patients feel that the results are less predictable over long periods of time.

Another option to balance and enhance the lips is lip lift surgery. It involves removing a small bowtie or mustache shaped piece of tissue at the base of the nose above the upper lip, where the scar is best concealed, to shorten the upper lip that lengthens as we age. This surgery restores harmony between the upper and lower lips and causes the upper lip to roll outward more, appearing more voluminous.

Historically, dermal grafts taken from your own body or that are made of donor collagen matrix, have been used to provide lip fullness. This technique is utilized more in reconstructive surgery and over time has fallen out of favor due to the easier and more reliable options listed above.

Lip implants and permanent fillers are also available, but these treatments are not as common as they have higher complication profiles. A lip implant requires an incision and the creation of a tunnel in the tip to place a permanent implant. While the scars can heal well, there is a risk of extrusion where the implant can work its way out of the incision.

Whatever your lip plumping goals are, make sure to see an expert who can give you a sense of what options are best for your anatomy while achieving your ideal look.