Lisa Rinna has had a very successful Hollywood career which she credits, in part, to her large, Augmented Lips. When it comes to a beautiful face, the lips are second only to the eyes. Subconsciously, we associate fuller lips with youth and fertility. Larger lips are a big contributor to the “glow” of a pregnant woman’s face. As we age, so do our lips, and gradually they become thinner and thinner. Lip augmentation can be an integral part of facial rejuvenation.
Lisa Rinna is putting her lip troubles behind her.
Lip Augmentation with Silicone Injections
Lisa Rinna had been very forthcoming with the fact that her lips were enhanced with injectable silicone. Liquid silicone injections are problematic, and her honesty has helped other young women avoid the same fate. Right after silicone injections everything looks great, but with time, the body creates scar tissue around the globs of silicone. The result is palpable, and often visual, lumps and lip distortions. Lisa does not regret her decision, but 20 years after the Silicone Injections, her lips were a lumpy mess. She underwent surgery to remove as much of the silicone and scar as possible. Here is the story in her own words:
“Here’s the story: 25 years ago, I had my lips injected with silicone. Stupid thing to do at 24. I saw ‘Beaches.’ Remember that movie ‘Beaches’? I did it with my best girlfriend, so she and I go and we get our lips done. Fine. I have it like that for my whole career, right? So then cut to a couple of years ago, I have a doctor remove as much as they possibly can because it got to the point where they were yucky. You know, they get hard. It’s gross. They are now whatever that was after they took out as much of the silicone as they could.”
Surgical Correction after Silicone Injections to the Lips
Lucky for Lisa, her lips still look fine. Twenty-five years ago, the risks of silicone injections were not as clear cut, and the only approved injectable was Collagen, which was hard and completely gone in a month or two. Today, we have much better alternatives. Lip Augmentation can be performed with injectable HA’s like Restylane and Juvederm in a few minutes in the office. The results do need to be maintained; however, the results are full and soft, something that has not been possible previously without surgery. How long the results last is variable. Average results are 4-6 months and if you decide you not longer need it, after the plateau phase, the lips gradually return to their original size.
Permanent Lip Augmentation
Since lips thin as we age, there are no Permanent Lip Fillers. Even the perfectly sized lips will need a little maintenance to counteract the normal aging process. Inserting permanent fillers, like silicone, promotes the formation of chronic scars and foreign body reactions like granulomas. HA fillers are made from Hyaluronic Acid (HA), a normal component of skin and joints. Unlike free silicone injections, our bodies recognize HA as a normal component of the skin, and we have natural hyaluronidase, an enzyme that can clean up HA.
Lip Augmentation Before and After Pictures
Lip Augmentation Before and After Photos: Lip enhancement performed with HA filler.
Lip Enhancement Consultations
If you are considering Lip Augmentation, especially if it is your first time, consider a brand name HA filler like Restylane or Juvederm. They can give a soft natural result, which is easy to maintain. Swelling is minimal, and with ice and elevation, the appearance is normal in 24-48 hours. Longer lasting alternatives are available, but they require a longer recovery, and are best when the goal size is well known.
Other Lip Enlargement Resources
Other articles on lip augmentation are available on the San Francisco Plastic Surgery Blog and my main web site. Here are the links:
If you’ve been considering smoothing the lines around the mouth, or enhancing the size of your lips, now is the time to do it. Right now, our Walnut Creek Plastic Surgery office is accepting Gilt City vouchers for Restylane and Perlane. If you are already familiar with facial wrinkle fillers, you can take advantage of this offer too. Here’s how it works…
Restylane and Perlane Discount Coupons
Go to Gilt City before August 16, 2012, and purchase a voucher good for $100 dollars off any 1 ml Restylane treatment for only $49. If you need more volume, $300 coupons, used for any 2 ml Restylane treatment, can be purchased for only $149. Vouchers are valid 24 hours after purchase, and must be used by September 30, 2012. Vouchers are transferable, and can be combined. Some restrictions apply, see Gilt City Restylane voucher’s web page for full details.
How to Redeem Your Restylane Vouchers
Your Restylane voucher will arrive via e-mail in 24 hours. Print your coupon, you will need to bring it with you to your appointment. Schedule your appointment with Dr. Mele by calling (925) 943-6353. You can use the voucher toward treatment on the day of your consultation.
What if I’ve never had Restylane, Perlane or other HA fillers (Juvederm)?
If you never had correction of facial rhytids or lip augmentation with an HA filler, you will need to be evaluated prior to your first treatment. An in-person consultation is required to determine if treatment is right for you. If you are eligible, treatment can be administered that day. Although uncommon, in the event that you are not eligible for treatment with Restylane or Perlane, Gilt City will provide a refund.
The Liquid Facelift - Wrinkle Fillers: Restylane, Perlane, Juvederm, Radiesse; and Neuromodulators: BOTOX Cosmetic, Dysport and Xeomin.
The Liquid Facelift is a quick way to reduce the signs of facial aging. Technically not a facelift, the term liquid facelift refers to use of volume restoring injectables like Restylane, Perlane, Juvederm and Radiesse. These products can fill unwanted wrinkles and enhance facial features that are desired.
Filling Unwanted Wrinkles
Dermal Fillers are a class of pharmaceuticals designed to plump sagging skin. Unwanted facial wrinkles, like those found around the mouth, can be carefully filled to significantly reduce their appearance. The treatments are performed right in the office, and the downtime is minimal.
Dermal Fillers are administered with a fine needle, and come complete with local anesthetic inside. The most common unwanted side-effects are temporary and include swelling and bruising. Icing after treatments can help reduce both. A few days prior to your treatment, it is important to avoid medication that thins the blood like: aspirin, ibuprofen, naprosyn, vitamin E, fish oil and many natural supplements. This will reduce your risk of bruising. If you are planning to do some wrinkle reduction for a special occasion, do not delay. Ideally you should have the treatment done several weeks in advance. If you bruise, you will have plenty of time to recover, but your results will last for months.
Enhance Facial Features
Sometimes the goal is not to disguise, but to augment. Restylane, Perlane, Juvederm and Radiesse can be used to increase the size of some of the face’s most desirable features. Hyaluronic based fillers like Restylane, Perlane, Juvederm, can be used to enhance the lips. While Radiesse can be used to enhance the cheek bones and chin. If you are considering facial augmentation with cheek or chin implants, dermal fillers can provide a way to try it out on a temporary basis.
Maintaining the Result You Want
If you want to maintain the results, it is necessary to touch up the areas from time to time. For most patients, touch-ups require less volume than the initial treatment. This is because we are adding volume before the previous correction has completely resorbed, and because these product promote your face to produce collagen in the areas of injection. Even after treatment, the face continues to age. Dermal fillers cannot provide permanent results. The amount of wrinkle reduction, and the time it will last for you, may vary.
2011 Holiday Discounts on Selected Dermal Fillers and Neuromodulators
For the month of December several promotional specials are being offered in our San Francisco Bay Area, Walnut Creek plastic surgery office:
Any HA filler, buy two get one free includes: Restylane, Juvederm, and Perlane. All product must be administered by December 31, 2011.
Up to $65 rebate with each syringe purchased. (May be combined with above!)
Perlane – $65 rebate on each 1.0 cc syringe (maximum of 6 cc’s)
Restylane – $50 rebate on each 1.0 cc syringe (minimum of 2 cc’s & maximum of 6 cc’s)
$50 rebate on BOTOX Cosmetic and Dysport treatments of $200 or more.
Liquid Facelift Appointments
If you are interested in learning more about the liquid facelift and facial wrinkle fillers, or you want to know more about neuromodulators like Botox, Dysport and Xeomin, please give our San Francisco Bay Area Plastic Surgery office a call at (925) 943-6353, and schedule a personal consultation appointment. More information is also available on our web site under face: facial wrinkles (minimally invasive) or on DrMele.com under skin.
Dr. Mele discusses Rhinoplasty (aka: Nasal Surgery, Nose Surgery or the Nose Job) on the San Francisco Bay Area's News Station, KRON4.
Nasal Surgery (Rhinoplasty) Video – Part 2
Below is a nasal surgery (rhinoplasty) video from a recent appearance on KRON, channel 4. The show is Body Beautiful with host, Vicki Liviakis. What follows is part 2 of a 4 part special presentation on cosmetic nasal surgery (nose jobs). Rhinoplasty before and after pictures are included and a closely related procedure, chin augmentation (chin implants) is also discussed.
If you have questions about nose surgery, please give me a call at (925) 943-6353, or use the contact form on the left. Additional information and links are also available at the end of this post. The 800 number in this nasal surgery video was only for viewers to call in during the live show.
Sushruta, the Original Nose Job and Ancient Plastic Surgery
Sushruta - The Father of Indian Surgery and Plastic Surgery
While many consider plastic surgery a relatively new discipline, its origins are documented more than 4000 years ago by the Indus River Civilization of India. In Sushruta’s Compendium (around 1000 BC – 600 BC), Sushruta documents ancient medicine, surgery and midwifery 150 years before Hippocrates.
The Nose Job is one of procedures which defines early Plastic Surgery, and Sushruta is credited as the first to describe the details of rhinoplasty. His compendium shows clearly that surgery and cosmetic plastic surgery have always been linked. Sushruta’s techniques spread from India to Persia, Arabia, Egypt and eventually Europe, and some methods are still used today.
In the next part of this series Rhinoplasty (Nasal Surgery) San Francisco Bay Area (Cosmetic Nose Job) Part 3 of 4) we will jump forward a few thousand years to Gaspare Tagliacozzi, the Father of “Modern” Plastic Surgery.
Nose Job Video on KRON4′s Body Beautiful
Rhinoplasty (Nasal Surgery) Questions
This Rhinoplasty (Nasal Surgery) Video includes:
Nasal Septal injuries
Methods used to build up the dorsum of the nose?
Asian Rhinoplasty techniques
Septal cartilage grafts
Ear cartilage grafts
Rib (costal) cartilage grafts
Weir excisions – to reduce the width of the base of the nose.
Rhinoplasty before and after pictures with and without chin augmentation (chin implants)
Dorsum hump reduction with nasal tip-plasty and nasal tip reduction
Dorsum reduction with chin implant
Before and after pictures – chin implant alone
What is the role of Computer Imaging for planning cosmetic surgery of the nose and chin?
Types of chin implants
Silicone chin implant
Medpore chin implant
Comparing proportions to size of nose?
Non-surgical rhinoplasty, building up the nose with HA fillers:
The form of the nose vs. the function of the nose
The treatment of Nasal Obstruction
Additional Information on Nasal Surgery, Rhinoplasty and Nose Jobs
This is part 2 of 4 in a video series on Rhinoplasty (Nasal Surgery) in the San Francisco Bay Area. Additional segments can be found here:
Stem Cells Facelifts, Stem Cell Breast Augmentation, Stem Cells in Plastic Surgery - Marketing Hype or Next Big Thing?
Stem Cells seem to be everywhere today: Stem Cell Breast Augmentation, Stem Cell Facelifts, Stem Cell Facial Creams, but what is it really worth? Does the marketing hype live up to the objective evidence? Are Stem Cells the panacea? First a little background.
The idea of a Stem Cell is exciting: a cell that has the potential to change into any cell type you would want, placed where you want it. Sounds too good to be true, but science is marching towards exactly that. Currently, these types of results are reproducible under laboratory conditions, but are currently not as predictable in the patient.
Stem Cells Grafts and Stem Cell Injections
The original “Stem Cell” grafts were done for years, without doctors realizing that’s what they where doing. San Francisco Plastic Surgeons have been removing fat and transplanting it into patients’ wrinkles to reduce folds long before there was Restylane®, Juvederm®, Perlane®, Radiesse® or any other currently available prepackaged wrinkle filler. Fat grafting predates even the Bay Area’s own contribution to fewer wrinkles and larger lips, Collagen, and it turns out that fat grafts also contain stem cells.
Fat has More Stem Cells than Bone Marrow
I remember attending a presentation at the California Society of Plastic Surgery in Napa in 1995, during which the discovery of numerous and varying stem cells in liposuction aspirate was being discussed. It was at that time, we plastic surgeons began to realize that fat transplants contain more than just fat cells. Whether the fat is surgically removed and replaced as fat grafts, or is removed with liposuction and injected, stem cells are present.
Stem Cell Breast Augmentation
The first documented breast augmentation was done with fat in 1895. Surgeon Vincenz Czerny used a benign lumbar lipoma (fatty growth), to repair the breast asymmetry caused by removing a tumor. Larger volumes of fat could be used for primary breast augmentation; however, then as today, larger transplantations can be problematic:
The volume of fat that lives can be variable leading to unpredictable amounts of augmentation.
The area grafted can become lumpy and irregular.
Nodules can develop.
Calcifications can develop making it difficult to properly screen for cancer on a mammogram.
As the patients ages and gains weight, so too do the grafts.
Stem Cell Facelifts
Part of the reason the face ages is that the fat on the face atrophies (goes away). Healthy babies have big fat round faces, and youthful faces maintain this padding. As we age, we lose the fat that adds volume to, and supports the skin. The result is a longer, narrower face, and skin that sags. Replacing this lost volume is one of the holy grails of plastic surgery. Facial implants, fillers, fat injections all have there place, and each can be helpful. Most stem cell facelifts are simply fat grafting to the face. While expensive machines are available to concentrate the stem cells in the graft, most practitioners do not use them, and there is simply no evidence that concentrating stem cells helps. This is one of the questions that the Stem Cell Task Form considered, and the answer still remains unclear.
ASPS and ASAPS Joint Stem Cell Task Force 2011
I was in Boston this week for the annual ASAPS meeting, and on Monday, the ASPS and ASAPS joint position paper on Stem Cells and Fat Grafting was released. While the data looks promising, there is nothing currently in the literature to support the marketing claims you are currently hearing, and there is concern that these unsubstantiated claims will harm patients and tarnish the reputation of Plastic Surgery. The following is from the above referenced paper:
Terms such as “stem cell therapy” or “stem cell procedure” should be reserved to describe those treatments or techniques where the collection, concentration, manipulation, and therapeutic action of the stem cells is the primary goal, rather than a passive result, of the treatment. For example, standard fat grafting procedures that do transfer some stem cells naturally present within the tissue should be described as fat grafting procedures, not stem cell procedures.
The marketing and promotion of stem cell procedures in aesthetic surgery is not adequately supported by clinical evidence at this time.
While stem cell therapies have the potential to be beneficial for a variety of medical applications, a substantial body of clinical data to assess plastic surgery applications still needs to be collected. Until further evidence is available, stem cell therapies in aesthetic and reconstructive surgery should be conducted within clinical studies under Institutional Review Board approval, including compliance with all guidelines for human medical studies.
The collection and reporting of data on outcomes and safety by any physician performing stem cell therapies is strongly encouraged in order to advance the knowledge and science of stem cells.
Stem cell based procedures should be performed in compliance with FDA regulatory guidelines. If devices are employed that are subject to regulation by the FDA, surgeons should use these devices with appropriate approval in place, especially when used for investigational purposes.
Patients are advised to seek consultation for aesthetic procedures by a surgeon certified by the American Board of Plastic Surgery. These physicians are able to properly evaluate a patient’s concerns and offer a wide range of safe solutions. Extreme caution should be exercised when a physician is promising results from any treatment that sound too good to be true.
I continue to follow the debate, and as much as I want stem cells to be the next greatest thing, I also don’t want my hopes to cloud my judgement. Even among the tight knit aesthetic plastic surgery community, there is vigorous disagreement about the methods, safety and efficacy of fat grafting and the use of stem cells. At least a frame work for discussion has been defined, and the research is under way.
For now, buyer beware is still the best advice I can give. We all know that when something sounds too good to be true, it is probably not true, but we want to believe. Just because something claims to be new, it does not mean it is new, and being new has nothing to do with being better. We all want the greatest improvement with the least down time and no scars; however, there is something to be said for the tried and true. The older the procedure is, the longer it has survived, the more it has stood the test of time as a safe and reliable option.
Silicone is used in many beauty aids. While most people equate silicone with breast implants, there is much more to how silicone is used. From contact lenses to shampoo (dimethicone) silicone is around us every day. Silicone drainage tubes can be life saving after brain injuries to prevent fluid on the brain and death. Silicone implants are used throughout the body to improve both form and function. Most silicone implants are solid. Injection of free silicone is different than using silicone implants. Free silicone injections are liquid, and unlike with breast implants, the liquid is not contained.
Q: Is Silicone a Liquid or a Solid? A: Yes
Silicone is extremely flexible in its use. At body temperature, silicone can be made with a wide range viscosities: liquid like water, cohesive like honey, soft solid like Jello, more firm like rubber or hard like a rock. The fact that silicone is extremely well tolerated by the human body, makes it an excellent substance for implantation; however, only silicone meant for medical use should be used, and only by a qualified professional should be consulted.
How is Silicone Used
As a Board Certified San Francisco Bay Area Plastic Surgeon, I use silicone implants every day in my Walnut Creek Plastic Surgery practice. In California, silicone implants are used to augment the breast, cheeks, chin, nose and many other areas.
Silicone Facial implants are made of a soft solid silicone. Since they are solid, they cannot leak. They are used routinely for Cheek Augmentation, Chin Augmentation and Nose Augmentation. Since silicone facial implants are used to augment boney prominences, the fact that they are firm is an advantage. They can be molded into specialized shapes and sizes, depending on the amount and location of augmentation desired. The smooth surface does not adhere to normal tissue, so it needs to be meticulously placed. The smooth surface also allows for easy removal, should removal ever become necessary. Solid silicone facial implants are firm but flexible. For larger augmentations, silicone facial implants may not be firm enough.
An example: for small to moderate chin augmentation, silicone chin implants work great. For larger chin augmentations, I prefer Medpore®, which is made from porous high-density polyethylene. It is much firmer, and since it is porous, it allows in-growth. In-growth can help stabilize the Medpore® chin implant, and further decrease the already small risk of infection. These are decisions best made during your presonal consultation with a Board Certified Plastic Surgeon. This allows an open, honest discussion of the pros and cons of each option with a trained expert who has the experience to back-up your specific surgery.
Silicone Breast Implants
All breast implants have a silicone shell, even saline filled breast implants. When we say silicone breast implants we are talking about what is inside. Silicone breast implants have a solid outer shell, and a center filled with a cohesive silicone gel. Some older silicone breast implants were filled with a thin liquid, which would migrate if the shell ever broke. Currently, the cohesiveness varies from a very thick gel that likes to stay together (Allergan Natrelle® and Mentor Memory Gel® breast implants – currently available) to a solid with the consistency of Jello® (Gummy bear, Allergan Natrelle 410′s and Mentor Cohesive III Implants – Not yet FDA approved). These gummy bear implants can be made with various asymmetrical shapes, because they are thick enough to retain their shape.
Free Silicone Injections – Buyer Beware
The San Francisco Bay Area is a great place to be a plastic surgeon. We have an educated population that is interested and aware of many of the latest options in plastic surgery. Unfortunately, new doesn’t mean better, and sometimes new isn’t even new. Silicone injections are a great example. Even San Francisco plastic surgeons are still looking for the perfect injectable to fill wrinkles and augment the face without surgery. A well tolerated, stable substance, free from allergy, that will last a hundred years and remain soft remains elusive. There was a time when silicone was felt to be that substance.
Silicone is well tolerated, and can be made thick enough to prevent migration. The augmentation obtained is better than Restylane®, Juvederm®, Perlane®, Radiesse® or any other available dermal filler. It can remain soft for many years. Unfortunately, the body will form scar around free silicone, and this scar can continue to develop over years into a hard disfiguring mass.
Free Silicone in the Lips
Silicone has been used for lips. Initial results are great; however, the long term results are not predictable. Lisa Rinna, famous for her silicone augmented lips, recently had to have surgery to excise the silicone from her lips.
Free Silicone in the Buttocks
Silicone has been used for buttock augmentation. At first it looks great, but with time, it becomes hard and can cause visual disfigurement. Since medical grade silicone is not available in the United Stated, reports surface every year of an unqualified injector offering cheap buttock enhancement using silicone purchased at the local hardware store.
Free Silicone for Breast Augmentation
Free silicone was used for breast augmentation, as was fat injection, until they were replaced by a much more effective and safer alternative – breast implants. Breast implants use a solid silicone shell to contain the silicone inside. A thicker, more cohesive gel is used inside to help prevent migration, but even this should be removed if the implant breaks. Since the center is highly cohesive, it acts as a unit rather than a liquid, so it can be hard to tell if a silicone filled breast implant has leaked. This is why the FDA recommends women who have silicone gel breast implants obtain an MRI at three years and then every two years after having breast augmentation surgery.
“New” Silicone Injections
Research is on-going to find the perfect formulation for silicone injections. The latest attempts are looking into silicone with increased viscosity to help prevent migration and reduce the scar reaction. Since it often takes years for the scar around free silicone to develop into a noticeable mass, the results are still pending. One problem is that the thicker gel is much more difficult to inject without resorting to something like a caulking gun. Until the known problems are solved, the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery and the FDA do not approve of the use of silicone injections outside of clinical trials.
The previous two posts were about Rhinoplasty and Chin Augmentation. Sometimes combining procedures gives the best result. The Mommy Makeover, for example, combines breast enhancement with a tummy tuck. The two areas are anatomically independent, but by addressing two areas simultaneously, the recovery periods can be combined, and the results appreciated more quickly. When the two procedures are anatomically related, like when Rhinoplasty and Chin Augmentation are combined, simultaneous treatment allows for the creation of the optimal facial proportions and a pleasing cosmetic result.
Rhinoplasty and Chin Augmentation to refine the nose, improve the jaw line and create more balanced proportions of the face.
The Balanced Nose and Chin
The woman above presented with complaints of a bump on her nose (a dorsal hump) and a weak nasal tip that curved downward. She also had a small chin (microgenia) with a chin prominence well behind the projection of her lips. A rhinoplasty and chin augmentation were performed to smooth the dorsal hump, define and elevate the nasal tip and bring the chin forward. By combining the procedures, not only could each complaint be addressed, but the mid face and lower face profiles could be made harmonious.
How the Nose and Chin are Related
A small chin makes the nose appear larger, and visa versa. Modifying one will have the opposite effect on the other. In other words, if you make the chin larger, the nose will appear relatively smaller. By combining the procedures, the aesthetic balance of the nose and chin can be addressed, while each individual area is enhanced.
How to Choose a Plastic Surgeon for Combination Procedures
Combination procedures are best performed by a Board Certified Plastic Surgeon who is experienced with each component, and with the synergy that the combination provides. If you are looking to combine surgeries, you want a Board Certified Plastic Surgeon with experience in a wide range of cosmetic plastic surgery procedures, and the ability to seamlessly combine them.
How to Check if Your Plastic Surgeon is Board Certified
Facial enhancement can be accomplished with a filler or an implant. Fillers (Restylane®, Perlane®, Juvederm®, Radiesse®) are by far, the most common means of providing enhanced fullness. They provide almost instant results, with minimal recovery. With fillers, results need to be maintained with periodic treatments. Implants, on the other hand, require a recovery period, but can provide long lasting enhancement.
Chin implants are the most frequently used facial implants. Over 11,000 chin implants were inserted last year alone. The implant shape, size and material can be varied to help achieve the desired result. Even chin implants with clefts are available. The chin implant may be inserted through a small incision under the chin or inside the mouth.
Chin Augmentation – Before and After
Chin Augmentation with Chin Implant. Before (Top Row) & After (Bottom Row)
The woman above presented with a desire for a stronger chin. The before pictures (top row) show that the most prominent aspect of her chin is well behind her lips. This relationship is most often seen in children. In an adult, the weak chin is not necessarily youthful, instead it gives a meek or timid look. Before surgery, the jaw line is also not well defined.
After chin augmentation (bottom row), the chin implant moves the chin profile anterior, and in line with the lip prominences. A strong jaw, with a well defined jawline is the result. More youthful appearance, and a more beautiful balance between the middle and lower face is the result.
How Much Chin is Enough?
On the profile view, the ideal chin extends as far forward as the lips. When the chin is shorter than the lips, this is called microgenia; literally “small chin” in latin. Computer imaging can help decide how much chin augmentation is enough. A digital photo of your profile can be modified to provide just the right amount of chin augmentation. This is used to guide implant selection, and helps provide you with a predictable result. To find out is if chin augmentation is right for you, schedule a consultation appointment today. Give me a call at (925) 943-6353.
If the red color of the lips (the vermillion) is with barely visible, adding volume may not be enough. If the vermilion is short, over filling may lead to increased projection without adequately increasing the height of the vermillion. This can result in a “trout pout”, rather than a fuller more voluptuous lip.
Lip advancement surgery can help. This is not the most mainstream lip enhancement, but in carefully selected patients it is the best option. Originally designed to improve the function and appearance of the lips after removing lip cancer, it preferentially enlarges the red part of the lip (the vermillion). The upside, lip advancement surgery will reveal more vermillion and can be done with or without increasing lip volume. The down side, it leaves a scar along the border of the skin and the vermillion of the lip.
Here is an example of an average scar at 4 months after surgery. The volume is stable at this point in time, and the scar will continue to improve, it is hard to see already. Most patients can cover the scar one week after surgery with lipstick.
Lips before lip advancement with reduced height.
Lips after lip advancement with full restored height.
Lips before lip advancement with lip skin projecting farther forwards than the vermillion.
Lips before lip advancement with lip vermillion now projecting farthest forwards.
If you have very thin lips, that are barely visible when the lips are at rest, lip advancement surgery may be the answer to how to achieve fuller lips. If dermal fillers increase lip projection forward, but are not revealing more vermillion, lip advancement may help. Lip advancement surgery is the most direct and effective method of increasing the amount of red lip that shows.
Several alternative methods are available for enhancing your lips. To learn more click on the links below:
Dermal fillers (Restylane®, Juvederm® and Perlane®) are the most popular way to enhance the lips. The procedure is safe, effective, predictable and relatively simple. It is the best way to “try out” large lips, as it is reversible. In order to maintain your results with lip filler, you need periodic touch-ups. These can be from 3 to 12 months apart depending on your lips.
Sometimes an alternative treatment is desired that has the potential to last years. Lip surgery can give longer lasting results. The local lip tissue can be advanced from inside the lip to provide fullness (V-Y lip advancement), or dermal tissue can be taken from elsewhere on the body and used as implant (dermal grafting).
This entry focusses on V-Y lip advancement, a procedure that rearranges the lips tissues to preferentially give fullness to the vermillion (the red part) of the lip. For information on other methods of lip enhancement, please see the links at the bottom of the page.
Lip Enhancement with Local Tissue Rearrangement
The upper row shows before and the lower row shows after lip enhancement with V-Y flaps. The soft tissue of the lip is moved forwards to enhance the fullness and natural curves of the lips. (Click picture for an enlarged view.)
This particular type of lip enhancement borrows fullness from the inside of the lip to enhance the outside. The soft tissue inside the lips can be pushed forward to enhance lip fullness and the central pout.
The Pro’s and Con’s of Surgical Lip Enhancement
No artificial materials are necessary … no allergies or foreign body reactions.
Stability … Soft tissues won’t migrate.
Softness … Since lip is enhanced with lip, it feels like lip.
Results … Longer lasting results
Recovery … weeks rather than a few days with the fillers.
Size … maximum volume is limited to the soft tissue available.
Cost … more than one filler treatment, but often less costly over time .
Complications … overall complications rates are low, but slighter higher than with fillers.
Alternative Lip Augmentations
Several alternative methods are available for enhancing your lips. To learn more click on the links below: