The two main goals of lip enhancement surgery are to:

• Increase lip volume, and
• Increase the amount of vermillion (the red part of the lip) seen.

To accomplish these different goals, different procedures may be selected.

Lip Enhancement Surgery – Volume, volume volume

Lips: Woman in her late 50's with thinning lips before lip implants (dermal grafts taken during a facelift)

Lips: After lip enhancement with dermal grafts. Notice restoration of the balance and projection of the lips.

Adding volume to the lips is how lip fillers work. Dermal fillers like Restylane®, Juvederm® and Perlane®, add volume from right off the shelf. The amount of volume is virtually unlimited, and can be added directly to where it is needed.

Surgery can add volume too. This can be accomplished with:

• Lip Implants
  • Natural Implants (Dermal and/or Fat Grafts)
  • Man-Made Implants (Gortex, Silicone)
  • Man-Made Natural Implants (Restylane, Juvederm, Perlane, Collagen – man made but normally found in the lips)
• Rearranging the soft tissue already present in the lip (V-Y flaps, lip advancement flaps)

This article focuses on Lip Implants, information on the other available methods of lip enhancement San Francisco, and lip augmentation can be found via the links at the bottom.

Lip Augmentation With Man Made Materials

Gortex® and SoftForm®

Lip implants have been used for years. The most frequently used artificial lip implants are made of Gortex®. It was selected because it is soft. In fact, one of the most popular Gortex® lip implants is named SoftForm®. While it can work well in carefully selected patients, unfortunately, it is not soft enough. I am not a fan of artificial lip implants for several reasons.

Because lips move, and because lips are softer than artificial lip implants, lip implants can:

• Tether the lips, and prevent the lips from stretching when smiling fully (even when the implants is sectioned).
• Be felt along the edges.
• Can cause a visible bulge at the ends of the implant (especially with motion).
• Can erode through the skin causing exposure and infection requiring removal of the implant

Silicone Lips

Silicone is available in two forms for lips: Solid (Silicone Lip Implants) and Liquid (Injectable Silicone). I am a fan of neither. Solid implants have the same problems as Gortex® implants, except worse. They are more stiff and thus more likely to erode and get infected.

Liquid silicone injections are even less predictable. They may give you the softest, poutiest lips one day, and then become hard, lumpy and uncomfortable without warning. Once this happens, it is rarely correctable, ask Lisa Rinna. Last year, while touring for the release of her book, Rinnavation, she confessed to having silicone injected into her lips. She also disclosed her personal silicone lip injection problems.

Lip Augmentation With Your Own Cells

Dermal Grafts

Because of the recent advancements of dermal fillers, I rarely use artificial lip implants any more. Instead, when injectable can’t do the trick, I rearrange what is already there. Dermal tissue can be taken from elsewhere on the body and used as an implant (dermal grafting), or the local lip tissue can be advanced from inside the lip to provide fullness (V-Y lip advancement discussed in the next article).

A small incision is made hidden in the corner of the lip, and the dermis is inserted under the vermilion. The results are similar to adding volume with a filler; however, can be much longer lasting. The swelling after this type of surgery lasts longer too. Instead of a couple days, it may take a couple weeks.

Fat Grafting

When more volume is necessary, fat can be retained on the dermal graft. This adds volume, with better volume predictability and better contours than injecting free fat grafts.

Free fat grafting is when fat is removed (liposuctioned) from one area, and reinjected into an area where more volume is desired. For small volumes this can be safe and predictable, and I use this technique most frequently for the nasolabial folds (the parenthesis around the mouth). On the lips it can be more problematic. We want soft lips, especially when kissing, and free fat grafting can cause firm lumps in the lips. Because better alternatives are now available, I rarely use free fat grafting to the lips.

These are minor surgical procedures, and can be done as an outpatient with local, sedation or under anesthesia. Lip augmentations can be done as a stand alone operation, or can be incorporate as part of plan for overall facial rejuvenation. My patients considering a facelift are frequently also experiencing lip thinning. A lip enhancing procedure can be incorporated to solve two problems at the same time.

Alternative Lip Augmentations

For information on other methods available for enhancing your lips, click on the links below:

• Lip Enhancement 101 – Lip Augmentation San Francisco (Lip Enhancement): Introduction
• Dermal Fillers (Most comon in US are Restylane®, Juvederm®, & Perlane®)
• Dermal Grafts and other Lip Implants (You are here.)
• Local flaps (V-Y advancement)
• Lip Advancement (Vermilion Advancement)