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.
Facial Implants
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.
Dove took some criticism for its Curves ad campaign.
Perhaps the most difficult decision in breast augmentation surgery is the size. When Dove tried responding to criticism that the women seen in ads are not representative of real women, they found themselves being criticized again for selecting a broader, but still restricted, subset. It is really hard to represent all women in a single print ad or even a 60 second commercial. Women come in all shapes and sizes, and for this reason, so do breast implants.
Selecting the best breast implant is an important part of obtaining the optimal breast enhancement. And when it comes to breast implant volume, there is more to it than choosing a number. Size matters, and in more ways than you might think. The size of the existing breast, the size of the desired breast and the size of the woman, are all important. Here is one example.
Not Your Average Breast Augmentation
A young mother came to me with a desire to repair some of the damage caused by pregnancy. A big part of her concern was the almost complete loss of breast volume. She was not trying to “make a statement” with her breasts. She just wanted them back. Her clothing no longer fit, and she missed the more feminine curves she once possessed.
Trying to figure out your desired breast implant volume can be very confusing. For breast size, we tend to think more along the lines of cup size rather than cc’s, and cup sizes are confusing enough. The most common breast augmentation requested is a C-cup, but C-cup volumes vary by the manufacturer and even by the style of the bra.
Internet resources claim anywhere from 100 to 250 cc’s will give an increase of one cup size. The highest volume in the range is more than double the lowest volume, yet the range is about right. Cup size depends on band size — the distance around the rib cage below the breasts. To state this in the most obvious terms, bigger girls need bigger volumes, to get similar results.
Before breast augmentation.
After breast augmentation.
The average implant size used varies by region. The average volume used in the United States is in the 300-350 cc range. My patient desired a breast size proportional to her body. She wanted to be able to find clothing that would fit without being too baggy or feeling too tight. Being of average height and desiring an average size, you might think she would require the average implant volume. If only it were that simple.
The breast augmentation pictured above was accomplished with saline breast implants placed under the muscle via a periareolar incision. A moderate profile implant was selected so that the diameter of the implant matched the diameter of the breast. Matching the breast diameter is critical with saline implants. The correct breast implant diameter, especially for saline implants, is often more important than the implant’s volume.
The volume selected was above average at 420 cc’s. A larger breast implant was necessary because there was smaller amount of native breast volume present before surgery. Additionally, the larger volume was needed so that the implant’s diameter would match the chest. While 420 cc’s may seem large, in this case, the result is just what the patient wanted.
The result is a beautiful breast that is well shaped and well proportioned. Despite using a round implant, the shape is natural. Placing the implant behind the muscle, for a woman with little breast tissue to disguise it, can give a round implant a pleasing teardrop shape.
Too Small, Too Big, Just Right
Most patients want breast enhancement that is big enough, but not too big. They want enough change so that they know breast augmentation was done, but not so much that is becomes a new source of embarrassment. After breast augmentation, you want to feel comfortable, and you want clothing to fit well.
The most common reason for breast augmentation revision surgery is to increase the size of the implants. As a breast augmentation patient, the most helpful thing you can provide your surgeon is a good idea of how much breast enlargement is enough. I have tried to offer useful suggestions in: How to Choose the Correct Breast Implants: Size.
Breast Implant Profiles – Shape Matters Too
The profile of the implant can influence the final shape and location of the breast. For implants of the same volume, the wider diameter found in lower profile implants, adds more “side boob”. On the other hand, the narrower diameter of a high profile implant, will increase the space between the breasts.
For implants of the same diameter, the lower volume in a low profile implant will result in a breast with less forward projection. The opposite effect is obtained with a high profile breast implant. A high profile implant will result in a breast with more projection, and a larger cup size. Here is some additional information about Breast Diameter and Breast Implants in Breast Augmentation.
The Advantage of a Board Certified Plastic Surgeon
In determining the correct volume for my patient, the advantage I have, besides being a Board Certified Plastic Surgeon, is that I was able to do a physical examination, take measurements, determine skin elasticity and compare what I saw with the size, shape and volumes available for breast implants. There is no better way to determine what needs to be done for a cosmetic procedure than with a focused medical history and physical examination. My patient’s goals, combined with her measurements, determined that a larger than average volume implant was necessary in this case.
When it comes to breast size, there is no secret formula and there is no right answer, there is only the right size for you. It varies with each individual, and it is often the most difficult variable to pin down. This is the advantage of seeing a Board Certified Plastic Surgeon with experience in breast augmentation who cares about how you are going to look and feel afterwards.
Breast augmentation remains the most frequently performed cosmetic plastic surgery procedure in the United States. At the recent American Society for Aesthetic Plastic Surgery (ASAPS) meeting in Washington DC, breast implants, and breast implant revision surgery were hot topics.
I had the opportunity to compare notes with other breast augmentation revision specialists both formally and informally. National meetings are a great place to share information. Instructional courses are useful, but informal conversations with other Board Certified Plastic Surgeons who are faced with the same opportunities and challenges that I face can be just as enlightening.
What’s new in Breast Implant Revision Surgery?
Neosubpectoral Pockets
Implant malposition includes breast implants which are:
too close to the center (symmastia or bread loafing)
too low (bottoming out)
too wide apart (heading for the armpit)
or too high
are all addressed by modifying or changing the pocket in which the implant sits.
For symmastia, the problem is that the implants are too close together, so that the skin between them becomes elevated. Traditional treatment has been to close off the pocket centrally to reestablish cleavage. If the implant is above the muscle, they can be moved to new pockets below the muscle. This allows for the creation of two new pockets that are separated sufficiently in the center to preserve the definition between the two breasts.
When the implants are below the muscle, they can be moved to in front of the muscle. There are some disadvantages to moving the implants to a subglandular (in front of the muscle) position. This is where the neosubpectoral pockets can help. The name literally means “new pocket under the pectoralis muscle”. By working outside the old pocket’s capsule, a new space can be created for the implant. This can be used to correct symmastia and other problems with implant malposition.
Acellular Dermal Matrix (ADM’s)
An Acellular Dermal Matrix is dermis that has been treated to remove all the living cells, leaving a collagen matrix that can be used as an internal patch to help cover breast implants. It can be used to help disguise rippling and to help support an implant that is displaced. Both human and pig skin are used in the manufacture, and the off-the-shelf availability is a big plus when the native tissue is sparse. Brand names include:
The downside – it is very expensive. A sheet of ACD costs more than a breast implant. So when local tissues are available, it can save you thousands of dollars.
Fat Grafting and Stem Cell Grafting to the Breasts
Interesting cases where presented of utilizing fat (which contains lots of stem cells) as a volume expander for the breast. Some techniques involve suction expansion of the breasts for a month or longer before grafting to increase the size and vascularity of the recipient bed. This is bleeding edge new, and the long term results are unknown.
Breast are mostly fat, and the principle of replacing like with like is a good one. However, if some of the graft doesn’t take – it dies, and dead fat can lead to lumps, hard spots, infection and calcifications. The problems with lumps, hard spots, and infection are pretty clear, so what is the problem with calcifications? Calcifications are what we look for on mammograms to help identify breast cancer. They stand out as bright white spots in the relatively dark breast tissue, and make identifying breast cancer much easier. If a breast is already full of calcifications, it can be very hard to identify a breast cancer. Either every calcification would need to be removed (making the breast smaller) or risk the early detection of a breast cancer. The implications of increasing the number of stem cells (cells that can become anything) in the breast is also unknown.
For now, research in this area should only be performed in carefully controlled studies. The problems that still need to be overcome include insufficient volume, unpredictable take, interference with mammography, long term outcome. Remember, before breast implants, not too long ago, free silicone was injected into the breasts to increase their size. It worked and felt very natural, at first. Long term, however, the breast became firm, lumpy and painful. The outcome may not be the case with fat grafting, but long term follow up is not yet available, and an assumption that everything will be fine is naive.
Gummy Bear Implants (Gummi Bear Implants)
Still awaiting FDA approval.
The most recent delay was rumored to be that the FDA was waiting to see that the current breast implant follow-up studies where progressing. I am an investigator for both Allergan and Mentor, and each has filled both their Saline Breast Implant and SIlicone Breast Implant follow-up studies. All that remains is to collect 10 years worth of data.
Will it take 10 more years to get FDA approval for the gummy bear implants? It took 14 years to get the current silicone implants re-approved.
Emend
Originally marketed to prevent the nausea and vomiting associated with chemotherapy (CINV), Emend is meant to prevent nausea and vomiting rather than treat it after it has occured.
Emend would need to be administered prior to post operative nausea and vomiting (PONV) to be effective. Currently this is an off-label use, and it has only sparingly been tried to date. Zofran, another medication that is currently widely used, started down the same path 20 years ago.
Risk factors for PONV:
female gender
young age
non-smoker
motion sickness
Since most of my breast augmentation patients have several of these risk factors, they all get treated prophylactically, often with several medications. If one med could prevent all PONV, it would simplify the treatment. Fingers crossed…
The world is crazy. There has been a lot of chatter about terrorists implanting women with exploding breast implants in a effort to crash planes. But first, if you are reading this to find out if your normal, non-explosive, breast implants will explode the next time you board an airliner, rest assured, they won’t.
Why Your Breast Implants Won’t Explode in the Airliner
Airliners are pressurized, and must be maintained to atmospheric pressures below 8000 ft. While the air inside our ears and belly expands, the fluid inside breast implants barely does. Cabin pressure regulations are more complex than you might think. (Reasons for maintaining cabin pressure and the allowed tolerances can be found on Wikipedia’s Cabin Pressurization page.)
While Lady Gaga is red hot, and her fans may enjoy the visual, there is nothing entertaining about the sudden loss of cabin pressure. That would be a terrorizing event. TSA would not allow her to board with the outfit pictured to the left, the concern is that explosives inside a breast implant would be difficult to detect.
If you are still worried about your non-explosive breast implants, in the event of a complete loss of pressurization, your breast implants would easily survive the pressure change. Since they are mostly water, the breast implants would expand about the same amount as the rest of body. (I will not elaborate on all the real problems that would occur elsewhere in the body, but Wikipedia has a page on uncontrolled decompression with many unpleasant facts.)
Booby Traps
It sounds like a script contrived for a Hollywood movie: terrorist implanting their breast with PETN filled breast implants. The idea of surgically implanting an explosive inside the body is horrifying. Though from the terrorist’s perspective, it is only a short leap past strapping on a bomb. The worst part is, it is entirely possible. A small amount of explosive would be enough to disrupt cabin integrity, and cause explosive decompression with devastating results.
Media Coverage – KABC Los Angeles
It’s not surprising that the possibility was broadcast this February in Los Angeles.
But by March it has made world headlines on Fox News and The Sun. and the story is now being given further credibility by the need to discredit the report on True/Slant with science and with satire.
It Could Happen
Possible?
Yes. With enough determination and thought, anything is possible.
Probable?
No. I’m no terrorist, but there must be easier ways.
Reality
There is a fine fine line between a cautious and phobic. The reality is, we could spend our entire lives worrying about what could go wrong, and become paralyzed.
Bombshells not Bombs
As a plastic surgeon, the surgery I perform is elective and is held to a higher standard. While I worry about the complications of surgery, this is my motivation to achieve safer and more predictable results, day after day. This is why I spent years in training to become a Board Certified Plastic Surgeon. This is why I operate only in Accredited Surgery Centers, and use only Board Certified Anesthesiologists. This is why my patients trust me, and can keep their thoughts on the goal, rather than the process. No matter how bizarre the news from the outside world, when I am performing surgery, there is only one thing I am thinking about — my patients well being and happiness, and there is no greater gift I can give this crazy world than a happy patient. ( …and non-explosive breast implants)
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
The Advantages:
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
The Disadvantages:
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:
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:
Nothing says youth like full lips. Research shows that full lips are a requirement for a youthful face. Grace Gold of AOL’s StyleList reports in The Pursuit of Beauty: The Secret to Youth: Full Lips. Her inspiration? An article in the DailyMail.
Thin is Not Always In
It is an unfortunate truth that as we age, our lips shrink. Whether conscious or unconscious, the size of the lips is one of the most important variables programmed into our brains’ youth calculator. In other words, thin lips are aging. There are several ways to turn back the clock on lip aging, and dermal fillers are currently the most popular treatment.
Off the shelf dermal fillers, are safe, effective and convenient. These lip fillers are supplied as prefilled, single use syringes. Any volume can be used, and a simple block with local anesthesia, makes the procedure an in office option. All three of these products have received FDA approval for new formulations with Lidocaine in the mix to ease the injections.
What Makes Lip Fillers so Popular?
Lips before enhancement with a Dermal Filler (Restylane®, Juvederm® and Perlane® are the most popular in the US)
Lips after enhancement with a Dermal Filler. Notice the augmentation and preservation of the normal curves.
The advantage of this type of lip enhancement is its simplicity. I can choose different products for different lips. Lip enhancement can be performed in the office, with local anesthesia if needed, and the results are quickly apparent. There is sometimes mild discomfort, swelling, and bruising, which normally resolve quickly. While the enhancement is instant, it is best to have a few days for the lip augmentation to settle before an important event.
Dermal fillers provide two main benefits for the lips: increased volume, and wrinkle reduction. Lip enhancement is performed for small, thin lips, to increase volume. In this situation, the main goal is to increase the size of the lips. Lip enhancement can also be used to smooth the wrinkles that can form around the lip. Sometimes called Smoker’s Lines, they can occur without smoking. Often radially aligned, the wrinkles that form around lip edges can cause the lipstick to bleed. For lip wrinkles, the primary goal of lip enhancement is to attenuate the aged appearance. Both volume enhancement and wrinkle reduction may be desired for the same pair of lips, and these techniques can be easily combined for optimal results.
The longevity of the results can vary. Most results last 3-6 months, and many patients experience longer satisfaction. It is the perfect product to try out larger lips. The volume can be gradually increased to your comfort, and maintained.
But, what if you are looking for a longer lasting result? The are several surgical alternatives for enhancing lips. While no results are permanent, surgery can give longer lasting, natural results.
Lip augmentation is a popular and very satisfying procedure. Full lips are one of the most significant signs of youth. In my San Francisco Bay Area, Walnut Creek office, I perform hundreds lip enhancements. The most common method for lip augmentation is with a dermal filler like Restylane®, Juvederm® or Perlane®. While fillers of the most widely used method for lip augmentation, there are several other options available.
When I first started writing this week’s article on Lip Enhancement Walnut Creek, my goal was to quickly cover today’s options for lip augmentation. I realized, however, this is going to take more than one post. Over the next two weeks I will briefly review the latest trends in enhancing lips. Be it the ubiquitous injectable fillers you see advertised daily on TV, or lip enhancing surgical procedures known to a smaller group who desired a longer lasting result, and who can afford a little more downtime.
There is more to lip augmentation than meets the eye. In the coming weeks, links to the latest and the most popular ways to enlarge and rejuvenate your lips will be activated at the end of this article. I will try to illustrate each method with lip enhancement before and after pictures. The goal is to provide general information, but to determine the methods best for your lips, you will want to make an appointment with a board certified plastic surgeon, and explore your options.
It Seems So Simple
Plastic surgery often looks simple, but it takes careful planning and the meticulous attention to detail to makes it look simple. Lip enhancement is more than just lip enlargement. While making the lips larger is often the goal, it must be done carefully to keep the lips balanced. It is important to match the volume of the lips to the size of the face, and more importantly, to maintain proper proportions between the upper and lower lips. Hint: the lower lip is meant to be bigger.
So What is Important for Beautiful Lip Enhancement?
The goals:
Volume, volume, volume … the correct volume is very important
The shape of the lips … maintaining or creating the curves
The projection of the lips … the proper pout (not the trout pout)
The height of the lips … must match the facial proportions
The amount of vermilion (red stuff) seen on the lips … fillers may not be enough
The softness of the lips … one of the big benefits of HA’s over Collagen
The motion of the lips … one of the limiting factors for lip implants
Correcting the wrinkles around the lips … last but definitely not least
Most lip enhancement treatments can help with more than one of these goals, but no treatment is perfect. It is important to discuss all the available options with a Board Certified Plastic Surgeon who is experienced in all methods of lip enhancement. This way, you can be certain that you are getting the best possible treatment for your individual lips.
Alternative Lip Augmentations
Several alternative methods are available for enhancing your lips. To learn more click on the links below:
Lip Enhancement 101 – Lip Augmentation San Francisco (Lip Enhancement): Introduction (You are here.)
Lip augmentation is a popular and very satisfying procedure. Full lips are one of the most significant signs of youth. In my 
