As we age there is a gradual loss of fullness of the lips and the region around the mouth. In addition, some patients have relatively small lips to begin with and this is continues to worsen with aging. While we are not big fans of excessive lip enlargement which can result in an unnatural appearance, restoring and adding fullness to the lips often can enhance your appearance and give a more youthful appearance.
Adding this fullness can be done in a number of ways. While some of these involve surgical treatment, the most popular methods and the ones we use most frequently involve the injection of synthetic fillers or fat transfer. We have been impressed by the relative ease, lower cost, and effectiveness of these methods. In a highly visible and mobile area of the face, it is important that any treatment not only increase the fullness but leave the lips soft and flexible, something we have been impressed with when using injectables for lip augmentation.
We typically use Restylane or Juvederm, both hyaluronic based products to enhance the fullness in the lips. These widely used products have a good track record in both our hands and others in proving to be a safe and effective way to increase the size of the lips while maintaining softness. One or two syringes are injected into the lips and provide an increase in volume that typically lasts around 9-12 months, sometimes longer. It is the quickest, easiest, and least expensive way to add fullness.
Prior to injection we chill the area with an ice pack, apply a topical anesthetic and/or inject a local anesthetic to provide a nerve block. The lips are then injected with the filler using an ultra fine needle. Afterwards you will have minimal pain but may experience some bruising and swelling. After a few days the swelling subsides and your lips will show their final, fuller appearance. You may resume normal activities right away. This office procedure takes about 30-45 minutes.
For those desiring a longer lasting effect, we suggest fat grafting. Under a local anesthetic fat can be removed using gentle suctioning techniques from your abdomen or other areas where you may have some excess. This is then prepared in a centrifuge and injected into the lips or other areas where you require more volume.
Fat has the advantage of being living tissue, not just a temporary filler. The results generally last many years. Unlike “permanent” fillers, we have not seen patients develop the firm nodules or irregularities that have been reported with some of these products. You are not going to “reject” your own fat.
Harvesting and injecting fat is more involved procedure than injecting synthetic filler. The procedure takes about 1½ hours and there is more swelling and bruising afterwards. Some of the fat is inevitably reabsorbed and a second injection may be required to achieve particularly full lips. However, we feel that for patients desiring a longer lasting alternative to injectable hyaluronic acid products this is a great way to go. We discuss the advantages of fat grafting further under the fat grafting section.