Lip Enhancement

 

Two major characteristics dominate esthetic surgery today. Both have to do with significant advances in technology and techniques that have taken place over the past 10 years. These 2 characteristics are:

1. Combinations of procedures.
2. Less need for very invasive procedures to obtain some beautiful and youthful changes.

The lip enhancement, like most plastic surgery procedures today, proceeds these 2 characteristics.

In the past, the most popular procedure for lip enhancement was the injection of collagen. The injection of collagen was temporary, fraught with some complications, due to the fact that it was heterogenous collagen and since it could last only 4 to 6 months maximum, the cost was another consideration. Within the past 10 years, fat transplant has become available in the U.S. and it is a good alternative to collagen since it is the patient's own tissue. However, usually the fat transplant has to be repeated at lease 2 or 3 times to become permanent. The procedure is more extensive than the collagen and the recovery time much longer. Patients were reluctant to go to a surgery that would give them a result that wasn't permanent.

Within the past 2 years, after a lot of studies, a new homogenous material is available.

This new material is called alloderm. It is the first of its kind since it is live homologous collagen and therefore, permanent. It is today's filler. There is practically no risk and it is permanent. The only disadvantage is the fact that it requires a little surgery but the recovery time is shorter than with the fat transplant and it doesn't need to be repeated as opposed to the fat transplant.

Methods of enhancements of the lips, particularly the upper lip:

Part of the aging process of the lips is to get longer, thinner with a less visible vermilion. At the same time, small vertical wrinkles tend to form all over the upper lip. This stems from the aging of the skin, the contraction of the lip muscles and the loss of bulk in the upper lip.

Knowing this, the methods that are presently available to restore a youthful upper lip are as follows:

1. Filling with permanent filler such as alloderm.
2. Try to evert the vermilion by performing a so-called w-plasty on the mucosa of the upper lip. This procedure consists of making a W-shaped incision within the mucosa of the lip; that is to say no scar will form nor be visible. The mucosa is advanced so that the vermilion in continuation with the mucosa will be everted to some degree, thereby becoming more exposed and youthful looking. This procedure is simple. There is practically no recovery time, little bruising and some swelling. The patient has to be somewhat careful 5 to 7 days after the procedure not to pucker the lips, not to use a straw, no sucking, no heavy chewing and less vigorous teeth brushing.
3. If vertical wrinkles are present, treatment with the erbium laser which is the state of the art for resurfacing would take care of them with a recovery time that is much shorter than it was with the CO2 laser. Within a week to 10 days, make-up can be reapplied and you can go back to normal daily activities at work as well as social.
4. In cases where the upper lip has lengthened or has reached a vertical length that is not in proportion to the size of the other facial units, a shortening procedure can be performed just as the base of the nose. It means a small surgery with a quick recovery and practically no visible scar later on.

These are the 4 most recent advances that are available for rejuvenation of the upper lip. The same principles can apply for the lower lip but usually the lower lip ages differently from the upper lip and it requires less treatment. The enhancement of the upper lip results from the combination of filling, resurfacing, and working on the mucosa of the inner lip. All of these procedures are rather minor, non-evasive, inexpensive with short recover and provide usually a beautiful long lasting result. The fact that the incidence of complications is very low and the recovery time very short, makes it quite appealing. The benefit of such a relatively minor procedure is surprising. It is part of the facial rejuvenation.