Lip Augmentation and Injections

Lip augmentation represents a term for a variety of procedures that can enhance the shape, size, and appearance of the lips. Cosmetic surgeons use dermal fillers, collagen, and the patient’s own fat injected into the lips to add fullness, along with lip implants or surgical procedures to lift the lips.

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Summary

Lip enhancements have grown in popularity over the past 20 years, with beauty fiends wanting to go beyond the fuller-lip look that makeup can provide via lipstick, lip liners and lip gloss. Lip enhancements have come a long way in terms of subtler improvements that offer beautiful changes to the everyday person since that time.

By 2015, popular reality TV star Kylie Jenner admitted that her enhanced lips were the result of lip fillers, helping to de-stigmatize the cosmetic treatment and making the treatment a common topic.

Although patients are relying on a number of different options to turn their natural lip size into plump lips, using dermal lip fillers is one of the most popular options to make enhanced lips a reality. In past decades, lip augmentation may have been relegated to a smaller segment of the public - people who were willing to endure larger and firmer lip implants to enhance their pouts. However, advancements in dermal fillers have made it easier and more affordable for a greater amount of beauty fans to increase the volume of their lips - even during lunch-time appointments.

According to the 2017 Plastic Surgery Statistics Report from the American Society of Plastic Surgery, lip augmentation procedures accounted for 29,797 surgeries in 2017. However, that doesn't include the much greater number of people who took advantage of injectable materials to enhance their lips.

Soft tissue fillers were used in 2,691,265 minimally-invasive procedures in 2017, without a distinction made between how many of those fillers were used to plump up thin pouts versus those being used as facial fillers to restore cheeks and fill in frown lines. What is known is that the use of soft tissue fillers is up 3% since 2016, and has increased in usage 312% since 2000.

And since lip augmentation patients are having largely positive experiences, the popularity of the practice is growing. According to hundreds of reviewers on RealSelf, lip augmentation was deemed "worth it" 96% of the time. Whether patients are choosing to use dermal fillers like Restylane or Juvederm - or even their own collagen and fat to enhance their lips - or are selecting from a variety of soft lip implants to create fuller lips - the trend of improving the lip structure is continuing to grow.

What Substances and Dermal Fillers are Being Used on the Lips?

A number of substances are being used to enhance the lips. There is the acellular dermal matrix known as Alloderm, which is a soft tissue gleaned from the human skin's collagen layer. Actual collagen is also utilized as a lip filler. Other lip filler substances include the patient's own fat being used to fill the lips after being transferred from other areas of the body via a liposuction technique.

The most popular substances used are hyaluronic acid fillers (found within brand names like Juvederm Ultra, Juvederm Ultra Plus, Perlane, Restylane, or Belotero), which accounted for more than two million of the soft tissue filler procedures in 2017. Other substances, such as calcium hydroxylapatite (know as Radiesse) were used more than 200,000 times in 2017, although conflicting information exists from physicians online about whether or not it should be used as a lip filler or strictly a dermal facial filler. Polylactic acid in the form of Sculptra joined other fillers in the list of popular substances as well, although dermal lip fillers are only one method of enhancing the lips.

Types of Lip Augmentation

From common fillers used for filler injections to lip lift surgeries that require small incisions along the vermillion border or the upper lip’s subnasal region, patients have a number of options when it comes to enhancing one of the most prominent facial features. Scientists note that one of the first things a person notices about another person is his or her smile, therefore, it stands to reason that folks desire to make the lips that frame the teeth the best they can possibly be.

Here are several ways that people can choose to enhance their lips:

#1: Lip Augmentation with Autologen

Autologen injections represent collagen that has been extracted from the patient's body and injected into the lips. The human collagen injections are comprised of collagen that will last up to five years in cryo-freezer storage in a liquid form, so the patient can continually use their own collagen as a lip injection source.

Despite its benefits, procuring Autologen is not as easy as getting fat for lip injections, for example. That’s because Autologen is skin tissue that is garnered from the patient when an unrelated procedure is undergone. Afterward, the tissue has collagen extracted and put through a procedure that sterilizes it in order to prepare it for re-injection.

Candidates for and Benefits of Lip Augmentation with Autologen:

  • Patients are using their own collagen, so the substance should react well with a person in good health getting the injection
  • Autologen easily injects into the lips like other dermal fillers
  • Anyone who wants fuller lips might be a good candidate

Who Should Avoid Lip Augmentation with Autologen?

  • Pregnant and nursing women
  • Anyone with infections such as herpes
  • Patients with a cold sore should let their practitioner know and receive antiviral medicine and wait for treatment

With autologen injections, the results of the lip fillers are not permanent. Therefore, patients who want to maintain the look of fuller lips must return every six months for follow-up injections. Side effects from autologen lip fillers can include bruising, swelling and pain.

#2: Fat Transfer for Lip Enhancements

Plump lips received via a fat transfer begin with liposuction on the patient to garner the fat from other places in the body. After the fat is harvested, it is cleaned and made pure, prior to being injected in the lips.

Advantages of Lip Fillers From Fat Transfer Include:

  • The lip fillers with fat taken from the individual means a low risk for sensitivity and bad reactions, which might happen with foreign fillers
  • The natural-looking results may last up to 5 years

Who Shouldn't Get Fat Transfer Lip Fillers?

  • Those afflicted with health issues like herpes, diabetes, and lupus should consult their physicians about lip enhancements
  • Avid smokers not willing to quit

Side effects of fat transfer lip fillers include possible bruising, swelling, infection, and fat calcification. The entire portion of fat transferred may not “take,” therefore fat injections might be needed every six to 12 months.

#3: SMAS Lip Implants with Tissue from a Facelift

SMAS is an acronym for the superficial musculoaponeurotic system. The SMAS layer is a deep facial layer that exists between the muscles of the face and the skin atop the face. Made up of fat, collagen, tissue, and fibers, the SMAS layer is excised during a facelift procedure when there are excess amounts of the substance, which can then be used for lip augmentation.

Benefits of Using the SMAS Layer for Lip Enhancements Include

  • Long-term and permanent results that only change with age
  • Patients who are already receiving a facelift and have excess SMAS won’t have to waste the extra SMAS, if they desire lip implants
  • SMAS can be smooth and specifically tailored for the patient's lips

Who Shouldn't Get SMAS Lip Fillers?

  • Any patient who doesn't want or plan for a facelift shouldn't get SMAS lip enhancements
  • Patients with infections or various afflictions that may interfere with surgery should consult their doctors prior to considering this type of surgery

Side effects of SMAS lip enhancements might include numbness, lumps, and swelling.

#4: Vermillion Advancement of the Lip

A vermillion advancement of the lip is a surgical procedure, according to Caniglia Facial Plastic Surgery, which makes the volume of the upper and lower lip appear larger, but not by using lip fillers. During the surgery, the vermillion, also called the "white roll" of the lip line, is lifted by the plastic surgeon to create a better balance for the colorful portion of the lips.

The Benefits of Lip Advancement Surgery Include:

  • Permanent results
  • Decrease in space between the nose and upper lip, creating a more youthful proportion

Who Should Not Receive a Vermilion Lip Advancement?

  • Heavy smokers or people not healthy enough to withstand minor outpatient surgery
  • Patients who are unwilling to have a possible scar on the lip line

Vermilion lip advancement side effects might include bleeding, swelling, and infection.

#5: V-Y Mucosal Lip Advancement Surgery

The V-Y lip advancement surgical procedure is named as such because of the shapes of the incisions made during the surgery. V-shaped cuts are created in the lower lip's inner lining, which is also called the “wet” mucosal surface. The tissue is then reshaped and manipulated to change the V-shape into a Y-shape, creating an optimal new shape to the lip.

The Benefits of a V-Y Lower Lip Advancement Surgical Procedure Include:

  • Injectable filler treatments may not be needed afterward
  • The lower lip mucosal advancement uses the patient's own tissue
  • More volume appears by manipulation of the "wet lip" portion
  • Local anesthesia is used
  • Fewer external scars

Who Isn’t an Ideal Candidate for a V-Y Mucosal Lip Advancement?

  • Those with infections or blood-clotting diseases
  • Individuals unwilling to quit smoking

V-Y mucosal lip advancement side effects might include scarring and numbness.

#6: Lip Implants

Permanent lip fillers are usually the term for lip implants, which tend to give patients a refined shape to their lips that differs from dermal lip fillers. Patients with thin lips can turn to implants such as GORE-TEX, SoftForm, and AlloDerm to gain fuller lips via a lip implant procedure.

With GORE-TEX lip implants, a porous area allows lip tissue to grow within the implant, which makes it a permanent part of the lips. The lip implants may feel firm at first, but patients may grow accustomed to them. Softform lip implants have a shape like a tube that also helps prevent the implant from moving around over time. AlloDerm, created from the human tissue or cadaver skin, should lessen a rejective or allergic reaction.

Lip implants are a longer lasting option than dermal lip fillers, but come with their own risks. The implants can be made from a variety of materials from silicone to AlloDerm (cadaver skin), or other soft materials, and are shaped to fit the lips in a natural way, with tapered ends.

The Benefits of Lip Implants May Include the Following:

  • Permanent fullness
  • Improvements in lip implants provide patients with a soft feel and natural look

Who Shouldn't Get Lip Implants?

  • Anyone not wanting an invasive surgery
  • Patients allergic to the implant material

Side effects of lip implants include the following:

  • Potential challenges if the implant needs to be removed amid the growth of scar tissue
  • Implant shifting can occur if the implant shrinks or shifts to an off-center position when smiling
  • There’s the risk of infection
  • Possible asymmetry can cause uneven lips
  • A small risk that the lips will stiffen or become scarred after implantation
  • Implant removal might be necessary in some of the above listed situations

#7: Temporary Lip Fillers

Temporary lip fillers are very popular because of the ease of obtaining lip injections, which are minimally invasive. Lip fillers work best for patients who don't require extensive changes in order to receive fuller lips.

According to the American Society of Plastic Surgeons, those who seek dermal fillers should search for a board-certified plastic surgeon with experience in injecting substances such as Juvederm and Restylane. Most dermal fillers are comprised of hyaluronic acid, which is a naturally occurring substance in the body that tends to reduce with age. Restylane Silk was the first lip augmentation dermal filler approved by the FDA.

Prior to receiving lip injections, the patient usually receives a topical numbing agent or a nerve block technique administered in the lip area.

The Benefits of Temporary Lip Fillers and Ideal Candidates Include:

  • Lip injections into the vermillion border can enhance the lip line
  • Dermal fillers can be more affordable than other forms of lip augmentation
  • Substances like Juvederm Volbella XC can improve lip volume and vertical lip lines
  • Patients who don't desire or require invasive surgical procedures to enhance their lip volume are good candidates
  • Those seeking little downtime or virtually no recovery periods

Who Shouldn't Get Lip Fillers?

  • Pregnant and nursing women

Lip filler side effects can include swelling, bruising, and the possibility of the dermal filler not being sufficient to create plump lips for patients who may want to consider surgery in the future.

#8: Semi-Permanent Lip Fillers

Semi-permanent lip fillers belong to a class of fillers that help the patient create new collagen of their own to enhance the fullness of the lips. As reported by the Aesthetic Surgery Journal, Radiesse and Sculptra can be used as lip dermal fillers, however, more recent publications note differing views.

Collagen fillers and those containing hyaluronic acid are injected into the lips’ fleshy body or the borders of the lip. Radiesse or Sculptra may be injected into the "white roll" vermilion border of the lip in strands. Sculptra promotes the growth of new collagen over time and dermal thickness.

The Benefits of Semi-Permanent Lip Fillers and Ideal Candidates Include:

  • Dermal fillers don't require surgery
  • They can be more affordable than lip surgery
  • Those individuals seeking less invasive procedures to enhance the lips

In spite of the advantages, semi-permanent lip fillers may have to be placed deeper in the lips, and may come with side effects of creating lip nodules. That is why certain plastic surgeons may not recommend them for lip augmentation.

#9: Permanent Lip Fillers

There are a variety of permanent lip filling agents that will reside in tissue for an indefinite amount of time. Bellafill, which was formerly known as Artefill, is the sole FDA-approved permanent filler, but that's only for the frown lines or nasolabial folds. Bellafill is the brand name for PMMA, which can be used to fill out thin lips, according to the American Society of Plastic Surgeons.

Bio-Alcamid is no longer being used as a lip filler.

The Cost of Lip Enhancers

According to more than 800 RealSelf reviews, the cost of lip augmentation can range from $25 up to $5,000. However, the average cost of lip augmentation is listed as $825.

Specific cost ranges for various lip enhancement procedures may run a wide financial gamut:

  • Lip augmentation with Autologen may cost from $1,200 to $1,500 per treatment
  • Fat transfer lip injections may cost from $1,000 to $5,000 per treatment
  • SMAS lip fillers may cost $5,000 to $8,000
  • A vermilion lip advancement procedure may cost $3,000 to $4,500 for the cosmetic surgery, which is the same cost range for a V-Y mucosal lip advancement
  • Lip implants may cost from $1,200 to $4,000
  • Lip fillers can cost $500 to $1000 per session

Recovery from Lip Augmentation

With most lip surgeries, patients should rest during their recovery periods by not engaging in high-intensity and strenuous cardiovascular exercise for six hours after their treatments. Patients should sleep in an elevated position for 24 hours after surgery. Those who have had lip augmentation may use ice packs in order to control swelling, and plan to return to work in approximately 48 hours after surgery. Bruising and swelling can occur during the two- to 10-day recovery time.

Certain patients may have stitches in other areas of the body where fat was extracted, so extra recovery time to heal from surgery on the thighs or stomach may be needed. With sutures generally removed after 10 days, patients are recommended to sleep with their necks and heads elevated as well, for six weeks after their procedures. Selected lip surgeries come with a more extensive recovery period than other lip augmentation procedures, since a facelift may accompany the cosmetic surgery. Patients can expect stiff and swollen lips that might appear larger than they want them to be for the first few weeks following surgery as the swelling decreases.

Lessening mouth movement by avoiding laughing, big smiles, and plenty of talking for about one week after surgery can help patients heal. This includes limiting mouth movement after surgery such as not stretching the mouth open wide to eat large and hard foods. Instead, patients should drink liquids and ingest soft foods in small bites. Avoiding exercise for one to two weeks can also help speed along the healing process. Patients should not lift heavy items, strain themselves nor bend over for several days after surgery. Patients should also rinse their mouths with saline substances or antibacterial liquid provided by the physician to keep the mouth clean.

With lip implants, recovery times can range from one or two weeks, with at least a three-day period away from work scheduled. Ointments may be required to place on the incisions following lip implant surgery.

Before & After Lip Augmentation

According to the American Board of Cosmetic Surgery, it is essential to research cosmetic surgeons and select a board-certified cosmetic surgeon when choosing a cosmetic procedure such as lip implants.

Prior to receiving lip augmentation, it helps to have an idea of the type of lip enhancement you desire. A wide range of costs and recovery times exist when comparing lunch-time lip injections with permanent lip implants or those that require fat transfer liposuction surgery or facelifts to graft tissue into the lips.

Viewing before-and-after photo galleries of specific patients - such as those who have received a variety of differing types of lip implants - can help you decide if you want a more permanent option when it comes to undergoing the cosmetic surgery. For example, more than 1,000 Instagram posts use the label "lip implants," with some of the posts displaying actual patients who have received lip implants, along with photos of the silicone lip implants prior to being implanted.

Similarly, pre-op and post-op photos of lip lift patients can be found online, along with many more individuals who have posted the results of their lip fillers.

AEDIT is taking the stigma out of plastic surgery, cosmetic procedures and injectables. Welcome to the future of beauty.

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