What is a Lip augmentation?
A Lip augmentation is a procedure which gives you fuller lips and can be performed on the upper lip, lower lip, or both lips. The lip can be augmented with the patient’s own tissues (Fat transfer or Fat injections, biologic tissue fillers (Juvederm or Restylane), or soft synthetic implants (Advanta or SurgiSil). Results with biologic fillers typically last 6-9 months, while synthetic implants and your own fat are permanent solutions.
Lip augmentation is very popular because it produces immediate results which can be subtle or dramatic, in a very short amount of time. The degree of fullness of each lip (upper and lower) can be controlled as the lips can be injected with different amounts, as well as the lip implant size can be varied for each lip.
If you choose to augment your lips with Restylane or Juvederm, those injections will be performed by Dr. Rodriguez personally.
What problems does a Lip augmentation address?
My lips are thin and I really want fuller lips
-a Baltimore, Maryland patient
The lips are an important feature of your facial appearance. Lip augmentation can generally address the following concerns:
- thin upper and/or lower lip
- loss of volume in the lip (or lips)
- lips that 'disappear' when you smile
However, patients should be aware that Lip augmentation is not a good solution if they also have a long upper lip. While a Lip augmentation is great for creating fuller, plumper lips, it will not address a long upper lip. In fact, using fillers if you have a long upper lip can produce a 'duck-lip' look, which is often not attractive at all.
When an upper lip that touches the bottom lip at rest gets fillers, the fuller lips have nowhere to go but outwards (like duck lips). A Lip lift is the only way to reduce the long space between the top of your top lip and the bottom of your nose.
If you have a long upper lip, you might want to consider a Lip lift, with or without augmentation. Often times, the Lip lift has such a great result that patients do not even consider the lip augmentation afterwards. However, both procedures can be done if desired.
How is a Lip augmentation performed?
Type of Anesthesia
Lip augmentation performed with Restylane or Juvederm can be performed within 30 minutes. The lips are first numbed with a combination of lidocaine and marcaine. The injections are then performed.
Permanent Lip Augmentation with synthetic implants or your own fat can be performed within a 1-2 hour time frame, while under local anesthesia or monitored IV sedation. Most patients have the procedure done under local anesthesia in the office. Having lip augmentation done as a local procedure in the office is comparable to the experience you might have with a dental procedure.
What types of fillers are used to augment lips?
There are three basic filler choices when it comes to lip augmentation:
- biologic tissue fillers (dermal fillers)
- synthetic implants
- your own fat
Biologic tissue fillers (dermal fillers):
Biologic tissue fillers, such as Restylane and Juvederm are absorbable. Restylane is made from a component of naturally occurring joint fluid. Juvederm is made by Allergan, the same company who manufactures silicone breast implants. Results from Restylane and Juvederm each last for approximately 6 months. We do not use collagen for lip injections as some patients have developed adverse reactions.
Juvederm and Restylane are prepackaged in a syringe and injected directly into the lips. To fill both the top and bottom lips, up to two syringes may be used. If you want a subtle look, only one syringe may be needed to fill both lips. However, to achieve 'full lips' you may need two syringes to fill out both the upper and lower lips.
Prior to the injection and to help with discomfort, a numbing cream or a nerve block can be performed so that you do not feel anything. In addition, ice packs can be applied to reduce the sensation that you feel with the injections. The entire injection procedure usually takes 20 - 30 minutes.
Lip Implants such as Advanta and PermaLip by SurgiSil are permanent because the material is implanted in your lips. Some patients don't choose them because they don't like the fact that they will 'feel' the implant. However, if you want a permanent solution for your lips, I have used the Advanta implants for over 20 years with a high satisfaction rate. For the past few years I have used the SurgiSil implant and patients are pleased with the results.
With both Advanta and SurgiSil, a tiny incision is made into the corner of the lip, and the implant is then threaded into position. It can be done under a local anesthetic or IV anesthesia. If the procedure is performed with any of these materials, it takes approximately one hour in time.
Fat injections to lips
Fat Injections require a little more surgical time than either of the above methods, as Liposuction is first performed to remove a small amount of fat. This fat is then decanted and centrifuged, and then re-injected into the lips.
Even though I am a huge fan of fat transfer procedures, it is not my first choice for Lip augmentation. This is because the fat graft does not survive as well in the lips as it does in other areas of the body. Fat survival is poor because we can not realistically ask you to limit your mouth movement for 2 weeks. For this reason, I actually prefer synthetic fillers like Restylane in the lip.
Are fat injections ever preferable to fillers in the lips?
Fat injections are only preferable when the patient wants to use their own tissue, instead of using a synthetic filler. To perform this procedure, we get fat from the stomach area (using liposuction), process it, and then inject it into the lip which gives a very soft look.
However, all of the fat injected into the lips will not stay because it is nearly impossible to keep the lips closed for 2 weeks! After fat injection to the lips, you still need to eat and talk, and therefore your mouth will still have a lot of activity post operatively. For this reason, not all of the fat will 'take' because the fat grafts will be disrupted by normal mouth movement during the post op period. However, a significant percentage (more than half) of the fat is retained permanently. Because of this, we 'over inject' knowing that in three to four weeks the final result will be closer to what the patient wants.
What are the preoperative requirements?
Lip augmentation with fillers
Lip augmentation with injectable fillers is performed in the office setting. There is no preparation required. However, if you are pregnant or your immune system is compromised, it is a good idea to check with your doctor first. If you are a smoker, it is a good idea to stop 1 week prior to your injections. However, patient who smoke can have fillers.
Lip augmentation with lip implants or your own fat
Both of these procedure are performed in the operating room, under sterile conditions. Lip augmentation with permanent implants can be performed under local anesthesia, or with IV sedation. If you elect to have a lip augmentation with local anesthesia, no pre-op testing is required. This is comparable to visiting the dentist to have a procedure performed. However, if you elect to have monitored IV sedation, we will require you to have medical clearance (H&P, CBC blood test) within 30 days of your surgery date. If you are a smoker, you should stop smoking 2-3 weeks prior to surgery.
What is Lip augmentation Post-Op recovery like?
Patients who have the procedure performed with permanent implants or their own fat should stop smoking for a period of 2 weeks after surgery. Those who have the augmentation with fillers are able to resume smoking, but it is always a good idea to quit for your own general health.
Lip augmentation with fillers
For Lip augmentation performed with Restylane or Juvederm injectables, you can return to work the following day. You may have a small bruise at the injection site, but if so, that should go away completely within a few days.
Lip augmentation with permanent implants, or your own fat
Recovery period for the permanent implant or may last up to a week. Recovery period for fat injections can take up to 2 weeks for the swelling to subside. With implants, all sutures placed inside the mouth for the permanent implant will dissolve within a few days. You may be restricted to a soft diet for up to ten days. We do ask you to avoid sleeping on your stomach for up to 1 week, and avoid foods that require a lot of chewing.
Immediately following either method of augmentation, you will be able to use an ice pack to help reduce swelling. Over the counter pain relievers can help relieve any discomfort you feel for the first 24 - 48 hours.
What are the risks and possible complications?
Side effects and risks associated with Lip augmentations are usually temporary and include (but aren't limited to):
- redness, tenderness
- allergic reactions
- need for more filler or larger implants to achieve desired results
How much does a Lip augmentation cost?
Lip augmentation with injections is less expensive than permanent lip implants. However, keep in mind that injectable fillers only last approximately 6 months, so those should factor into your consideration as well.
Lip augmentation costs are as follows:
|Type of Lip augmentation||2019 Price|
|Injectable Fillers (top + bottom lips)||$600 - $1,200|
|Permanent Lip Implants (top + bottom lips) with Advanta||$3,850|
|Permanent Lip Implants (top + bottom lips) with Surgisil||$3,500|
The actual price of injectable fillers depends on which product, and how many vials, are used.
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Board Certified Plastic Surgery, ASPS Member
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