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| Browse questions and answers on topics that are hot right now. |
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| Lip Augmentation: About the Procedure |
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Injections
Grafts
Local Flaps
Lip augmentation - also known as lip enhancement and lip enlargement - is a procedure that either temporarily or permanently changes the appearance of your lips. Sometimes, the procedure takes place in an outpatient surgical clinic with the use of a local anesthetic. Other times, it is done in an operating room under anesthesia. If a local anesthetic is used, you will be alert and comfortable throughout the procedure; the area being worked on will be numbed. There are a variety of lip augmentation techniques from which to choose, so depending on the one that's right for you, the surgery can take anywhere from 20 minutes to two hours.
Most people return home shortly after the lip augmentation has been completed and spend a couple of days - in some cases, up to two weeks - recuperating from the procedure. With some techniques, though, you may even be able to return to work - or to your normal daily routine - the same day. If you have the procedure under a general anesthetic, plan to have someone with you; you will not be able to drive home alone. Pain medication will be prescribed, and you'll probably want to take it on the first and second day.
There are three main categories into which lip augmentation techniques fall: injections, grafting and local flaps. Each one requires a slightly different procedure and will result either in a temporary or permanent change to the look of your lips.
Injections
This method of lip augmentation entails placing a semi-liquid substance into your lips. It is an office procedure requiring a little topical anesthetic only applied to the surface of the lips. Substances that can be injected provide a general enhancement to the area, or they can help correct asymmetries of the lips. The procedure also can be repeated with little to no danger; some materials are more permanent than others.
Collagen
In use since 1981, collagen is the oldest technique and one of the most popular methods of lip augmentation. Though collagen is proven to work well, its effects are temporary.
Collagen, a purified preparation of bovine (animal) skin available in different concentrations and compositions, is implanted with small needles into your lips. It is a relatively painless procedure. There is minimal swelling or bruising, and patients can return to work or most activities right away. The injection either can enhance the entire area, or it can be localized to adjust for any asymmetries on and around your lips.
A reasonably safe technique, collagen from injections has been known to cause allergic reactions in some people. This usually takes the form of some redness around the treatment area that lasts for a couple weeks to months. For this reason, you must take a skin-allergy test prior to the procedure.
Your doctor will inject a small amount of collagen just beneath the surface of your forearm. An allergic reaction could occur any time between two weeks and six weeks after the skin-allergy test; your lip augmentation procedure usually is scheduled at least six weeks following the test. The risk of an allergic reaction aside, collagen causes very few if any problems or complications.
Collagen temporarily alters the look of your lips. The substance is easily absorbed into the body, especially when injected into an area - like the lips - of great movement and heavy blood flow. Your lip augmentation with collagen will last between four weeks and three months. Extra can be added at any time.
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Dermalogen
Another substance injected into your lips to enhance their shape, or to equalize both sides of the mouth, is Dermalogen, which is a substance prepared and derived from the human skin of a human cadaver. It is a relatively new product on the market, but does not appeal to everyone because of its source.
The use of the substance does not require a skin test because the material is rendered non-immunogenetic, which means you cannot contract an illness, like hepatitis, from the donor. So unlike collagen, Dermalogen can be administered right away. It is inserted like collagen and is similarly tolerated.
Though Dermalogen is believed to last slightly longer than collagen, its effects also are temporary, lasting anywhere from four weeks to three months.
Autologen
Autologen also is relatively new to the market. It is made from a patient's own skin, usually from the excess removed during another procedure, like a facelift. The extracted material is sent to a lab, where your own, natural collagen is squeezed out of the skin, prepared and preserved. Because it is made from the patient's own tissue, it is the one theoretically more resistant to resorption than collagen or Dermalogen injections. People who have required repetitive collagen injections should consider the option of autologen, as its effects may last longer.
Autologen is inserted like collagen. The injection does not cause allergic reactions and recovery time from this technique is similar to that of collagen or Dermalogen.
The use of Autologen requires an incision in the initial phase to obtain the skin for making the natural collagen, so, if you're also undergoing a procedure that requires skin removal, such as a breast augmentation, the procedure may be of particular interest to you.
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Artecoll
Artecoll is a synthetic material used frequently in Europe and in some Canadian cities, such as Vancouver, B.C., but it is still under investigation by the U.S. Food and Drug Administration. Though since 1989, more than 100,000 people have received Artecoll injections for lip augmentation procedures, only a handful of U.S. doctors are currently approved to use it in this country for lip enhancement procedures.
Artecoll, a synthetic material, has been successfully implanted in humans since the 1940s and today is frequently used in dental, neurosurgical and orthopedic patients. The substance is composed of microscopic spheres of material suspended in collagen. As the body degrades the collagen, then our own natural collagen replaces it and encases the microspheres, providing tissue augmentation that is long lasting.
Administered like collagen, Artecoll results in minimal pain and bruising, and you can plan on a quick recovery and return to your regular daily routine.
Fat Injection
A fat injection is performed with a small syringe and needle. Using a tiny needle and a local anesthetic, your doctor will extract fat from one part of your body and prepare it for reinjection. Special, small needles are used to place the prepared "threads" of your own fat into your lips. Though this technique promises good results - especially after the first time - up to 20 percent of patients are not pleased with the results. And the technique has only short-term staying power; fat injection is unsuccessful in about 30 percent of lip augmentation patients.
For the remaining majority of patients for whom fat injection works, they have to undergo two or three sessions for the desired changes to take hold. One doctor described this process as "building a layer cake."
You can expect a lot of lip swelling for the first few days after the procedure and minimal bruising or pain. You won't know how well it has worked until at least six weeks afterward. Most doctors will perform a fat injection up to three times; if after three times you're not satisfied with the results, your doctor can employ an alternative technique to give you the look you desire.
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Grafts
Alloderm
Alloderm essentially is a sheet of human collagen tissue, which has been purified and rendered non-immunogenic. It is related to Dermalogen, which can be injected. Alloderm is well-tolerated and does not cause allergic reactions or require a skin test prior to the procedure.
An outpatient procedure performed under a local anesthetic, Alloderm is rolled up and inserted into an incision made on either side of your lips. This technique allows the materials to pass through the body of your lips. A few tiny stitches are used to seal up the small incisions. Post-surgery swelling disappears within three to five days, and complete healing occurs after two months. At that point, the material becomes soft and supple just like the skin surrounding it.
More than 25,000 patients have received Alloderm skin grafts since it first was used in 1992. You can look forward to having your new look for up to one year, at which point the extra "pout" put into your lips will deflate a bit. Though many patients don't like this technique because the substance is guaranteed eventually to reabsorb, it is usually a complication-free lip augmentation option.
Gortex
Gortex - yes, the same material that keeps you dry in a rainstorm - is a synthetic substance that, to date, successfully has been used in more than 5 million humans. It is most often used in vascular bypass surgeries. Since 1988, doctors have been using it for facial implants. Though no allergic reactions have been traced to the internal use of Gortex, there is a slight potential for infection.
Gortex is desirable because it is a biocompatible material that passes easily through tissue, acting as a filler to increase the reddish color and projection of the lips. You might like it for lip augmentation because the result is permanent and gives your upper, lower, or both lips a full, sensual youthful appearance.
Yet, there is the possibility of infection. If this occurs, the substance can be easily removed. It also can be slightly palpable to the touch, and your lips can look distorted. The Gortex can "kink" every now and then, which makes your smile look crooked or odd-looking. If this happens, the procedure will have to be redone. In that case, the Gortex is extracted and then replaced; strands can be surgically added or removed as needed.
Dermis-fat Grafts
For the dermis-fat graft procedure, your doctor will make an incision somewhere on your body - usually in the groin area - and take out a wedge of skin with fat still connected to it. This sample of the skin with a bit of fat attached to it continues to nourish the fat after it has been transplanted. The skin also continues to bring in the body's own blood supply to ensure the graft's survival.
If you opt for a dermis-fat graft, your doctor will make an incision on each side of your lips, and the substance will pass from one side to another. This procedure is performed in your doctor's office, usually under local anesthetic, and you can go home the same day. You can plan to return to work in two to three days. Yet, the swelling is significant, so many patients opt to take a week to recover.
Though your lips will retain their new shape for a long time, unusual scarring and distortion can occur. If this happens, your doctor will have to perform a second incision to recover another plug of partial skin with fat attached. Patients have also complained of hardness. Most plastic surgeons do not recommend this technique.
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Local Flaps
Inside the Mouth
This last category of lip enhancement has been around since the 1950s, and was the first technique employed to enlarge the lips. It is still commonly used today, but because it is more invasive, it often is used when other techniques have been unsuccessful. Other times it is used when the patient knows he/she wants a long-lasting result and does not want to experiment with other procedures.
This technique involves making incisions inside the mouth to detach and roll out the pink tissue up and into the lips. It is an outpatient procedure and requires anesthesia. There is a lot of swelling, numbness and some drooling. These symptoms are very prominent for the first three weeks and diminish in the following three weeks. Stitches are removed in 10 to 14 days.
Due to the invasive nature of this procedure, you will experience temporary numbness and severe lip swelling that will last from two to six weeks. Sometimes, this technique is performed in combination with a graft implant, such as Gortex or Alloderm.
Outside the Mouth
Another procedure is an incision in the upper lip that follows the lip line, often referred to as "Cupid's bow." Some skin is removed and the lip is lifted and turned outward to create a fuller look with more "pout." This incision can be slightly visible, but often can be camouflaged with makeup.
This technique is not as popular as others because many plastic surgeons hesitate to make an incision in a completely normal upper lip and to risk an unsightly scar. In well-chosen patients, though, the result is excellent. The surgery is done in your doctor's office with a local anesthetic. It takes about one hour. You'll experience minimal pain, mild swelling, which disappears in up to 14 days, and enjoy a quick recovery.
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