The lip area is essential for facial harmony. Today, it is possible to treat all aesthetic aspects of this region: augmentation of volume for lips that are too thin, reduction of lips that are considered as too thick, reduction of the height of the upper lip if it is hiding the teeth. It is also possible to treat perioral wrinkles and bitterness folds which deepen with time.
Lip augmentation
Full lips are considered as a sign of youthful beauty and health. Certain factors such as heredity, aging, sun exposure, or tobacco can contribute to a loss of volume, the appearance of perioral wrinkles and deepening of bitterness folds. Better appearance at this level will improve the overall aesthetics of the face and give a person greater confidence in him or herself. There are several methods (fillers, fat transfer, implants) that can be proposed depending on the patient’s desires and available recovery time.
During the consultation for all of these types of treatment, there will be Q&A on the patient’s current prescriptions and medical history. The areas to be treated will be selected and the postoperative period will be explained (edema, bruising, social eviction). The technique and the duration of action of the treatment will be discussed. A list of medications to avoid, postoperative care and prescriptions will be provided. An informed consent document must be signed and finally, the total cost of the treatment will be specified.
Once the desires of the patient and the therapeutic possibilities are matched, an appointment will be made for the treatment.
Fillers
In the great majority of cases, FDA-approved fillers with a hyaluronic acid base are used in a reproducible and safe manner. Their duration of action ranges from 9 to 12 months depending on the type of hyaluronic acid used. The surgical approach will depend on the exact area to be treated and the wishes of the patient.
In general, injection consists of an augmentation of lip contour and the visible part of the red lip. Additional injections for perioral wrinkles, the corners of the mouth and bitterness folds can be associated.
The procedure
The products used contain a local anesthetic but an anesthetizing cream or a block similar to an injection practiced by dentists can be proposed which will render the procedure almost painless. Injection of the specific filler is strategically practiced with a sterilized needle or cannula. Ice packs are of interest to reduce edema and bruising and gentle massages are recommended. This method is minimally invasive and the patient can come to the center and leave after the procedure on his or her own.
Contraindications
Autoimmune diseases, certain blood pathologies, pregnancy, and an acute attack of perioral herpes are all contraindications.
Risks
- Redness, bruising, edema or local bleeding may occur.
- There is no known allergy to hyaluronic acid but an allergy to lidocaine (a local anesthetic) should be reported to the physician.
- Post-procedure asymmetry should be reported and could require correction.
- Infection can occur and injection in a vessel is a serious complication that can cause tissue loss.
- You will be asked to contact your physician immediately in case of fever or cutaneous problem.
Questions you should ask your physician
- Am I a good candidate for this method?
- Do you have a lot of experience with this type of injection?
- Are my expectations realistic?
- What type of anesthetic do you recommend for me?
- When will I be able to return to my normal social and sports activities?
- What are the risks?
- How long will the effects last?
Finally, the patient should not forget to indicate a possible history of herpes.
Fat injections
It is possible to use the patient’s own fat to increase lip volume. This is a more invasive method than that of augmentation by fillers but is a method that aims for a more permanent result without the use of foreign material.
The procedure
This is a surgical procedure that is performed in an operating room under local anesthesia and on an outpatient basis. However, the patient should be accompanied.
A small quantity of fat is harvested from a preselected donor site (abdomen, hips, knees…) or during an associated liposuction. The fat is then purified before being reinjected with fine cannulas. There is no risk of rejection since it is autologous fat. The percentage of graft take ranges from 50% to 70% and can sometimes be less. Therefore, several injections can sometimes be necessary to obtain the desired volume but the results can potentially be permanent. Postoperatively with fillers, there will be edema and bruising that can last 7 to 10 days. Pain will be minimal and can be easily treated with classic painkillers.
Contraindications
They include all of the contraindications that can follow a surgical procedure.
Risks
The risks are the same as those with fillers but they also include the donor site. Nodules and unevenness can be observed and major and very disappointing resorption can occur in the months following the procedure.
Implants
For safety reasons, we do not practice this type of augmentation (Gorets, Alloderm, Softform…) which are permanent but not without risks including persistent redness, infections, migration, scars.
WARNING: Silicon injections have not been approved by the FDA and must not be used. Make sure to consult a certified plastic surgeon.
Lip reduction
Some patients present upper or lower lips that are too thick and wish to equilibrate them. Lip reduction can be proposed in such cases.
The procedure
This is a surgical procedure that is performed in an operating room and on an outpatient basis. It lasts approximately 45 minutes per lip. Postoperative pain is minimal. Daily oral hygiene will be recommended postoperatively. The stitches will be withdrawn after seven days and normal socio-professional activities can resume at this time. The lips will be swollen during the first week.
Contraindications
They include all of the contraindications that can follow a surgical procedure.
Risks
The risks are the same as those after any surgical procedure: infection, healing problems (unsightly appearance, hypertrophy, incorrect alignment) can occur and require reoperation.
Edema can sometimes persist for several weeks.
The final appearance of a scar will be judged after one year.
Lip lift
During the aging process, certain patients can present a natural or acquired white upper lip (from the nose to the mouth) that is too long and a red lip that is too thin, tight and drawn in that hides the teeth and gives the person a severe look.
A lip lift can be very effective in such cases. The operation consists in resecting a strip of white lip very close to the nostrils with a scar concealed on the edge and in the nostrils. The result is a reduction in the height of the white lip and eversion of the red lip which will appear to be more hemmed and better show the teeth when the person smiles.
The procedure
This is a simple surgical procedure that is performed on an outpatient basis in an operating room under local anesthesia or short sedation. It lasts 30 to 45 minutes and pain is minimal. Treatment of the scar will be necessary during the first week and a return to normal social life will be possible 7 to 10 days after the stitches have been removed. Recommendations will be provided on what to do to render the scar almost invisible.
Contraindications
They include all of the contraindications that can follow a surgical procedure.
Risks
The risks are the same as those after any surgical procedure: infection, healing problems (unsightly appearance, hypertrophy, incorrect alignment) can occur and require reoperation.
The final appearance of a scar will be judged after one year.
