Lip enhancement, gained much popularity in the '90s. Patients desire fuller, more sensuous lips. Our lips thin with age and demonstrate less fullness and projection when viewed both in front and in profile. It’s important to follow the curves of the lip for a natural result. The silhouette of the lip and the V shaped area of the upper lip called "Cupid's bow" can be enhanced. For a natural appearing lip the body of the lip should be plumped as well for a fuller yet more natural shape. Lips should not be over-filled, with proper techniques they can be made fuller yet still look natural. Like other areas of cosmetic surgery, there are a number of ways to enhance lips. A complete dialogue with Dr. Pearlman will help determine the best treatment for you. There are a number of substances that can be injected into the lips to make them fuller. Dr. Pearlman has an algorithm ranging from the simplest to the most complex, the short-term to permanent and least to most expensive.

The simplest and most cost effective treatment is with Collagen or Cosmoderm/Cosmoplast as fillers. Hyaluronic acid substances, Restylane and Hylaform have become the most popular lip enhancing substances in our practice due to the simplicity of placement and greater longevity than Collagen. The patient's own fat may be used as well. The next level of lip enhancers for longevity and a natural appearance is Alloderm. For the most permanent result, ePTFE (Advanta, Gortex) insertion is used.

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Not only does the lip deflate with age, but it may become longer to the point where it completely covers the upper teeth. This can be camouflaged by upper lip enhancement. It can also be shortened by a "lip lift operation". The lip lift removes a small amount of skin below the nose, in a natural crease to both lift and reshape the upper lip. For a very small upper lip, the vermilion (red) border can be advanced by surgically removing a strip of skin just above the border. By tapering this excision, an enhanced Cupid's bow shape can also be restored.

Lip Reduction

For patients who have lips that are too full, the lips can be made smaller. The incision is hidden completely inside the mouth and a strip of lip mucosa (the red skin of the lip) along with some of the deeper lip tissue is removed.

Lip Enhancement Summary Table

Fillers
Collagen: Zyplast, Cosmoplast	Simplest, shortest acting
Hyaluronic Acid: Restylane, Hylaform	Last 2-3 times longer than collagen
Fat	Longer lasting, but needs to be harvested fresh
Inserted Substances
Alloderm	Lasts 1-2 years or longer
ePTFE (Advanta, Gortex)	Permanent, may be felt under the lips, more complicated insertion, may extrude
Surgical Procedures
Lip lift	For elongated lips, dental hooding
Lip advancement	Pulls “red” vermillion up, may flatten lip though
Lip lengthening	For high upper lip with excessive “dental show”
Lip reduction	Reduce size of oversized lips

Questions? Contact Dr. Pearlman about Lip Augmentation.