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Steven J. Pearlman, MD, FACS Dual Board Certified in Facial Plastic Surgery

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Lip Augmentation

We empower beauty. ®

lipsBeautiful lips are something everyone wants and now everyone can have. Lip enhancement has gained much popularity over the past two decades. Patients desire fuller, more sensuous yet natural lips. Patients who come to see us for lip augmentation fall into two categories: those who desire more voluptuous lips and individuals who want to restore a more youthful shape. Fuller lips are sought out by younger patients. The latter group is treated using our “Cupid’s Bow Lip” technique. Dr. Pearlman was featured in Vogue Magazine, August 2008, highlighting his exclusive use of the Cupid’s Bow Lip treatment. The Cupid’s bow lip is the V-shaped area in the center of the upper lip along with the philtral columns that go up to the base of the nose. However, all lip treatments are individualized for each patient’s special needs, regardless of what’s en vogue.

No longer do patients have to settle for the “trout pout,” “duck” lips or “flotation devices.” Tough terms to be sure, but professionals in the industry as well as beauty experts actually assign these descriptions to women who have unknowingly gone overboard. Lips should be treated by first determining what should be enhanced. Is it more definition? Is it a fuller body of the lip that is desired? Each is treated differently. Just like putting on lipstick. The lips are first outlined by enhancing the border, akin to lip liner. This is followed by filling the body of the lip for volume. Dr. Pearlman actually developed this technique long before it became popular. In the late 90’s, he was treating a budding fashion designer who didn’t need more definition. She wanted lips like Michelle Pfeiffer and pointed to the underside of her upper lip and asked for filler in just that area; and then she looked great. This was a departure from what we were originally taught, to only fill the rim of the lips, and when patients wanted larger lips, more was put into the rim; hence the duck lips.

Aging lips

Gravity eventually takes a toll on every part of the body, even the lips. As we get older, the upper lip loses not only volume, but firmness and definition. As a result, the Cupid’s bow, a signifier of youth and beauty, is lost, leaving an undefined, flat line in its place.

As in all areas of cosmetic surgery and enhancement, there are a number of ways to recreate beautiful 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. It has to be right for you.

The Power of Glamour

Dr. Pearlman is on a mission to re-introduce the power of glamour. Celebrities have long been the inspiration for what patients look for. However, the latest trends have been to make lips too large. They look great on Angelina Jolie, but how many of us can realistically pull off that look? For truly aesthetically perfect lips, the lower lip should be at least 1 1/2 times the size of the upper lip. That is the way medical books on aesthetic surgery and beauty experts alike define it; that’s what the well-informed patient desires, to achieve natural – yet enhanced – glamorous lips.

So who do we look to emulate? We aim to create more coy, flirtatious lips. This more refined and natural look references the Hollywood glamour of yesteryear when starlets like Gloria Swanson, Carole Lombard and Greta Garbo were the defining power of beauty- and the most coveted women in America, the age of “Crème Glamour” can be regarded as the barometer of beauty.

Actual Patient of Dr Pearlman

Lip treatment options:

The simplest and most cost effective treatment is with Collagen or Cosmoderm/Cosmoplast as fillers. However, this treatment is fading in popularity as these fillers may only last a few months.

Hyaluronic acid substances, Restylane and Juvederm have become the most popular lip enhancing substances in our practice due to the simplicity of placement and greater longevity over Collagen. Dr. Pearlman prefers Restylane since it is a little firmer than Juvederm in the lips.

Perlane and Juvederm Ultra Plus are thicker hyaluronic acid products that last even longer, but since they are thicker they may also feel a little lumpy, but these lumps are rarely visible to others.

The patient’s own fat may be used as well. This is known as fat lipo-transfer.

Because of the simplicity and longevity of hyaluronic acid fillers, other procedures that require surgical placement such as Alloderm and ePTFE (Gortex and Advanta) are rarely used any longer.

Surgical Procedures:

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.

Surgical lip enhancement

There are a number of procedures that are used to enhance lips. They include lip advancement and V to Y plasty. According to medical publications and experts who have tried them, these techniques have proved to be unpredictable and can leave scars so we very rarely perform them.

Lip Lift

Not only do the lips deflate with age, but the upper lip may become longer to the point where it completely covers the upper teeth. This can be camouflaged by upper lip enhancement. The upper lip can also be surgically shortened by a “lip lift operation”. The lip lift removes a small amount of skin below the nose. The incision is placed 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.

To find out which lip augmentation techniques are best for you please contact our office.


Answers to frequently asked questions about the procedure

Q: What do you use to augment lips?

The most common way we augment lips is by using hyaluronic acid (HA) fillers, mostly Juvederm or Restylane. For a more permanent result, we can place soft silicone implants called SurgiSil with a minor surgical procedure

Q: I don't want to look like I have fish lips, how do you avoid this?

Not all individuals need to look over-done after lip fillers. Unfortunately, poorly performed or over-filled lips gives this procedure a bad name. Artistic placement of fillers along the border of the lips (lip liner) followed by filling the body of the lips (the lipstick) can yield beautiful, yet natural lips.

Q: Why can't you use permanent injectible fillers for the lips?

Due to the motion of the lips, the particles in permanent fillers can be compacted or mounded up by the muscles of the lip. If you really want something that can last more than the 4 to 8 months than HA can last, we recommend SurgiSil implants.

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