Charlotte Lip Augmentation Specialist – Dr. Graper
Full lips are one of the many signs of youth and vitality. All one has to do to recognize this fact is to visualize the difference between the lips of a 20-year-old versus the lips of a 70-year-old. The change is one that occurs throughout the whole body and is that of decreasing blood vessels and collagen, which provide bulk.
The three main ways to enlarge lips are to use either an injectable filler such as Juvéderm (hyaluronic acid), use one’s own body tissues, like fat or dermis, or use a synthetic implant such as PermaLip. Each method has advantages and disadvantages.
Hyaluronic acid is the main component of Juvéderm. This material is a mucopolysaccaride filler that is present throughout our bodies. Bacteria have been engineered to make this substance in a sterile fashion. The material is harvested and can be injected into lines in the cheeks, lips and perioral area. There is no harvest site and the procedure can be done in 15 minutes in the office with minimal recovery time. The effects last 3-6 months. Recently the FDA approved Voluma which is an 18-24 month treatment for adding fullness to the cheeks, jawline and temple area. Because of these advantages, this is our preferred approach at this time for temporary correction of the lips.
Fat can be harvested from an area of abundance, using a tiny incision, and then injected into the lips. Lips are over-corrected because we know that some of the fat will melt. The advantage is that the procedure is easily tolerated with virtually no incisions. The disadvantage of this cosmetic surgery is the uncertainty of how much fat will survive the transfer and keep the lips full.
Dermis grafting to the lips is a very reliable way of permanently enlarging the lips. The cosmetic surgery procedure is done by removing a strip of skin underneath the buttock crease, then removing the epidermis and fat and placing the dermis graft into the lips. The advantage is the predictability of the augmentation and the natural feel of the lips. The disadvantage is the incisions under the buttock, well hidden though they may be.
The implants are categorized into synthetic implants such as PermaLip, Gore-Tex, radiated human dermis such as AlloDerm, and purified Bovine protein know as Collagen. Collagen is the main building block of the skin and can be refined from human or animal sources. Bovine Collagen implants have been used for twenty years as a temporary (4-12 weeks) filler for lip augmentation. It is great for that special occasion or for someone who is not sure they want a permanent lip enlargement. It is very temporary. One can have Collagen implants made from their own dermis, which reportedly lasts longer, but is still not permanent. Hyaluronic acid has virtually replaced this treatment option as it lasts longer and feels more natural.
AlloDerm implants are human dermis that has been treated to make it safe for transplantation. The implant is placed in the lips just like the dermis graft except there are no donor scars and no donor site discomfort. The disadvantage of this cosmetic surgery procedure is the lips can only be made so large and the material may shrink with time.
Synthetic materials like Gore-Tex implants are very safe and have a long tract record of biocompatibility in many areas of the body. The Gore-Tex comes in different size tubes and is placed through small incisions on the border of the lips. The effect is to increase the size without any donor site issues, but the lip size increase tends to be smaller than with the other methods. Some patients note a different feel to the lips after the procedure.
PermaLip is the newest entry into the lip augmentation options. This is a very soft silicone implant that feels very natural in the body. It has all the advantages of a permanent implant, but none of the unnatural feel that Gore-Tex often has. There is no donor site and it is permanent without any shrinkage. The swelling after the procedure is more than after Juvederm injections, but you don’t have to ever do it again. We favor the Juvederm injectable fillers for temporary improvement and the PermaLip for the patients who know they want fuller lips for permanent correction.
All of these cosmetic surgery procedures are done in our facility with local anesthesia and sedation either by mouth or intravenously. The procedure takes between 45-90 minutes, depending on the technique. Everyone is swollen after the cosmetic surgery, but this resolves over the next several weeks. Most people take a few days off work and expect not to be perfect when they return to work. Lipstick may be worn approximately five days after the cosmetic surgery. The lips are initially numb due to the swelling. This resolves quickly as the swelling goes down. Many patients feel ChapStick is helpful post-op as their lips are more easily chapped due to the increased exposure to the sun and the wind. This too will resolve over time. For patients who have a history of fever blisters, we recommend a prophylactic anti-viral medication to prevent the unlikely occurrence of a sore post-operatively.
Obviously, since there are many different techniques to increase lip size, no technique is perfect for everyone. Each patient must maximize the advantages and minimize the disadvantages for their situation. We have experience in each cosmetic surgery technique and will guide you in your decision, for we really do know what you want.