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Background: Lip augmentation is done by a variety of non-surgical and surgical methods. By far the use of injectable fillers dominates these methods and is highly effective for many patients. The success of injectable fillers is dependent on having enough vermilion tissue so it can be adequately expanded. As a plastic surgeon once said a long time ago….’fillers work in lips that already has some volume.’

In thin lips, however, injectable fillers often do not work as well as patients would like. There is not enough vermilion tissue that can adequately expand the lip vertically. As a result, fillers create more of a horizontal push and bring the lip forward. If too much filler volume is added this creates the classic ‘duck lip’ appearance…an undesired sign of an unnatural looking lip.

Lip or vermilion advancements offer a surgical lip augmentation method that is technically the definite approach. By changing the location of the vermilion-cutaneous border through skin exciseon, increased lip size is achieved that is permanent. There is always an understandable concern about the resultant scar but with good surgical technique this risk can be minimized.

Case Study: This older female desired larger upper and lower lips. She have been through numerous injectable filler treatments but was tired of the cost and lack of permanently. She had very thin lips with 5mms of less of vertical vermilion height.

Under general anesthesia (as she was undergoing other procedures) an upper and lower vermilion advancement was done of 3mms on each lip margin.

Her six month result showed a substantial change in the size of her lips with scars that were virtually undetectable. (and this was done using 6-0 plain suture for skin closure)

Lip advancements are a powerful and definitive method of lip augmentation While they are not for everyone, thin lips in older men and women are an ideal use of them.

Case Highlights:

1) Full lips are perceived as having a substantial amount of vertical vermilion height.

2) Lip advancements are the most powerful method of lip augmentation as it changes the location of the vermilion-cutaneous junction.

3) In older female with thin lips, lip advancements offer an assured and permanent method of achieving larger lips.

Dr. Barry Eppley

Indianapolis, Indiana

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