Lip augmentation continues to be one of the primary uses for injectable fillers. While some may debate as to which filler material is the best to achieve one’s desired look, that discussion is not nearly as important as the technique used to do it.
The two primary concerns that I have observed in my Indianapolis plastic surgery practice are the fears of being too big and unnatural in which the lips don’t match the face and the level of comfort during the procedure.
While lip injections do make the lips bigger, they really only enhance what you already have in terms of lip shape and size. This means that small lips can never really be made big and very flat lips can never have too much shape or cupid’s bow accentuation. Trying to make something a lip is not is exactly what can make them look unnatural.
Overfilling a small lip usually gets ends up looking like a duckbill because there simply is not enough natural volume in the lip to accommodate the amount of filler material. As a result, it will simply push out the lip rather than make it really look much bigger which is more of a vertical expansion of the vermilion. (pink part of the lip) The same applies to the central cupid’s bow part of the lip. A filler material will not make it more arched or give it higher peaks to the bow.
The key to thin lip augmentation is to do a limited amount right at the white roll junction. (where the pink meets the skin) The white roll can be highlighted and that is often sufficient in the thin lipped patient. Lips with more vermilion can get more material into it by placing it at the white roll and into the body of the lip. I always use a mirror after the first layer so see how the patient likes what has been done. The patient tells me whether to stop or to go further. I call this the ‘layer and look’ method of injectable filler use.
Comfort with lip augmentation is a very important issue. While topical numbing creams and the use of fillers with local anesthetics in them helps, putting a needle into your lip is uncomfortable. I still prefer to do dental (infraorbital or maxillary vestibular nerve) blocks. They are a lot more confortable to do and go a long way to making lip augmentation a minimally uncomfortable procedure. The more comfortable the procedure is made the first time, the more likely a patient is willing to undergo it in the future.
Dr. Barry Eppley
Indianapolis, Indiana