Injectable fillers are one of the most frequently performed office-based cosmetic treatments. Their immediate results with just a few minutes of treatment time provides a satisfying experience that will last numerous months. Of all the facial injection sites, the lips are one of the most popular. With today’s fashion trends of larger lips, injectable fillers provide an instant method for achieving fuller, more sensual lips.
Most commonly, the goal of lip enhancement with fillers is to increase the size of the upper lip to match the size of the lower lip. To adequately increase the size of an upper lip, one has to have enough vermilion (or pink part) so it can be expanded or pushed out vertically as well as horizontally. Without enough vermilion, injectable fillers may only push out the lip horizontally creating an unnatural or ‘duckbill’ appearance.
There is an old plastic surgery axiom about lip enlargement that goes as follows…’thin lips can not be made big, big lips can easily be made bigger’. This statement speaks specifically to the very thin upper lip patient. Thin lips can be made somewhat bigger with injectable fillers but they can not be made truly full and luscious. If trying to do so, they will end up looking overstuffed and unnatural due to the shortage of adequate vermilion.
When I see a very thin-lipped patient in my Indianapolis plastic surgery practice, I advise them of a realistic outcome. Whether their expectations can be met is not assured, but injectable fillers are a good first approach. Its simplicity and reversibility (goes away) makes it a safe first treatment. While the most effective and permanent method of lip enlargement is a vermilion advancement procedure, the commitment to an irreversible lip scar is a difficult initial leap for most patients.
For lip injections, the use of hyaluronic-acid based fillers (e.g., Restylane, Juvaderm) is the preferred material. The hyaluron gels are easy to inject, flow easily through a small 30 gauge needle, and have very limited side effects. Plus they produce a soft enlargement that has very few irregularities. Coming in concentrations that last from 3 months to up to a year with different price ranges, patients can choose a material that fits their budget. For the very thin-lipped patient, I prefer to use one of the shorter lasting hyaluronic fillers. At a low cost, one can quickly find out if injections make enough of a difference. If so, one can use a longer-lasting one the next time. If not and one decides a surgical procedure would be more effective, the cost to find out was relatively small.
Dr. Barry Eppley
Indianapolis, Indiana