Lip Augmentation San Francisco

Full lips are a sign of youth and fertility. The lips tend to be ample in youth, and slowly shrink with age. Many options exist for plumping thin lips, so it is important to choose the option that is best for you.

The most common cosmetic procedure for lip enhancement is by way of an injectable filler. Since the 1970's, Collagen® has been available off-the-shelf for wrinkle correction and lip enlargement. It still provides a very precise means to augment the lip and fill in pucker lines. While Collagen® provides better definition than some of the new fillers, there are several downsides.

Collagen® has a shorter duration of correction, so there is an increased need for repeating treatments. Collagen® is suspended in solution, so initial overcorrection is needed. Collagen® is white making is visible if the injections are too superficial. Last, and certainly not least, Collagen® use is associated with a 1-3% incidence of allergic reaction. To help avoid the reaction in patients who are allergic, a skin test and a waiting period of four weeks before use is required for the initial treatment and if you have not had Collagen® recently.

Products have been designed to avoid the last problem, Cosmoplast® and Dermaplast® are two. These products do not have a Bovine source, so the collagen fibers in them are much less likely to cause an allergic reaction.

More recently hyaluronic acid products have received FDA approval. Hyaluronic acid (HA), like collagen, is normally found in the skin and joints. Brand name products include Restylane® and Perlane® distributed by Medicis and Juvederm®, Captique® and Hylaform® distributed by Allergan. Each has subtle variations in firmness and longevity. It is important to choose a professional who can explain the differences and choose the product the best suits your needs. In general these HA products last two to four times as long as Collagen® and are softer to the touch. There is no need for a skin test, and since the gel is clear, it tends to be less visible than it predecessor.

Many other fillers and implants exist, but the above are all FDA approved for lip enhancement and the correction of facial wrinkles. Some fillers claim to be permanent, but as anyone who has come across a picture of themselves from five or ten years ago knows, the face continues to age. Regardless of the permanence of the filler, further correction will be necessary if the effect is to be maintained.

Surgery has been used to enhance the lips for many years. Plastic surgeons transplant fat and dermis into the lips to provide fullness using the patients' own tissues. Dermal-fat grafts are still the gold standard to which all other fillers are compared. While fat alone can sometimes give a lumps, the dermal-fat grafts tend to give a smooth and soft result. I frequently use this trick to enhance the lips, and to fill deeper facial wrinkles to enhance the results of a facelift.

Local "flaps" can also be used to enhance the lips. Rearranging the lip itself can help to enhance a normal lip, restructure an misshapen lip or completely reconstruct a lip lost to cancer, trauma or birth defect. These procedures are more specialized and require a careful consultation.

When considering lip enhancement, you will want to explore the various procedures and find the one that is best for you. It is important to consult with someone who is familiar with all the options so that you can make an informed decision. When choosing an off-the-shelf filler, stick to FDA approved fillers. Ask to see the box and syringe. Manufactures use holographic safety seals to assure you that it is the genuine product and that it has not been tampered with. Products licensed for the US should include the words "FDA Approved." It's going into your body. You deserve the best.

By: Joseph Mele MD, FACS