Let’s Get Lippy: Safe and Permanent Lip Augmentation Through Plastic Surgery

If you’ve ever had lip injections, you know it takes a certain fortitude to get through it. The process is painful, the results are temporary, and not all injections are created equal. In order to make the process worth it, the filler must either be injected in exactly the right place for the desired natural effect, or else a ton of it must be used to fill the lip entirely. In the latter case, the end result is often less than optimal: a lot of frog, not enough princess.

To achieve a more natural look, the lips must roll out rather than push forward. This usually means injecting into the edge of the lip at just the right angle. The slight roll outward makes the lip look taller without leaving it heavy and without lifting away from the teeth (aka frog effect). If properly done, this technique can be very successful in achieving a very natural look. However, it is temporary, and for some patients, not enough to meet their aesthetic goals.

Permanent Filler

As a surgeon, I'm used to providing permanent results for my patients. It's one of the things that drew me to my profession in the first place — a real, lasting fix for the problem. While lip augmentation is a fantastic procedure with high patient satisfaction, until recently there were few options for permanent results, and none were very good.

There are countless filler materials on the market today, all with subtle variations in their profile and durability. For the most part, however, they are generally all temporary, requiring repeat treatment at least two to three times a year. Variations in type of filler, the person administering it, and other factors can also lead to some unpredictability or inconsistency in the results. For a more permanent solution, the options have always been either fat or silicone, both of which are fraught with issues.

Lip Injections

Although a great idea in theory, fat transfer leaves a lot to be desired at this point in medical history. Fat is easy to harvest and place, but very hard to control. While the fat can be moved, it usually loses some of its blood supply in the process, and then has a very hard time staying alive. As it dies, it shrinks slowly, waiting for the body’s cleanup crew to pick up all the pieces. The reality is that many fat grafts do not last, at least not in any amount that would make the procedure definitive.

Liquid silicone, on the other hand, is completely permanent, for better or worse. The particles get into the tissues and stay there forever. Placement can be controlled depending on the injector’s experience, but once injected, the stuff can't be removed without removing the tissue that holds it. If something doesn't look right or there are any complications, the piece of lip holding the silicone must come out with the silicone itself. Liquid silicone complications are often unpredictable, can become chronic, and are sometimes irreparable.

The Surgical Lip Lift

Drawing from the theory of lip rolling, the question then becomes: Can you roll the lip out permanently without injections? The answer is yes, you can.

As a plastic surgeon, tissue rearrangement is the basis of what I do. If properly executed, aesthetic procedures can truly mold the skin, fat, muscle, and sometimes bone. With surgery, we can achieve shapes with lasting results. The only drawback is that surgery usually comes with scarring. But with appropriate insight and planning, it can be extremely safe and scars as inconspicuous as needed.

The lip lift procedure involves removing a strip of skin right under the nose and then pulling the lip up to meet it. This results in a taller lip that is stretched upward instead of inflated outward. No fillers are used, and therefore there's no risk of the injection getting to the wrong place and causing complications. The distance between the nose and the lip also shortens, creating a more feminine and youthful look. And because the surgeon can control the change in height, the peaks of the upper lip (aka cupid’s bow) can be emphasized as needed to solve the problem of a flat upper lip line. The best part of the procedure? It takes less than an hour, can be performed under local anesthesia, and is completely permanent.

Balance is Key

Not many surgeons perform lip lifts. This is a relatively new technique and requires a good knowledge of anatomy. The lip muscles are right under the skin, and they must be spared and carefully managed. Extreme pulling can lead to deep, wide scars or an overly shortened upper lip. But the biggest issue is that most lip lifters only address the upper lip, creating an imbalance often seen in filler use. When the upper lip is thicker than the lower lip, the mouth appears to be upside down.

As an artist and designer, I have always believed balance is key. The lips come in a set, and it looks best if they match and complement the rest of the face. In planning your procedure, consult with fully trained and credentialed surgeons and make sure to discuss issues of symmetry and shape. Also, consider that not every part of the same lip requires the same lifting. Just like a good suit, the way it wears is only as good as its tailoring.

Lip Service

Considering lips are a symbol of femininity and carry a lot of weight in terms of how you present yourself to the world, it makes sense that there is so much focus on them these days. As a surgeon, I feel most satisfied with safe, controllable procedures that have lasting effects. The lip lift has finally provided me with a tool that can do for lips what has been so successful for breasts. I can now offer patients a transformative experience and a celebration of femininity across the board. Now, that deserves a big fat kiss.

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