By Andrew Jacono, MD, FACS
Throughout the past several decades, there has been a dramatic increase in cosmetic surgery with a focus on achieving aesthetic ideals and maintaining a youthful appearance. Full, pouty lips have become increasingly desirable, as they are considered both appealing and beautiful.
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The problem is that lips age with the rest of the face, and aging clients may experience atrophy of the lips, where tiny vertical lines appear and the graceful “Cupid’s Bow” (curve of your upper lip) begins to flatten. Younger clients who are born with naturally thin lips often want a more defined “Cupid’s Bow” and great lip volume to balance the other features of their face.
According to the American Academy of Facial and Reconstructive Surgery, lip augmentation using injectable fillers was one of the most common facial plastic procedures performed in 2012. There are two major types of injectable fillers for lip augmentation – those that are permanent and synthetic, such as silicone, and those that are temporary and are made of a protein or a sugar that the body can reabsorb. Because the body can reject permanent fillers, temporary fillers such as hyaluronic acid and collagen are a safer bet. Hyaluronic acid fillers tend to last longer than collagen, and the gold standard of hyaluronic acid on the market is Restylane. But there are different versions emerging, including Juvederm and Perlane, which promise to be more stable and last longer.
The way in which these injectable fillers are placed in the lips is as important as the type of material used. The traditional technique currently favored by plastic surgeons and dermatologists worldwide involves injecting filler into the lip border, which can make the lip look unnatural and over-stuffed. This is a problem that plagues celebrities and socialites from Park Avenue to Rodeo Drive. To deliver a more natural-looking result, I created a technique called French Lips.
French Lips is a new lip augmentation technique that uses hyaluronic acid to deliver sexy, pouty lips that look completely natural. This customized technique targets approximately 15 different anatomic zones of the lip. Injections are made into the philtral columns (the two vertical lines above the lips), the center part of the “Cupid’s Bow” to accentuate its curvature, and the outer half of the lips toward the corners, which rolls the lip out slightly. Lipstick bleed lines and downturned lips can also be corrected at the same time. The cost of the French Lips procedure is approximately $1,000, and according to our study, lasts about five to six months. The procedure can be performed on a client’s lunch hour and there is essentially no downtime.
For individuals with naturally thin lips who are seeking a permanent solution, plastic surgeons often perform surgical procedures that require a week or two to recover. These include fat transfer, a technique called V-to-Y lip augmentation, and lip lifting.
Fat transfers are performed by liposuctioning some fat from the abdomen or thighs and transferring it with specialized syringes and instruments into the lips. Fat injections are placed in the same subunit zones as described above. This procedure takes five to seven days to recover from bruising. These results can last up to three years.
The V-to-Y lip advancement surgery procedure delivers permanent, voluptuous lips like those of Angelina Jolie. This technique uses small, imperceptible incisions in the corners of the mouth and the inside of the lips. The lip is rolled out from the inside out, making it pouty and full. Because the incisions are on the inside of the lips, there are no visible scars. Also, this procedure creates a permanent result and does not need to be repeated.
The most popular lip lift procedure targets your upper lip, elevating it to reveal a broader smile and increasing both the volume and the vermilion. One popular type of upper lip lift is called the Bull’s Horn Lip Lift. During this procedure, your surgeon makes an incision just beneath your nose. He or she then removes a tiny strip of skin and tissue, and raises your upper lip to its new position. This cut-out is crafted like a “Cupid’s Bow” to reshape your upper lip. With this lip lift, your scar is virtually undetectable.
Other upper lip lift types vary based on where the incision is placed. For example, a Gull Wing Lift removes a strip of skin above the border of your upper lip. The cut out is M-shaped to advance the border of your upper lip. The incision is made where the pink part of your lip meets the skin of your top lip. This lip lift leaves a visible scar and is therefore not as desirable.
The decision as to which lip enhancement procedure is right for you is based on your aesthetic goals and your anatomy, along with your surgeon’s expert opinion. In general, an upper lip lift procedure can be performed in a cosmetic surgeon’s office using local anesthetic and takes one to one and a half hours to complete. There will be some swelling in the first few days after your surgery, and any non-dissolvable stitches are typically removed within a week.
Protect yourself by choosing an experienced, board-certified facial plastic surgeon who has performed many of these procedures and follow his or her instructions. He or she will make sure you are an appropriate candidate, and that the benefits outweigh any risks. This is the primary way to minimize complications and maximize the cosmetic results of your upper lip lift.
Dr. Andrew Jacono is a board-certified facial plastic surgeon and medical director of The New York Center for Facial Plastic and Laser Surgery. He has practices in both Great Neck and Manhattan. For more information, call 516-773-4646, or visit NewYorkFacialPlasticSurgery.com.