Lips

Q. My upper lip is very thin and I would like to ask for your advice about the most suitable techniques and the safest materials for lip augmentation.

A. Increasing lip volume can be achieved through several medical and/or surgical procedures which consist of using injectable filling materials (known as fillers), solid implants (or threads), tissue grafts or local flaps. The choice of the kind of procedure (medical or surgical) and of the material to be used depends upon the cosmetic result you want to achieve and of your body’s ability to tolerate the products used.

The filling materials may be absorbable, semi-permanent or permanent.

Absorbable fillers, such as collagen and hyaluronic acid, have the advantage of being easily tolerated by the body but provide a temporary volume increase lasting from 4 to 12 months.

Semi-permanent fillers have the advantage of providing a more durable result from 12 to 36 months though in exceptional circumstances, may provoke foreign-body reactions known as granulomas.

Permanent fillers have the advantage of providing a permanent result but, sometimes can induce a rejection reaction that is not easy to control and correct.

Generally speaking it is always preferable to use absorbable fillers, because they allow the patient to decide whether to continue the treatment or to regain his/her natural state; also, they don’t have any long-term effect.

Q. Are there any cosmetic treatments or cosmetic surgery operations capable of producing definitive and permanent lip augmentation?

A. To achieve a permanent increase in lip volume, they can be filled with permanent materials (fillers), or implanted with threads made of non-absorbable material which are inserted inside the lips (vermilion) or along the contour of the mouth.

Another alternative is to graft tissue or fat taken from a part of the body which is then implanted into the lips a process known as lipofilling. Alternatively a solution is known as ‘local flaps’ is possible – a surgical procedure which involves making incisions (W-, V- or Y-shaped) in the internal part of the mouth and transferring a flap of local tissue to the external part of the lips.

Q. I’m 60 and small and quite deep wrinkles have appeared around my lips. I would like to know what the best treatment for this problem is.

A. The wrinkles that appear vertically above and under the contour of the mouth (perioral wrinkles) are frequent among thin-skinned people and among those who often tense the orbicular muscle of the mouth. This is common among those who smoke for example. In male skin, which is much thicker, this defect hardly ever occurs.

Perioral wrinkles can be improved (but not eliminated completely) by a combination of various treatments acting on all the factors that cause them to appear. More precisely, the skin should be treated with techniques that smooth its outer layer, such as dermabrasion, CO2 laser and intermediate (TCA) or deep peelings such as phenol.

The subcutaneous fat that has thinned out and can be replaced through the use of filling materials such as hyaluronic acid, collagen. Finally, the orbicular muscle of the mouth can also relaxed through little injections of botulinum toxin (botox) to prevent this muscle from contracting, which inhibits the appearance of worry lines.

Your consultant would be able to discuss the most appropriate course of action with you based following an examination of your skin and current state of health.