Lip enhancement refers to a variety of procedures intended to improve the appearance of the lips. The most common complaints I see include: lipstick bleed lines (sometimes referred to as smoker’s lines), thin lips, turning down of the corners of the mouth and long lips.
“Lipstick bleed lines” are not always a result of smoking though I suspect that smokers are indeed more likely to have these lines and that the lines are more likely to be deeper. If the lines extend less than a quarter of the way up the upper lip, treatment with a filler along the white roll and selected individual wrinkle injection with hyaluronic acid works well. If the lines extend beyond that, a procedure to smoothen the entire upper lip is often a better choice. I use Fraxel® laser resurfacing or dermabrasion in my office. Any lines remaining after these treatments can be touched up with a filler. My filler of choice at present is JUVÉDERM® because it is clear, flows evenly, rarely forms lumps and lasts up to a year or more. JUVÉDERM® now comes with a local anesthetic mixed in. This, along with ice compresses before injecting, allow for a tolerable injection experience.
Turning down of the corners of the mouth is also something that occurs with age. These areas are also effectively filled and lifted with JUVÉDERM®.
Thin lips can also be made fuller by the injection of JUVÉDERM®. Although there are implants made of Gortex available for this, the extrusion rate after a year is high. Lumpiness is even more common. Injection of a filler is far safer. Grafts of tendon, fascia or dermis can be used as fillers but may need to be repeated because of partial resorbtion or incomplete take. There is also something to be said for changing areas and relative volumes of fill as needs change over the years. What was appropriate and attractive at the age of 25 may be misplaced at the age of 45 if the material used was permanent.
The other problem some patients face with age is a flattening and lengthening of the upper lip. The best solution to this problem is to remove excess skin in the shape of two wings just under the nose. When the wound is closed the scar is well hidden, the lip is shortened and the white roll edge is pulled out a little bit, giving more shape to the upper lip.
As you can see, “Lip Enhancement” covers a wide variety of conditions and I individualize treatment according to each patient’s needs.