Many patients seek a change to the shape or volume of their lips (cheiloplasty) alone or in combination with other aesthetic enhancements or treatment for aging changes. In most cases, the desired procedure is lip augmentation (enlargement). Making the lips bigger can be achieved with temporary fillers, permanent fillers or grafts, or by complex surgical rearrangement of the lip tissues. In some patients, lip implants made from a silicone-based plastic can be used; the most common variety is called PermaLip®. Dr. Ransom does not perform silicone injections due to the abundance of problems with this technique (see Lip Augmentation Revision).
Dr. Ransom recommends that all patients seeking lip augmentation for the first time start with temporary fillers before considering more permanent approaches. Temporary injectible fillers used for lip enlargement are generally composed of hyaluronic acid (“HA”) gel (the active ingredient in Restylane®, Perlane®, Juvederm®, and Belotero Balance®). Treatment involves carefully planned placement of small amounts of the filler material to highlight the lips’ natural curves and replenish the lips’ youthful volume. Dr. Ransom does this in the office, using topical anesthesia and/or local block techniques to enhance patient comfort.
If a permanent change to the lips is desired, Dr. Ransom can use the patient’s own fat cells (autologous fat grafting) or perform a surgical procedure designed to make the lips bigger, through rearrangement of the lip tissue. With autologous fat grafting, adipose tissue (fat) from the abdomen or thighs is harvested using a method that is very similar to liposuction. This tissue is then washed and purified to isolate the fat cells. Subsequently, the fat cells are carefully placed at key anatomic points using tiny injection cannulas; this highlights the natural structure of the lips while adding or restoring volume. In many cases, lip augmentation with fat grafts is a permanent solution. For some patients, however, the procedure must be repeated to ensure that just the right amount of volume is added.
Finally, for patients who desire a significant and permanent increase in lip volume, Dr. Ransom can perform a surgical procedure called V to Y lip augmentation. This technique uses the patient’s own lip tissue, which, by rearrangement and precise suture placement, allows for an increase in the size of the red part (vermillion) of the lips (either upper or lower, or both). This procedure is performed under sedation and can be combined with other aesthetic surgical procedures, such as an upper lip lift (bullhorn or subnasal lip lift surgery).
Who is a candidate?
Anyone who is interested in enlarging their lips or creating a more supple or sensuous lip contour. A variety of methods are available (see above), including temporary and permanent treatments. The only contraindications for a lip augmentation are active infection (including “cold sores”), or inflammatory and autoimmne conditions that cause blistering or open sores in the mouth or lips. These require adequate treatment before the procedure can be performed. Dr. Ransom advises patients who are interested in a lip augmentation to first try out the temporary soft tissue fillers. These generally last at least six months, and may last up to a year or more in some patients, depending on the filler selected. After this trial phase, Dr. Ransom will work with you to design your “new lips” – anything from a subtle refinement to a larger “bee stung” look.
Frequently Asked Questions
Q: Will lip augmentation change the way my mouth moves or affect the way I speak?
A: No. The lip augmentation procedure, no matter how it’s performed, does not affect the nerves or muscle of the mouth. If you select a surgical approach, immediately following the procedure there will be a moderate amount of swelling and bruising. While this is resolving, you may have some mild difficulty with enunciation or eating certain foods. This is temporary and generally resolves within two days. As your healing progresses, your lips will move normally and naturally.
Q: Is it possible to make just the upper or just the lower lip larger?
A: Yes. Dr. Ransom will work closely with you to determine the exact treatment plan that will best help you reach your aesthetic goals. It is common to treat only one lip, either the upper or the lower. Dr. Ransom is a face specialist and understands that everyone’s face is different. He will gladly go over the details of the procedure and your specific questions during your confidential consultation.
Q: I have had lip injections with fillers and I like the results… but I want something that lasts longer. What are my options?
A: This is a common question and there are a variety of treatments available. Procedures using your own tissues include fat grafting (where fat cells are taken from the abdomen and injected into the lips) and use of other tissue grafts (e.g., dermal fat grafts or SMAS grafts). Dermal fat grafts are generally harvested from the skin in the bikini line and have a better take rate than fat injections. SMAS grafts are an excellent choice, but are only harvested during a facelift surgery. Lastly, some patients will choose a lip implant, such as PermaLip®. These are made of a soft, flexibile silicone-based plastic and are inserted in a minor surgical procedure. They can be removed at any time – as opposed to silicone injections, which are not recommended.