Many patients seek lip augmentation (enlargement) alone or in combination with other aesthetic enhancements or treatment for aging changes. Unfortunately, lip augmentation injections and surgery does not always give the desired result or go as planned. The patient’s expectations are not met for a variety of reasons. The most common reasons for revision lip augmentation or lip reduction is asymmetry of the lips caused by poor technique, formation of scar tissue or granuloma (excessive inflammation or foreign body reaction), and contour deformities from infection after injections or surgery.
When temporary fillers have been used, such as hyaluronic acid (the active ingredient in Restylane®, Perlane®, Juvederm®, and others), treatment is simple. This involves carefully placed, very small injections of the enzyme that digests hyaluronic acid (called hyaluronidase and marketed as Vitrase or Wydase). Dr. Ransom does this in the office, and depending on the severity of the defect, may require more than one visit to appropriately measure the patient’s response.
*Actual patients in photos
If a permanent implant material or filler has been used, treatment can be more involved. Common lip implant materials include GoreTex (PTFE), Silicone injections, AlloDerm® (acellular dermis), autologous fat grafts, and rarely saline-filled silicone implants. With solid implants, surgery involves removal of the implant and repair of the lip contour. This may require a staged approach, with the implant removal followed by a later revision lip augmentation after some healing has occurred. Dr. Ransom is a specialist in revision lip augmentation surgery and is able to perform the revision surgery with incisions inside the lips so there are no external scars. In rare cases, he needs to graft tissue from your own body to create a natural symmetric contour to the lips. This is most often fat cells that are harvested from the abdomen, through a tiny incision hidden in the belly button.
For patients who have had silicone injections, surgical removal of the silicone particles alone is not possible. This is because the silicone integrates with the native lip tissue, and causes a significant inflammatory response (this is actually what cause most of the lip augmentation from silicone injection-based approaches). In these cases the lips must be carefully reshaped by specific excisions of the scar tissue or granulomas formed by the body in response to the foreign material (silicone gel). Dr. Ransom can perform this surgery in the office with local anesthesia and nerve blocks. Recovery is quick, with minimal pain or discomfort.
Who is a candidate?
Anyone who has undergone a procedure to increase the size of the lips, but is unsatisfied with the results, is a candidate for revision lip augmentation. Given the variety of techniques used to make the lips bigger, the specifics of your revision procedure will vary. Most often, patients who seek revision plastic surgery of the lips have undergone silicone injection. And in many of these cases, the results are uneven, or too big, or there have been complications such as infection and scar tissue. Dr. Ransom will work closely with you to identify the exact areas of your lips that need improvement. He is happy to discuss details of the procedure during your consultation.
Frequently Asked Questions
Please note that all patients are different and individual healing times and results may vary. The statements regarding procedures and recovery made here are general rules.
No. Revision lip augmentation procedure, no matter how it’s performed, does not affect the nerves or muscle of the mouth. Immediately following the procedure there will be a moderate amount of swelling and bruising; this will vary based on the technique used in your first procedure and the details of the revision procedure performed by Dr. Ransom. While this is resolving, you may have some mild difficulty with enunciation or eating certain foods. This is temporary and generally resolves within a few days. As your healing progresses, your lips will move normally and naturally.
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.
Dr. Evan Ransom is an Ivy League-educated and Ivy League trained Facial Plastic and Reconstructive Surgeon. He is a Double Board Certified Head and Neck Surgeon and Facial Plastic and Reconstructive Surgery and fellowship-trained in facial plastic, reconstructive, and laser surgery. His practice is in the San Francisco Bay Area, serving patients from San Francisco, Oakland, Marin County, Palo Alto, Silicon Valley, Walnut Creek, the East Bay, and all over Northern California.