Lip augmentation has come a long way! From ancient jungle tribes inserting bones into their lips to attract the opposite sex, to the current methods of injections and topical applications, the goal of enhancing the lips has been the same.
Patients seek lip enhancement for many reason. Some of the most common reasons are fine lines, improve the lip shape, offset changes that come with aging such as volume loss and the ‘turning under’ of the upper lip, and a desire for a more voluptuous look. Whatever the reason, a consultation is the first step to determining what will work best for you.
I’ve been augmenting lips for the last 30 years, and have seen significant advances during that time. For example, cow collagen was initially used for treatment of fine lines and wrinkles only after patients underwent allergy testing weeks ahead of the planned injection. Strips of a patient’s dermis – the deeper layer of skin – were obtained and pulled through the lips to enhance the size and shape. For a time, patients also had small tubes of Gore Tex placed in the same fashion. I still have an insertion needle for that which I never used, because the control of the lip shape was too variable.
Restylane was the first hyaluronic acid available and was well received, since it kept its enhancement for around 6 months, and didn’t cause an allergic reaction like collagen could. A wide variety of permanent, semi-permanent, and absorbable fillers have been used over the years. The patient’s own fat has also been injected into the lips with significant enhancement, but this is not a technique I personally use. If you gain weight and fat cells enlarge, your lips will enlarge as well.
Enter Juvederm – the workhorse of all hyaluronic fillers. Juvederm has been used for years in lip enhancement, as well as the treatment of facial wrinkles. Allergan has continued to produce multiple variations of hyaluronic acids for injection, and there are now three key products I use when considering lip enhancement. These products – listed from stiffest to softest – are Juvederm, Vollure and Volbella. All can be used for lip enhancement depending on the needs of the patient.
For a first-time filler patient, who may be concerned about the possibility of a “First Wives Club” Goldie Hawn look, Volbella is a great choice. It is soft, has good tissue permeability, and creates a hydrated look instead of a filled look in the lips. It is reported to last up to one year after injection. I have found it to be “lip enhancement lite.” I still use it when indicated and appropriate, but feel its properties tend to make it seem less noticeable in 6-8 months than results from other products.
Juvderm is a firmer option, but is great in the patients that have little structure to their lips and need a firm foundation to build on with additional products. Juvederm lasts for up to a year, and I have found that with the auto-augmentation feature of fillers (the ability of the body to release its own collagen in the injected area), less filler is needed in subsequent injections. It may also take longer for the treated area to return to the pre-injection state. The one small downside to Juvederm is also its advantage for some – its affinity for water and the increased swelling that can occur will prolong the enhancement but also cause some increased swelling early after the injection.
Last, but definitely not least in my tool chest, is Vollure. It is soft and integrates into the tissue well, but does not go away quickly. In fact, it is reported to last up to 1 ½ years after injection. It is used in multiple areas so there is no waste if you desire a subtler lip augmentation and don’t need the full syringe there. It has a very low affinity for water so it doesn’t swell as much as Juvederm might, and lacks the blueish hue superficial Juvederm can produce. This is now my “Go To” filler for almost all applications in the face – especially in lip enhancement.
It is very important you seek the care of an experienced, trained professional for your lip enhancement. This is your face, which all will see. I have 30 years of filler experience and hold the Master Injector designation from Allergan for the advanced training I have done. This allows me to bring you the very best results in facial aesthetics.
Call me for your lip enhancement consultation and we can refresh your look and bring a smile to your face.
Jeffrey S. Poulter, M.D., FACS
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