 26 year old with congenitally thin lips. |
 1cc of restylane injected |
 28 year old desiring fuller lips. |
 1.5 cc fat injected into each quadrant |
Lip Problems
Small lips, Asymmetrical lips, Post trauma
ANALYSIS
Our lips always change during our lifetime. They will become smaller due to sunlight exposure, hormonal changes, and more so if a smoker. A study has shown the progressive loss of lip subcutaneous fat and thinning of the dermis starting every decade from 20 years on. This is more so in women than men due to estrogen changes.
Pre operative evaluation looks at the position of the lips in relation to the chin, nose and eyelids. The relationship of the upper lip to the lower lip is important too. The amount of mucosal show, number of vertical fine lines and quality of skin are noted.
The type of correction will depend upon the amount of deficiency, and whether that deficiency is in the forward-posterior plane, in the superior-inferior plane, in the distance to the nose and in the number of lines.
CORRECTIVE TECHNIQUES
Lip augmentation, Grafts, Lip advancement, Lip revision
If there is relatively small soft tissue deficiency, then an injectable such as Restylane, Juvaderm or fat works well. This can be layered to correct fine lines, turn up the lip, and give more substance. It will not turn the lip up or advance it.
Lip advancements. For those who have had injections that failed, and want more lip show, then an advancement works. The lip is advanced from either the nose (advancing skin into the nose) or by excising skin immediately above the white rolls of the upper lip, removing skin parallel to the lip border. The configuration of the lip can be changed if desired.
ANESTHESIA
Most procedures are performed under a regional block, similar to a dentist.
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