Lip augmentation is a type of cosmetic surgery or non-surgical procedure that aims to alter the appearance of the lips by increasing their fullness through enlargement using fillers.
Full lips with an accentuated border have often been associated with beauty and youth. Tribal peoples worldwide have introduced various materials into and through the upper and lower lips of all genders to enhance beauty. The perceived ideal size of lips has varied over time and in different cultures.
Around 1900, surgeons tried injecting paraffin into the lips without success. Liquid silicone was used for lip augmentation, starting in the early 1960s but was abandoned thirty years later due to general—and later, unfounded—fears about the effects of silicone on general health.
About 1980, injectable bovine collagen was introduced to the cosmetic surgery market and became the standard against which other injectable fillers were measured. However, that collagen does not last very long and requires an allergy test, causing the patient to wait at least three weeks before another appointment, after which more waiting is required to see cosmetic results.
Currently, fillers containing hyaluronic acid like Restylane and Juvederm have captured the attention of consumers and physicians in Europe, North America, South America and Australia.
In the late 1990s, with the huge popularity of surgical rejuvenation and concomitant increase of cosmetic surgery procedures worldwide, more substances, along with biocompatible materials commonly used in other medical applications for years, became available to surgeons for use in augmenting thinning or misshapen lips into more plump and attractive features.
Some of the first widely used lip augmentation substances were:
Since 2000, more products and techniques have been developed to make lip augmentation more effective and patient friendly. The relative ease of many injections is due to surgeons using tiny 30 and 31 gauge (about as thick as a dozen human hairs) needles that are used to inject the very sensitive lips. Nonetheless, topical anesthesias are often used for lip augmentation procedures.
Some of these new techniques and substances include.
Several studies have found fat grafting of the lip to be one of the best methods of maintaining a semi-permanent fuller and softer lip. When the lips are overfilled, the results can be comic, often supplying fodder to tabloid newspapers and offbeat websites. This look is sometimes mockingly called a ‘trout pout.’ Overaggressive injections can lead to lumpiness while too little can result in ridges.
Common reactions can range from redness, swelling or itching at the injection site(s). Other possible complications include bleeding, uneven lips, movement of the implants or extrusion, when an implantbreaks through the outermost surface of the skin. The usual, expected swelling and bruising can last from several days to a week.
Some patients are allergic to the common local anesthetics like lidocaine and probably should not consider lip injections. Some react badly to the skin test that patients must take before receiving collagen. Other patients who should forego procedures to the lip include those who have active skin conditions like cold sores, blood clotting problems, infections, scarring of the lips or certain diseases like diabetes or lupus that cause slower healing. Patients with facial nerve disorders, severe hypertension or recurrent herpes simplex lesions should also eschew lip augmentation. As in all surgeries, smokers complicate completion of their procedure as well as the speed of healing.
Fat transfer can last longer than other injected materials but can have lumping or scarring effects. The length of time a fat transfer may last in the lips is often determined by how much the area moves and how close it is to a major blood supply. In addition, the donor fat must be harvested from another area of the patient’s body which leaves another—albeit tiny—surgical wound. However, donor fat harvesting techniques have become extremely well refined.
Cosmetic surgery providers often advise their patients that many options now exist for improving the appearance of the lips. Most practitioners also admit that successful lip augmentation is highly dependent on the skill of the provider, with that skill stemming from many years of experience injecting the lips of many types of patients. Moreover, the surgeon must master the various injection techniques. With many injectables, the benefit to the patient is an immediate return to normal, usual activities. A few surgeons offer a procedure known as surgical flap augmentations in which small sections of skin near the lips or inside the mouth are excised and added to the lips. But the technique does not add volume and achieves only a slight outward protrusion of the lips.