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Lip Enchancement

Lip augmentation creates fuller, plumper lips and reduces fine wrinkles around the mouth. Lips may be injected with collagen or with fat transferred from another site in the patient’s body. Both liquid collagen and fat are absorbed and repeat treatments are necessary to maintain results. Newer, longer-lasting options include implantable materials like AlloDerm and SoftForm and injectable materials like Cymetra, Restylane, and Radiance.

There is a tremendous "Buzz" around the hyaluronic acid derivatives like Restylane, which will soon be FDA approved in this country. This material can last 6-12 months.

**However, something even more promising is now starting to be routinely used for injections - Radiance. Made by Bioform, this injectable substance is made of hydroxyapetite (something normally present in your bone and teeth). Because calcium hydroxylapatite is a normal constituent of bone, it should not elicit a chronic inflammatory or immune response. It is actually softer than collagen and very easy to inject. There is no allergy testing required. It is supposed to last 2-5 years which is truly remarkable!

It has been used in Europe and Canada for some time and is FDA approved for other uses, but not yet for facial rejuvenation. Remember, Botox was used since 1989 for facial rejuvenation without being FDA approved. Botox was only FDA approved in early 2002. FDA approval for Radiance is expected in the summer of 2003. Dr Speron has been using it since January of 2003 and is very impressed with it.

Technique: A natural or synthetic biocompatible material, or the patient’s own fat, is injected or implanted in the lips. One injection is usually sufficient to produce the desired result, which may be temporary, depending on the material used. Injections may need to be repeated periodically. Proper placement of the injected material is important. AlloDerm, a natural collagen sheet made from donated skin, is inserted through tiny incisions inside the corners of the mouth. Once the AlloDerm implant is in place, it eventually becomes integrated with the natural tissues. Gore-Tex, SoftForm and soft ePTFE are other synthetic implant options. Further options include:

1. Autologen - injectable dermal implant material made from the patient’s own skin.
2. Dermalogen - injectable Human Tissue Matrix (HTM) procured from donor tissue.
3. Cymetra - injectable human collagen which does not require skin testing and lasts 3-6 months.
4. Fascia - injectable donor tissue made from the dense white connective tissue that supports body structure. Can also be done as a surgical implant.
5. HylaForm -injectable donor tissue made up of a molecular component of the human body.
6. Restylane - crystal-clear injectable gel; the hyaluronic acid in Restylane is very close to that naturally found in the body.
7. Radiance - thin creamy injectable substance; hydroxyapetite is similar to that normally found in teeth and bones. It can last 2-5 years.

Another augmentation choice is laser lip rejuvenation, which tightens the natural collagen and elastic tissue beneath the lips.

Benefits:

1. Immediate return to normal activities (one-day return if sedated) for nonsurgical lip procedures; depending on the procedure and materials used, recovery period is within a week for surgical procedures.
2. AlloDerm and Dermalogen do not require patients to provide donor tissue and are not rejected by the body, because they are human tissue. Usually they have a pliable, natural feel for the lip.
3. Gore-Tex implants are permanent, easily inserted and well tolerated by the body.
4. Temporary procedures like collagen or fat injection can be appealing to patients who want to experiment with a fuller-lipped look, but not necessarily commit to it.

Other Considerations:

1. Allergic reactions can range from prolonged redness, swelling or itching, to firmness at the injection site. Other possible complications include bleeding, lip asymmetry, and migration and extrusion of the implant. Normal swelling and bruising lasts from three days to a week.
2. Patients with a reaction to the pre-treatment collagen skin test; who have a serious allergy history; or are allergic to lidocaine (a local anesthetic) should not consider lip augmentation. Treatment is sometimes postponed for patients with active inflammatory skin conditions or with infections.
3. Collagen injections have a short-lived effect (3-6 months); Radiance, Restylane and fat injections can provide longer-lasting results, but are sometimes unpredictable as to the degree of improvement, can have lumping or scarring effects, and must be harvested from another part of the body.
4. Soft-form is a foreign body and may become infected or be rejected.

While many techniques exist for lip augmentation, none are ideal.

Post Surgical Care:

While many of the lip augmentation techniques are temporary, there are certain clinical skin care products that can aid in maintaining a youthful appearance of the lips. Dr. Speron recommends neaclearplus Liquid Oxygen Lip Repair Cream. This unique product helps to repair sun damaged, wrinkled lips, while giving a fuller appearance.

neaclearplus Liquid Oxygen Lip Repair Cream:
 

Acts as a keratinization regulator, helping to improve firmness and texture

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