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Lip Augmentation San Francisco

Full lips with an accentuated border are associated with youth and beauty.

Dr. Maas is an expert in different techniques for lip enhancement and offers a number of procedures to achieve more beautiful lips and reverse some of the effects of aging.

With aging, the muscle and soft tissue that give the lips fullness and definition around the vermillion border (the lip border) gradually atrophy or diminish. The effects of aging include general thinning of the lips as well as fine “smokers lines” radiating from the vermillion border. These lines can be the result of smoking, repetitive pursing of the lips as well as from sun exposure. These effects can be improved with the use of a variety of lip fillers or surgical alterations. In some cases, a combination of these procedures is desirable for optimal results.

Lip Implant With Lip Injections of Surgically Implantable Materials

Over the years, many materials have been used to fill the lips by implanting them under the skin at the vermillion border or within the vermillion (red part) of the lip itself.

Some materials are autologous (meaning the tissue used for the procedure comes from the patient being treated.) These materials include fascia (thick connective tissue), dermis (second layer of skin), skin, fat, and muscle and are all materials that can be taken from the patient as a distinct operation or as an adjunct to another operation, such as a facelift. Autologous materials have the advantages of a more natural feel and lower infection rates. They have the disadvantage of being temporary.

Fat Injections for Lip Fillers

The products of liposuction can be separated (so that the fat cells remain) and injected into other parts of the body. There has been success with injecting this material into the lips. However, as with other tissue-derived materials, it may disappear, sometimes more quickly. There are reports of long-term results with repeated injections. Also, the surgeon can freeze fat (taken during liposuction) for up to four years and periodically re-inject it into the lips and other areas of the face. In order to get a result with fat injections, one must over-inject so that, for approximately a week, the lips will look very swollen. The results are often lumpy as some fat reabsorbs (is reabsorbed by the body) and some does not. Re-treatment can correct these bumps but often it requires several procedures.

Other materials are sterile homologous (meaning the tissue used for the procedure is derived from the same species, in this case human.) tissue products. Homologous materials also have the advantages of a more natural feel and lower infection rates, however the effects are temporary.

Alloderm- is essentially dermis (the second layer of skin), which is prepared from human tissue. The material is denatured, radiated, purified and stripped of cellular matter. It comes in dehydrated sheets which are hydrated at the time of surgery and pulled through tunnels underneath the lip. However, the desired fullness may decrease over months to years, requiring re-treatment to maintain lip enhancement. Resorption (the body’s process of degrading) of the materials derived from tissue is somewhat unpredictable and unevenness may result. However, many good long-term results have been reported.

Synthetic (meaning they are created in a lab and contain no human or animal byproducts) materials are also an option. The synthetic materials have the advantage of longevity but may be somewhat more detectable.

Gortex and Advanta are synthetic materials comprised of expanded polytetraflouroethylene (EPTFE). Gore-Tex has been used for many years in surgery as a suture and arterial grafting material. It is very biocompatible with the human body. In the lips or soft tissues, strips or strands of EPTFE tunneled (similar to the other materials) beneath the skin. Once the swelling has diminished, the results should be permanent. Because the material is permanent, the placement and healing must leave the implant in the correct position or it will need to be adjusted or removed. EPTFE has not been tolerated by some patients because it is firm and unnatural feeling and has a tendency to migrate from its original position. It is, however, safe because it can easily be removed if a problem arises after implantation. Infection rates are low with EPTFE, but, like any foreign material, infection can occur, requiring its removal.

Ultrasoft is a product designed especially for soft tissue augmentation of the face. It is a material that comes manufactured in a tubular shape with a hollow core. It has the same safety and biocompatibility features as EPTFE as well as some additional advantages. Because of the hollow core and the special manufacturing process, this material is softer than Gortex or Advanta. It is considerably more stable in the tissues than EPTFE and while it shares some potential disadvantages such as infection, it is, in our opinion, the best permanent solution for soft tissue augmentation. Ultrasoft implants may need to be adjusted; replaced or added to if the results do not completely or accurately fill the area of need. This is usually a simple office procedure.

Other Areas to Consider

In addition to the lips, other areas may be improved by employing some of the filler materials listed here. These areas include the nasolabial folds (the lines between the nose and corner of the mouth), the glabellar lines (the creases between the eyebrows), oral commissures (marionette lines), depressed scars, and other deep creases around the face. If you have concerns with these areas, ask Dr. Maas if these treatments are viable options.

Lip Lift or Lip Advancement

In certain cases the soft tissues around the lips can be advanced by creating flaps. This results in more of the red lip showing. These procedures will not work on everyone and scars must be hidden along the lip line or base of the nose. Older patients with a long upper lip (“white lip”) and short vermillion (“red lip”) are good candidates for the subnasal lip lift.

Excerpts from Dr. Maas’ most recent research and clinical papers:

“The lips are the foundation on which the remainder of the perioral region is centered. In the modern aesthetic, full lips provide a youthful healthy appearance. A key external anatomic feature of the lips is the Cupid’s bow complex of the upper lip, formed by two high points of the vermillion joined at a V-shaped depression centrally. The lower lip has no such depression. Lying between the cutaneous and red lip is the white roll which refers to the raised line of skin that separates these structures.”

Dr. Corey Maas and the staff at The Maas Clinic look forward to answering any questions you may have about your Lip Enhancement Surgery in San Francisco. To schedule an appointment, please call (415) 567-7000.

It is never too late, To be what you might have been.- George Eliot