“Today I wanted to talk a little bit or give a little introduction to lip enhancement which is a big issue now and in today’s world where we have lots options that are available to improve the lip. I wanted to go through them from the minimally invasive options to the more surgical options.

To start with, as many people know, there are many fillers available which include the HA fillers, Restylane, Perlane, the Juvederm family, Juvederm XC, Juvederm and now Voluma, which is more of a volumizing product. Then there are some other fillers like Belotero, which is an HA, and even some of the non-HA fillers like Radiesse or Sculptra, which I don’t recommend at all for lip enhancement because the potential for bump, lumps or irregularities.

Finally, there are the injectable fillers which are permanent. The two that are available in the United States which would be off label uses of these products are Silikon 1000, which is injectable silicone and ArteFill. These two products are synthetics which never go away which offers permanence, but they also offer the downside of permanent side effects or complications if somebody were to have a problem and so for those reasons, I don’t advice using them for volumetric lip enhancement.

The two categories that we can talk about with lip enhancement related to fillers are enhancement of the lip border or the lip roll and then volumizing the lip, and it’s all too common or frequent now, that I see people who have enormously over projected lips sticking out looking like a fish, where they’re trying to make the vertical height of the lip, the physician treating, the vertical height of the lip to have more volume, more attractive, more of the vermilion, the red part of the lip show, and in practice the lip is really like a tube.

So when a filler is used it’s being expanded circumferentially and at some point the benefit we get in improving the vertical height of the lip is exceeded by the downside of the projection of the lip being too great, in other words, the lip sticks out like a fish. So we want to avoid that and that means there are limits to what a fillers of any variety can do for lips.

With that said, when in proper usage, lip enhancement of the border to enhance what we call the lip roll or the white roll are very, very good options and using them to volumize the lip at the wet lip border which is basically right underneath the lip near the mucous or the wet part of the lip are too, very good options to do enhancements that are subtle and appropriate based on the lip size.

Generally the thinner the lip, the less volume that can be used, and the more full the lip the more volume that can be used with the fillers and still keeping natural enhancement of the lip without making one look silly, over over-volumized or puffy lipped.

The next category, if we get out of the non-surgical options are the surgical options, and there are a number of those which include the corner of the mouth lift, the direct lift which is an incision or vermilion lift where there’s an incision made right along the vermilion border and some of the white lip is removed and lip advancement is done with the red part of the lip, that’s a direct lip lift or lip border enhancement. I’m not fond of that because of the scar and the absence of the lip roll. Finally, there’s the sub-nasal lip lift where an incision is made directly underneath the nostrils and so it’s very well hidden and I’m able to elevate the lip in a fashion like this much like this, you’d think of lifting the lip and disguise scar effectively. It does two things, it makes more of the vermilion or red part of the lip show and decreases the height through the white part of the lip so we’re effectively doing just what it sounds like lifting the lip, and that’s an effective procedure for people who have very thin lips.

Lastly there’s a procedure that is a v to y advancement where I’ll go under the lip and make a surgical designed incision that allows for direct advancement of the vermillion from the inside to out which creates increase vermilion show and that’s done of course without any external scarring and in certain patients that might be a good option.

So the summary of available options for lip enhancement or the use of a whole number of injectable fillers, those are non-surgical options and then there’s the use of surgical options which as I said before include the direct lip advancement, I don’t advice that but I’ve seen a number of people who have had it, again it diminishes the lip roll. The sub-nasal lip lift which is hidden incision underneath and around the nostrils and finally the v to y advancement procedure, which includes advancement of the lip without scars and using incision primarily inside of the mouth.

If you have any questions about lip enhancement or volume, I welcome you to visit our website at DrMaas.com you can put videos, pictures or questions directly on that part of the blog. You can visit my website at MaasClinic.com and you’ll find some information there, or certainly call in the office 415-567-7000 and schedule an appointment to have you either a video consultation or a live on-site visit consultation are great options.

Any other questions please feel free to call as always I’m happy to get together and answer them and this is Corey S. Maas MDTM on Looking Your Best.”

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