“I’ve had a lot of questions throughout the week here especially, after the new year, about lip enhancement and what we can do for our lips. I think a lot of people default to using injectable fillers which are a great tool and one that we’ve increasingly used to accentuate the natural lip borders and to provide more fullness or body to the lip. In a way that is, important to me, natural.

What we see on television coming out of Hollywood often or coming often out of the reality shows with these very over inflated lips that look unnatural are really, not the result that most people get if they’re having it done correctly.

Fillers are just the beginning, and in fact, I categorize lip enhancement or lip management of the aging lip into several categories that start with not just the border of the lip, meaning the Vermillion or pink portion of the lip, but also the white part of the lip, what we call the white lip or the border between the two of them.

So we typically want to see enhancement of the lip border, we want to see improvement if you will, if there’s any wrinkles, lines or aging related changes in the white lip and we want to see appropriate fullness of the lip without creating too much projection. In other words, the lip shouldn’t stick out too far from the side, and there are nice ways of effectively changing that using a combination of treatments.

Again, first, looking at this would be describing the condition, whether it’s a condition of volume, shape or contour. The next step or thing we look at would be the surface of the skin, and seeing if there’s wrinkles, fine lines, the color changes that need to be addressed. Then, the third is really the anatomic configuration of the lip. We want to make sure that the lip is the right configuration in terms of the height of the lip, we’d like to see the pink to white boarder be about 1 to 3, 1 to 2, meaning one part of the Vermillion or pink lip to two parts of white lip would be ideal.

Some models and some certain facial features will get a 1 to 1 ratio, pink to white lip but that’s quite an extreme amount. Getting into the 1 to 3, 1 to 4 range is pretty normal and if patients don’t have that there are certainly surgical options that can be addressed which I’ll describe in more detail.

We also want to make sure that we’re looking at the lips as a whole, not just the upper but the lower lip because they should be balanced.  In the profile view, the upper lip should be projected evenly with the lower lip, it shouldn’t be sticking out much further.

The lower lip should be fuller in the midline here, and give a little bit of a “pout” look and overall the shape or the dimensions of the lip should be something like a “diamond” in the younger patients. We don’t want to see it square, that’s what happens when we’re aging, they get thinner and sort of longer and wider. We want to see nice fullness and a diamond shaped contour to the lip.

In terms of the surgical options for managing of the lip, I think that there are excellent ones for lip lifting, creating more vertical lip show of the vermillion. There are direct lip advancement procedures that I’m not fond of where the lip is actually lifted from the boarder but the sub-nasal lip lift is a very common procedure for us and one that provides an excellent result with a very well hidden incision that afterward gives a nice contour and a nice change in the ratio of the white to red lip.

And finally, the things we do for the skin surface including laser skin resurfacing and chemical peels and or treatments for enhancing or improving the color differentiations such as intense pulse light or photo rejuvenation become a tool that manages the entire spectrum of lip aging.

So with regard to lip enhancement or lip reconstruction or lip improvement or even managing the aging lip, the goal should be really well-defined to restore a natural appearing lip with good definition of the border, appropriate fullness, a nice ratio of red to white lip and having a nice smooth periorial, the area around the mouth, without radial lines or wrinkles. We can achieve that in patients of all ages as long as we’ve set the expectations correctly and it can be totally natural looking.

In contrast to what we see in certain social events and certainly on reality TV with these really over inflated and unnatural looking lips, that should not be a goal ever with plastic surgery, really it’s to make you look better, not to make you look different or like you’ve had something done.

If you have any questions on surgical and nonsurgical options for lip enhancement or lip rejuvenation please don’t hesitate to send us a note at DrMaas.com, you can send videos, photographs, I’m happy to comment on those or you can visit our website at MaasClinic.com and we’re happy to have you become a fan at our Facebook page at MaasClinic.

This is Corey S. Maas MDTM on “Looking your Best.””

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