Lip augmentation for fuller and more attractive lips is a very popular procedure that can be performed in a few minutes. When I discuss this procedure with my patients, they often express their concern about people they see with bloated and unnatural-looking lips. These overdone lips create a negative perception of cosmetic procedures, especially so-called “duck lips” associated with some celebrities and other people in the media. However, when lip enhancement is performed with artistry in experienced hands, lip augmentation can be beautifully proportional and balanced.
I perform a variety of facial cosmetic procedures such as: eyelid surgery, facelifts, facial fillers, facial implants, injectables like PRP and Botox, as well as lasers and other skin treatments. I can attest to the value of years of experience and artistry performing surgical and non-surgical procedures on the face provides a foundation and an advantage to treating specific areas like the lips. The key is balance – when someone looks at you, they look at an inverted triangle which includes the eyes, cheeks, lips, and chin.
The importance of lips aesthetically can be appreciated by a high level of interest in products such as lipstick and lipliner. Billions of dollars are spent on products that are sold to create the perception of full and youthful lips. The limitation is that no cosmetic can enhance or restore lip volume and definition.
How to Prevent Overfilled Lips
Before choosing fillers, or neurotoxins like Botox or Dysport for lip enhancement, I take photos of the face from different angles. Often, my patients will show me how their lips looked when they were younger to give me a sense of whether their lips were naturally thin when they were younger, or any other specific characteristic they want to preserve. Some of our younger patients bring photos to show an ideal lip appearance that they would like their lips to resemble. In addition, I review with patients some important principles which guide my approach to lip aesthetics.
I begin by looking at the front view of the lips. With some ethnic specific exceptions, the Golden Ratio, also known as Phi, is a ratio that underlies beauty seen throughout nature. The ratio of 1 to 1.6 applies to proportions in the face including the volume and size of the lips. This proportion in the lips is ⅓ to ⅔ which means that the balance is ⅓ for the upper lip to ⅔ for the lower lip.
I also look at the projection of the lips from the side with the projection of lips to the chin using specific measures referred to as Rickett’s, and Steiner lines. I look in detail at specific aspects of the lips such as the philtrum, cupid’s bow, the vermilion border, the lip body, the G and K points, and the orientation of the outer corners of the lips. I look at the skin quality around the lips such as the presence of vertical lines and skin discolorations.
Objective measures and proportions guide the artistry of determining how the lips will fit with the rest of the facial features. I think it’s important to recognize some concepts regarding the enhancement of the lips. When younger patients come in, they are interested in one of 2 things: first is the younger person who feels their lips are genetically thin, or they feel that the upper lip is too thin in proportion to the volume of the lower lip; the second situation is when a younger person has proportional volume in their lips, and wants to further enhance or beautify their lips.
For people who are noticing aging changes in their face such as loss of volume where the lips have become thinner, with loss of definition of the vermillion border as well as some or many vertical lines, the purpose is to restore or correct the lip volume and definition. I would also note that more men are coming in than in previous years for lip enhancement.
Lip enhancement primarily involves the restoration or augmentation of volume. This is where I use different fillers from the hyaluronic acid family such as Restylane and Juvéderm. Hyaluronic acid exists naturally in the body, and the filler material is slowly metabolized and usually lasts about 4-6 months. I use different fillers to fill fine lines and volume in the lips. There is a lot of artistry in lip filler placement.
How Swelling and Bruising are Avoided After Lip Fillers
Regardless of age, almost everyone considering lip enhancement wants to have natural looking results, and avoid looking overdone. They are also concerned about how they will look immediately after any lip enhancement procedure, in particular the risks of significant swelling or bruising.
I discuss a strategy with my patients based on their specific concerns as well as the techniques I apply to allow them to have minimal swelling or bruising. The challenge is to place the filler with minimal trauma. Repeated injections with needles can result in swelling which makes accurate placement more difficult. I routinely use blunt cannulas to minimize needle-related trauma to the lips and patients are often surprised as to how little discomfort they experience with my approach in comparison to having lip procedures done elsewhere. I also minimize pokes through the lip skin to avoid causing more bruising, and swelling. Naturally, less swelling and the absence of bruising allows my patients to return to their regular activities sooner than they would have with a more traditional approach. Many people come in at the last minute needing to look good in a few days, which generally is achievable.
Lip enhancement can include the use of neurotoxins such as Botox or Dysport for vertical lines, outer corner lip lift, and for the upper border of the lip to turn slightly upward often referred to as a lip flip.
I do routinely see all my injectable patients after two weeks to see how the filler material has settled, or to see the full effects of a neurotoxin like Botox. At the two week point, it can be decided if additional filler would be beneficial, or if more enhancement is needed with a neurotoxin. It’s always better to be conservative at first, then add more later if needed, than it is to overfill at first, then having to dissolve the filler and start over; or in the case of neurotoxins, add more later if needed, rather than to use too much, and be stuck with limited lip movement until the effects of the neurotoxin wear off.
There is no question that the appearance of lips is very important to facial appearance. Artistically performed lip enhancement can create a remarkable effect on facial balance and appearance. The popularity of lip enhancement procedures makes choosing the right practitioner challenging. Understanding that the ideal experience requires a combination of detailed analysis and planning with maximal comfort and minimal trauma.