Autologous fat, harvested from the patient's own fat stores, has also been used as a source for lip enhancement. Although fat stores seem almost limitless in most people, fat doesn't seem to "take" well in the anterior face [the lips, nasolabial folds, marionette lines] and is prone to resorption in some patients.

The biomedical implants - Alloderm, GoreTex, ect., also have a place in this discussion. These biomedical products may provide a predictable permanence but they often appear artificial and stiff.

That finally leaves us with the open surgical procedures that I endorse. I believe strongly in the use of demial-fascia-fat grafts which are inserted into the subdermal tissues of the upper and lower lips to provide a predictable and relatively permanent result. The procedures require "harvesting" skin-dermis, underlying fat, and fascia from a previous body scar site and then inserting the grafts into the upper and lower lips through well-concealed lateral lip incisions [Fig.2].

Click for bigger picture [Fig 2]

 

This lady underwent insertion of dermal-fat grafts into her upper and lower lips that were havested from a previous abdominal scar [Fig. 3a]. One year later, the lips have maintained their bulk [Fig. 3b].

Click for bigger picture [Fig 3a]

Click for bigger picture [Fig 3b]

 

In cases where there are no expendable or well-concealed scar sites I recommend harvesting dermal-fascia-fat grafts from behind the ears [post-auricular] thereby leaving well-concealed scars [Fig. 4a, 4b].

Click for bigger picture [Fig.4a]

Click for bigger picture [Fig.4b]

 

This lady had post-auricular dermal-fascia-fat grafts placed into her upper and lower lips [Fig. 5a.] One year later the grafts have "taken" well and have maintained their bulk [Fig. 5b].

Click for bigger picture [Fig.5a]

Click for bigger picture [Fig.5b]

 

Surgical lip enhancement may require ancillary preoperative preparation which may include lip peels, treatment for dry lip, and the superficial injection of Botox-A. Lip enhancement may also be augmented by dermabrasion to smooth out the "lipstick lines" and an upper lip lift to increase the exposure of the upper teeth [Fig.6a, 6b].

Pre-oral rejuvenation of the aging face may include dermabrasion to smooth out the "lipstick lines", an upper lip lift, and lip enhancement.

[Fig. 6a] [Fig. 6b]

This lady demonstrates the nuances of facial aging including peri-oral wrinkling, lip atrophy, and upper lip lengthening [Fig.7a]. One year after undergoing peri-oral rejuvenation, she continues to enjoy a refreshed appearance [Fig. 7b].

Click for bigger picture [Fig.7a]

Click for bigger picture [Fig.7b]

 

This elderly lady demonstrates even more pronounced signs of facial aging than Figure 7 [Fig. 8a]. Upper lip dermabrasion, an upper lip lift, and dermal-fat grafts to the upper and lower lips have all helped to reverse the aging process [Fig. 8b].

Click for bigger picture [Fig.8a]

Click for bigger picture [Fig.8b]

 

I have also combined the dermal-fascia-fat grafts with "wet" mucosal advancement flaps to reinforce the permanence of the procedure [Fig.9a, 9b].

Click for bigger picture [Fig.9a]

Click for bigger picture [Fig.9b]

 

The healing time for this procedure is slightly longer but the long-term results are more sustained. This young lady underwent lip enhancement combined with mucosal flaps [Fig. 10a– before][Fig. 10b-after]. Three years later, the lips have maintained their bulk and the mucosal scars are well-hidden.

Click for bigger picture [Fig.10a]

Click for bigger picture [Fig.10b]

 

Another example of the same procedure. [Fig,11a, 11b]

[Fig.11a]

[Fig.11b]

 

Finally, lip enhancement can also be highlighted by other facial surgery.This lady underwent upper and lower lip augmentation that was visually enhanced by tip rhinoplasty [nasal surgery] and facial rejuvination. [Fig.12a, 12b, Before] [Fig. 13a, 13b, After].

[Fig.12a]

[Fig.12a]

[Fig.13a]

[Fig.13a]

The surgery takes place in our accredited office surgical facility. The patient has a choice of either "twilight" sedation or general anesthesia. All stitches are the dissolving type and therefore the patient can wash their face and hair almost immediately post-op. The lips require little care other than keeping them well-moisturized with Vaseline salve.

In summary, there are several options to choose from for lip enhancement. I am here to help you make the best choice for your needs.

David A. Gilbert, MD.

Please write, call, FAX, or e-mail my office for a free consultation.

The opinions expressed here are Dr. Gilbert's alone and are not necessarily endorsed by other plastic surgeons or the plastic surgery societies to which Dr. Gilbert belongs.

American College of Surgeons
Diplomat: American Board of Plastic Surgeons
Member: American Society for Plastic Surgeons
American Society of Aesthetic
Plastic Surgery
American College of Surgeons
Society for Genitourinary
Reconstructive Surgeons

Dr. Gilbert is an Associate Professor in Plastic Surgery at the Eastern Virginia Medical School where he interfaces with medical students, surgical residents, and fellows.

Dr. Gilbert has written numerous articles on many plastic surgery topics and presents his work at national and international conferences. Over his plastic surgery career, Dr. Gilbert has maintained an ongoing interest in Cosmetic Surgery and, more recently. Body Scanning technology.

Dr. Gilbert lives in Virginia Beach with his wife, Deborah, and their three children.

"I profess both to learn and to teach anatomy,
not from books, but from dissections; not
from positions of philosophers, but from the
fabric of nature".

-William Harvey-

 

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