Lip Service

Posted Thursday, September 13, 2007 to PROCEDURES > Smile

Posted by The Original Anti-Aging & Cosmetic Surgery Magazine

Tony Norton explores different procedures for lip enhancement.

Until ten years ago, the lips were virtually an untouched domain in terms of cosmetic surgery or enhancement. Now they are a hotbed of cosmetic activity. There is a huge demand for plumper, smoother, more shapely lips, and it is easy to understand why. Lips have power. They are expressive, they are sensual, and at their best, they display vitality and youth.

Lip Lifts, V-Y Advancements and Autologous Fat Transfers

Treating lips on an individual basis is vital, according to aesthetic surgeon Randal Digby Haworth, because "Lips are very unforgiving they must be done perfectly from the beginning in order to get a natural result. The important thing is harmony with the face". Haworth has devised a number of lip enhancement procedures, each achieving a particular look or style. "Or you can have a combination of all these procedures, where I mix and tweak like a cook".

The upper lip lift, or paranasal lip lift, is employed to enhance an overly long or aged upper lip. Says Haworth: "The upper lip is a dead give-away of your age - a long, old upper lip can mean a 'horsy' appearance; where no upper teeth are visible when the mouth is in repose". The procedure involves surgery that is performed regionally as opposed to directly on or in the lip. "The results display more of the upper teeth when the mouth is in repose and everts the upper lip to expose more vermilion. Shortening the upper lip restores a youthful balance to the lower face", explains Dr Haworth. Recovery time is usually about five days, and the scar becomes invisible in a short time.

Drooping corners of the mouth can impart a sour, unwelcoming look to the face.This is where the corner lip lift can help. "It involves a small triangular excision of tissue at the corner of the mouth so that the lips turn up slightly in a youthful manner", says Dr Haworth. Once again, recovery time is only around five days, and the scar becomes virtually invisible.

When the upper lip has been lifted but the lower is still thin and unimpressive, a V-Y advancement is ideal. "This is often used to combat the lipless look," says Dr Haworth. "It rearranges the internal tissue to reveal more vermillion and form a natural pleasing shape as well as an enhanced, more youthful looking profile". The procedure involves three hidden, oral V-shaped incisions in the upper lip and one in the lower, with scarring disappearing in a short period of time.

Now that the lips have been successfully shaped, a patient may choose to give their lips more volume with an Autologous Fat Transfer (AFT). This is a method of plumping up lips by harvesting the patient's fat via liposuction, then injecting it into their lips. Dr Haworth is a keen exponent of this approach: "The patient's own fat is certainly the safest filler from a physiological standpoint". Currently the average survival rate for the transferred fat is between 40% and 60%, and improving with time. "The secret to fat longevity", notes Dr Haworth, "is to work with fat on its own terms and to understand its inherent properties". This means taking a careful, gentle approach to the harvesting, treating and injecting.

Lip tucks

Another approach to lip enhancement is the lip tuck procedure, as practiced by plastic surgeon Michael McGuire MD. "It has a lot of possibilities - it can be used to treat regional wrinkle lines, thinning of the lips as a result of aging, or elongation of the upper lip area".

The essential idea is to tuck in the lip muscle to form a fuller figure using the patient's own muscle tissue. Some older people have the unfortunate case of the upper lip completely turning under, explains Dr McGuire. The upper lip tuck is especially effective in reforming the upper lip in such a scenario. The lip tuck is most commonly performed on the upper lip, but it also benefits the lower lip in a slightly different way. "As you get older, those miserable vertical lines can appear at around the lower lip, causing even more problems than the upper lip for some people. The surgery can partially or entirely alleviate these lines and simultaneously leave the lower lip looking fuller and more attractive".

The tuck procedure is best done under a local anesthesia with some sedation, and takes about 1 hour for each lip. There is swelling for between one and two weeks, depending on the person and the surgery. The swelling is comparable to that of a bee sting, according to Dr McGuire. "The resultant scar is right at the junction of the red part of the lip with the skin, so this natural line makes it invisible".

Collagen

There is, of course, the alternative of collagen injection. While both doctors Haworth and McGuire were more partial to using the body's natural tissue for enhancement, they said that collagen injection is a valuable and proven method of lip enhancement, particularly for greater volume.

Collagen is actually a naturally occurring part of skin and bone; the collagen used in lip and other enhancements is highly purified and comes from cow's skin. The procedure is simple, quick (under an hour) and relatively painless. There are allergy tests prior to injection, but about 1% - 2% of patients may experience an allergic reaction after injection, involving redness, itchiness, swelling or bruising. These reactions are generally temporary. Collagen is gradually absorbed by the skin (after about 6 months), so repeated treatments are necessary for those wanting to retain the effect.

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