Boston Cosmetic
Boston Cosmetic

















Boston Cosmetic


What is lip augmentation?

Lip Augmentation gives you fuller lips and can be done to the upper or lower lips.  If both the upper lip and bottom lip are thin, most patients choose to shutterstock_139884175do both lips. Lip Augmentation is very popular because it produces immediate results, which can be subtle or dramatic, according to the needs of the patient. Lip augmentation can be performed in a very short amount of time, while under local anesthesia or sedation. Most patients have the procedure done under local anesthesia in the office.

The lip can be augmented with the patient’s own tissues (Fat Transfer or fat injections), biologic tissue fillers (Juvederm), or soft synthetic implants (Advanta).

Who can benefit from lip augmentation?

The lips are an important feature of your facial appearance.  If you desire fuller lips, most patients are a candidate for this procedure.  However, there are exceptions.  Some patients have a long upper lip and a Lip Augmentation will not help make them look more attractive.  When patients have a long upper lip, the use of fillers in the lip can create a ‘duck lip’ look.  This is because the upper lip touches the bottom lip at rest and the fuller lips have nowhere to go but outwards like duck lips!

If a patient has a long upper lip, she might want to consider a Lip Lift to reduce the long space above the top lip and make the mouth look more youthful.   Often times, the Lip Lift has such a great result, that patients do not even need the Lip Augmentation afterwards.  However, both procedures can be done if desired.

For the lips, when are Fat Injections (fat transfer) preferable to fillers?

Fat Transfer is used when the patient wants to use their own tissue, instead of a synthetic filler. To perform this procedure, we get fat from the stomach area (using liposuction), process it, and then inject it into the lip which gives a very soft look.  However, all of the fat injected into the lips will not  stay.  After fat injection to the lips, you still need to eat  and talk, and therefore your mouth will still have a lot of activity post operatively.  For this reason, not all of the fat will ‘take’ because the fat grafts will be disrupted by normal mouth movement during the post op period. However, a significant percentage (more than half) of the fat is retained permanently.  Because of this, we ‘over inject’ knowing that in three to four weeks the final result will be closer to what the patient wants.

Even though I am a huge fan of Fat Transfer procedures, it is not my first choice for Lip Augmentation. Since the fat graft does not survive as well in the lips as it does in other areas of the body,  I actually prefer synthetic fillers  like Juvederm in the lip. Alternatively, there is the Lip Lift procedure for patients with a long upper lip.

What are the types of fillers used for lip augmentation?

Biologic tissue fillers such as Restylane, Juvederm, and  Alloderm are absorbable. Restylane is distributed by Medicis Aesthetics (now known as Medicis-Inamed) and is made from a component of naturally occurring joint fluid. Juvederm is make by Allergan, the same company who manufactures silicone breast implants.  Dr. Ishoo prefers Juvederm to Restylane because it lasts a little longer.  Alloderm is a skin derivative . Restylane last several months , Juvederm lasts up to a year, and alloderm lasts one to two years. We do not favor collagen as it is absorbed relatively quickly and some patients have developed reactions to it.

Implants such as Advanta are permanent. However, some patients don’t choose them because they don’t like the fact that they will ‘feel’ the implant. But generally speaking, the Advanta implant has had a high patient satisfaction rate because it is very soft.

What’s involved in the lip augmentation procedure?

LiquidFaceLiftMost patients have Lip Augmentation as a local procedure in the office. This is comparable to the experience one has with a dental procedure. No pre-op testing is required if the procedure is performed with local anesthesia.

Juvederm and Restylane are prepackaged in a syringe and injected directly into the lips.  To help with discomfort, a numbing creme or a nerve block can be performed so that you do not feel anything. The entire injection procedure usually takes 20-30 minutes.

With Gor-tex, Advanta, and alloderm, a tiny incision is made into the corner of the lip, and the implant is then threaded into position. It can be done under a local anesthetic or IV anesthesia.  If the procedure is performed with this material , it takes up to one hour in total.

Fat Injections require a little more surgical time , as liposuction is first performed to remove a small amount of fat. This fat is then decanted and centrifuged, and then reinjected into the lips.