When considering lip augmentation, one must consider the degree of augmentation desired and the supple, intricately mobile character of the lips. The procedure chosen is then based on the integration of size and mobility.
Multiple choices are available and with this, the degree of augmentation can vary as well as the recovery time and risk of complications. On occasion, it is nice to consider temporary augmentation through the use of an injectable material, such as collagen, to determine if a change in the size and shape of the lips is truly desired. All forms of injectable augmentation are temporary including bovine collagen, human derived collagen, and fat injections.
Once it has been determined that permanent augmentation is desired, there are five procedures, which provide the most natural, reliable, and permanent forms of augmentation with the fewest complications. There is one procedure, which I discourage and make every effort to direct patients away from. This procedure is the augmentation of the lips with alloplastic, synthetic, materials. Although these materials hold promise to this point, they almost universally lead to distortion with animation of the lip.
When subtle augmentation is desired with the fastest recovery and fewest possible complications I recommend lip advancement. This procedure takes advantage of the adjacent tissue of the lip to enhance the visible pink portion. Multiple incisions are made inside the lip and mucosa is advanced outward. In patients with a broad smile, this procedure can lead to a degree of augmentation approaching twice the size of the pre-existing lip. The amount of pain is minimal and the sutures that are used to repair the incision dissolve so their removal is not necessary.
When a more dramatic augmentation is desired or if the smile is narrow, lip augmentation with tissue from another area of the body is the procedure of choice. This tissue can be taken from the lower abdomen, which is ideal in women that have had Cesarean sections or other abdominal surgery, the gluteal crease (the fold beneath the buttocks), or from the temple through an incision within the hair. This form of augmentation can create a more dramatic result but does require an additional surgical site. This tissue is placed in the lip through small incisions in the central portion of the upper and lower lip. When a facelift is being performed the tissue can be harvested in conjunction with the facelift foregoing the need for an additional surgical site.
If the distance from the base of the nose to the pink part of the lip, the height of the white portion of the lip, is excessive then a lip role is considered. This procedure requires the placement of a well camouflaged incision at the junction of the white and pink portion of the lip. Some of the skin of the white portion of the lip is then excised and the pink portion rotated superiorly. Meticulous closure of the incision and the use of the CO2 laser is done to diminish the visibility of the incision. When performed well, this procedure produces a very narrow, nearly invisible scar, which is noticeable only to the patient and surgeon when looked for.
As you can imagine, it is difficult to determine which procedure would be best for you without a thorough evaluation and discussion with Dr. Farrior.
After any of these procedures, there may be some bruising which would make it evident that surgery had been performed. Patients are discouraged from returning to work prior to 7 to 14 days after surgery and this may depend on the procedure chosen. The pain is minimal but the swelling can be significant. If work does not involve the daily interaction with other people, one can return to desk work, phone calls and non-personal contact activities as early as the day of surgery.
Complications and side effects associated with this procedure include; numbness, tightness, irregularity, asymmetry, and as with all surgical procedures, the risk of bleeding and infection. The augmentation obtained will be most dramatic for the first three months and as the wound heals will diminish somewhat. The sensation of tightness is present with all these procedures but resolves with time, usually occurring by six weeks after surgery, but on occasion the sensation of tightness may persist.
To intimate relations, the lip may feel hard or rigid for 6 to 12 weeks after surgery. The return to normal function occurs earliest with lip advancement and latest with lip augmentation. Completely normal texture and function of the lip will never occur if synthetic materials are used.