Juvederm is an ideal facial filler for lip augmentation

Juvederm and Restylane are ideal fillers for the lips and soft tissues of the face.  They both pose little harm as they are readily absorbable over relatively short periods of time and have a smaller risk of developing permanent granulomas.

Lip augmentation is a highly gratifying procedure performed in the office.  The ultimate outcome of the lip injection depends on technique and type of filler.  Unlike other fillers such as radiesse, artefill, and silicone, the hyaluronic acid fillers have a higher safety profile for the lips.

Ask your physician to discuss options regarding facial fillers.  Ask as many questions as you can about the risk profile, type of filler, and method of injection.

Juverderm, like Restylane, is a hyaluronic acid. This is a naturally occuring sugar in our bodies, so it is easily accepted by the body and not likely to create a reaction like you can get with man-made synthetic agents like silicone and Artefill.

Juvederm and Restylane work very well for lip enhancement, and while not FDA-approved for this use, I feel they are very safe and effective and I use them daily in my practice.

• Your lips are sensitive and, when injected, can be painful. Many doctors give dental blocks for this, but I use a strong formulation of topical ointment, which is specially formulated for me and works extremely well.
• I don't like dental blocks because they can distort the natural motion of the lips and cause additional swelling, which can make it difficult to see what is from the block and what is from the filler.

Lip augmentation/enhancement involves more than just injecting the lips. You must also add volume and restore the corners of the mouth, below the lip area and often the jaw and chin as well. It is only through this process of restoring the lost support of the lower third of the face that you can restore natural looking lips without causing a distorted over-filled look, which we all have seen walking the streets.

• I also use the application of ice before, during and after lip enhancement, which helps with the discomfort and with post-procedure swelling.
• Also, unless the is a medical reason not to, I ask my patients to discontinue aspirin, ibuprofen and other anti-inflammatory medications at least 5 days prior to the procedure. This helps reduce the chances of bruising.

My biggest tip is to spend time selecting your doctor. Not all doctors are created equal. You need someone who is well trained and a specialist in this area, not your family doctor. Make sure you see examples of his or her work and ask people who have been to them.

Remember, price should not be your main consideration when choosing a good cosmetic surgeon; experience, training and education are all important factors when making this important decision.

Augmentation of the lips should be subtle. A small increase goes a long way and gives a natural, sexy fullness to the lips. Your lips should not arrive in a room before you.

You should discuss what you'd like your lips to look like. Do you want more body in your lips, more definition of the edges of the lips, or both? Your upper lip should be smaller than your lower lip (70% the size of the lower lip). The lower lip should not be filled all the way to the corner (oral commissure) to avoid a "sausage" appearance.

For lip augmentation, I offer my patients dental nerve blocks to numb the lips, which makes the treatment much more pleasant for both of us. In patients who decline a nerve block, numbing gel is applied, and then prior to each injection an ice pack is held on the lip.

Lips should not be overcorrected with Juvederm, as the product attracts more water from under the skin after it is injected. Initially your lips should look more swollen than you would like, just from the trauma of the injections. Patients do comment that their lips feel smoother after Juvederm than with other fillers. Within 12-24 hours they should look how you'd like them to look.

If after one week there is asymmetry, then return to your doctor. If they are too big, then Widase can be injected to help dissolve some of the product. If they are uneven, a little more may be added.

Lastly, I just read Dr. Arnold Klein's (Dr. Klein is THE expert in injectables) comments here on RealSelf.com, which are very informative.

Good luck.
Dr. P

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