Which filler is the least painful and longest lasting for lips?
What Alternatives to Restylane Do You Recommend for Lips?
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Alternatives to Restylane for Lips
Juvederm XC works extremely well in the lips as well. Radiesse and Sculptra are two products to generally avoid in the lips.
Juvederm Ultra for lip enhancement
I tend to use a lot of Juvederm Ultra XC for injectable lip enhancement. It is pre-mixed with Lidocaine to make it more comfortable and tends to last around 6-9 months in my patients. Injecting Juvederm Ultra XC in the lips through a micro-cannula also helps to reduce bruising and swelling. It also hides the injection sites completely.
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Restylane - What Alternatives to Restylane Do You Recommend for Lips?
Of all the areas that undergo injection of fillers there's no question that this area - the lips - can hurt the most. Although both recommended fillers (Restylane and Juvederm) now come with lidocaine mixed in, which definitely makes it less uncomfortable, I have a certain group of patients who prefer a nerve block to diminish the discomfort of the injections. It's a matter of preference; it's generally up to the patient although as a physician-injector I cannot, of course, do the careful job I'd like to do if the patient is squirming.
So while I don't use nerve blocks for any facial areas aside from the lips - because it's not necessary - this is one area where I still offer it as an option.
And as far as options: Restylane or Juvederm. Those are the only products I would be comfortable (at this time) injecting into the lips.
I hope that this helps, and good luck,
Long lasting filler for fuller lips...
Juvederm Ultra XC is a great filler to use for the lips. In general it lasts for about 6-9 months. Now that the manufacturer has added lidocaine to the filler, the procedure is very easy and results in only little discomfort. Another alternative that gives permanent results would be the use of medical grade silicone. A microinjection technique is used to avoid bumps and the silicone is built up over a series of injections to create a permanent result. Be sure to seek out a practitioner who is highly experienced in injection techniques before having the procedure done.
I prefer Juvederm Ultra Plus XC. It is FDA approved to last up to 12 months, however, I always like to tell my patients it will last 6 to 9 months in the lips. Then, if it does last longer... you, as a patient, are happy. To help with the discomfort of the injections, I recommend my patients to come in half an hour to one hour prior to their actual treatment time for topical numbing to be put on them. This helps significantly. I also give a big bag of crushed ice to help in between injections. If with all of this the patient is still uncomfortable, I will then offer a dental block. -I rarely have to go to this measure for patient satisfaction.
Hope this helps.
Dr. Grant Stevens
Juvederm is the best for the lips, if you do not want restylane. The technique and skill of the physician will help reduce the pain.
What Alternatives to Restylane Do You Recommend for Lips?
Both available lip fillers, Restylane and Juvederm last about the same at 4-6 months. the other thicker fillers like Perlane, radiesse and the permanent one (Artefil) are more likely to create problems IMHO as these are meant to be injected into fat tissue which the lips have none. If you want longer lasting lip augmentation that these temporary fillers can offer, you might want to consider lip implants of which I believe Alloderm is the most superior in the feel, look and aesthetic results.
The best, least painful treatments for lips
Juvederm or Restylane are still the best options for correcting an aging lip. There are many tricks to minimizing the discomfort of the injections. Usually "fear of the unknown" is the worst part. The more tense you are, the more you feel. The following are my suggestions to minimize discomfort:
1. Restylane and Juvederm come pre-mixed with lidocaine, which helps.
2. I use a "dental block" which really works well to minimize discomfort.
3. "Talk-Aesthesia" to relax the patient.
4. A squeeze ball as a last resort because it will be counter-productive to tense up any part of your body.
The best and most natural lip enlargement is living tissue (dermal fat graft)!
Temporary fillers have been discussed in other answers; I will add my vote for Juvederm Ultra Plus or Perlane if you want temporary. But if you truly like enlarged lips, and want soft, natural, and permanent, choose dermal fat grafting with your own tissue.
I utilize a de-epithelialized 4-6mm strip of dermis (a few tiny attached fat globules are OK) obtained by re-excising an existing scar (about 3 inches long) and then reclosing the donor site. This can be an old C-section, tummy tuck, breast lift, or facelift scar (or a new one done at the same time); in a few cases where no scar exists but the patient still requests this procedure, I utilize a new scar just above the pubic hair. This is done under local anesthesia (unless part of a new facelift, tummy tuck, etc.).
This is not the same as fat graft injections, which CAN survive, but can also become irregular or lumpy if some of the grafted fat dies. The true advantage of a dermal fat graft is that it is a strong living strip of tissue that is easily placed (with a special introducer I have made from an old blunt-tip 4mm cobra liposuction cannula) within the living recipient tissues under local anesthesia, allowing it to heal uniformly and with natural softness, nerve regrowth, and sensation. Once healed, the procedure can be repeated for even more fullness. (You cannot simply use a larger graft or it will not survive, so this type of lip enlargement is subtle, and by requirement for proper graft survival, not Lisa Rinna "over-the top!"
Acellular dermal matrices do not survive long term, are costly, and are not recommended. Goretex threads, foam tubes, and other materials can feel firm, get infected (requiring removal), and are often not worth the cost or trouble. Radiesse is not recommended for the lips because of its firmness and lumpiness, and it can be seen (white) if too close to the surface.
Temporary: Juvederm, Juvederm Ultra Plus, Restylane, or Perlane.
Permanent: Dermal fat graft!
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.