Many patients want to enhance their lip volume. Maybe patients were born with thinner lips; others have noticed that over the years the lip volume has decreased and the corners of the lips have turned down, appearing to deflate. The most common goal is to create a beautiful, natural, full lip appearance.
Fortunately, there are now many ways to augment lips.
The most common method of lip augmentation is temporary augmentation with a hyaluronic acid (HA) product such as Juvederm or Restylane (or Prevelle, a new filler with lidocaine in it). This is an immediate, effective, non-surgical way of enhancing lip volume. Often, patients will want HA filler around other areas around the mouth as well, to achieve a more harmonious look.
In our practice we avoid Radiesse, silicone, Artecoll, etc. and other semipermanent and permanent fillers because of the long term risk of chronic lumpiness, chronic inflammation or migration of the filler.
In the past, many synthetic lip implants have been performed. Gortex, SAM, various threads etc. were threaded in the lips. Over the years, this technique has faded because of the patients complaining of feeling the unnatural implants. Some materials produced a great amount of scarring and constriction of the lips (i.e. Alloderm, cadaver material). Recently, actual lip implants were created to place into the lips. In our practice, we have removed numerous permanent implants and replaced them with LiveFill grafts, nontraumatized fascial-fat grafts from the patient's own tissues. Patients are now on our surgical schedule to have their lip implants removed and replaced with their own, softer, tissues.
Fat augmentation is a popular technique, athough many patients complain of initial swelling and slow loss of the graft material over time. This is due to the fact that fat grafts, once they are aspirated and then injected into tissues, lose many of the living cells and therefore consist primarily of dead cells and free fatty acids.
The most popular method in our practice for lip augmentation is the LiveFill lip augmentation graft (LALA). This involves grafts taken from the patient's own tissues and placed precisely in a non-traumatized fashion into the lips. Because of the high survival rate of the grafts (no miracle, you are just starting with live tissue), we do not overcorrect. In long-term studies with CT scans looking at the volume, graft retention is 75%. Therefore with the LiveFill technique the surgeon does not overcorrect, so patient's do not go through the initial "duck lip" phase.
Costs for lip augmentation vary from around $500 for temporary fillers to $6000 for LiveFill lip augmentation grafts, with fat injection somewhere in the middle.