What's the best lip augmentation treatment?

I have been fortunate to use Prevelle Silk hyaluronic acid filler with lidocaine on a few of my patients. It is the first FDA approved hyaluronic acid filler available in the United States. The word "silk" aptly describes the product as it flows and fills very smoothly.

It is too early for me to judge how long it will last, but if it lasts as long or longer than Restylane and Juvederm, this "new kid on the block" will rapidly become the most popular hyaluronic acid filler.

Patients have been very pleased with the comfort of injection, and I appreciate not having to use dental blocks to fill the lips.

Juvederm or Restylane

I prefer the hyaluronic acid fillers like Restylane or Juvederm Ultra for lip enhancement. I think they provide a soft, aesthetically pleasing lip augmentation.

Although this is an off-label use of these products, it is becoming more and more common. The benefit is that the HA fillers fade away with time, and do not cause as much tissue distortion of the lips as some of the permanent lip implants like Gore-Tex or silicone do.

The longest lasting filler is silicone; however, that is something I would never use.

The thing about the human face is that it changes over time, and the structure of your face five years ago is different than it is today and it's different than it will be in five years. So, you really don't want anything that is permanent injected as a filler because it might look good now, but it will look almost crazy five to ten years from now. Ideally, you would want an agent that can last approximately two years.

I stay away from the filling agents that have calcium particles because I have seen too many cases where patients will develop granulomas (festering, draining, pustular nodules) several years after these treatments as a distant reaction to the treatment. I have treated so many of these, I no longer use these types of agents.

There seems to be a big debate right now whether Juvederm lasts longer or Restylane/Perlane lasts longer as filling agents made from hyaluronic acid. In my clinical experience, the two are very, very similar, the two work very, very well, and I can't tell the difference in duration of these--I really can't. I think the differences might be subtle and the biggest is more marketing than what I actually see in my clinic. I use both with excellent results. When I am treating lips, the treatment of choice is a hyaluronic acid filler.