Bad Permalip Result - How to Fix Lip Implant Gone Wrong?

Question

Hello. I had a lip augmentation with Permalip two months ago. The problem is that the implant in my inferior lip seems to be placed further forward in the right side so that the lip seems a little uneven that side when I smile. However, everything is ok if I push the implant a little bit to the left side. Is there anything that I can do? How can I make the implant stay the way I want for ever? Thanks!

Otto Joseph Placik, MD · Answer

The permalip is a smooth implant and you are experiencing a common problem that occurs with any smooth implant. The only way to keep it fixed is to sew it in place or to somehow promote tissue ingrowth via other techniques which are discouraged by the manufacturer. In order to keep this in place, you would likely need an operation to sew closed the area on the right side to keep it over to the left.

Rikesh T. Parikh, MD, FACS · Answer

Hello, AT 2 months the tunnel is most likely healed. The implants are smooth and can slide around in the tunnel a little. The only was I see to permanently adjust it at this stage is to reopen the area and re-tunnel in the desired location. Thanks

James M. Pearson, MD, FACS · Answer

Thank you for your question. Lip Implants maybe a reasonable option for those individuals who are seeking permanent lipenhancement or for those who have not been satisfied with the longevity ofeffect afforded by hyaluronic acid fillers. The Perma Facial Implant is an FDA cleared device for permanent facial augmentation.. What you have described doesnot sound normal. In most cases, the implant is stabilized after a few weeksand does not migrate spontaneously. However, migration of any smooth implant iscertainly possible. Speak with your surgeon about your options. If it ismalpositioned, the implant may need to be repositioned or replaced.

Jennifer Lauren Crawford, MD · Answer

It does sound like the implant pocket is either off or the size implant you have is too short for the length of your lip and the implant is able to shift over for that reason. I have revised a patient who came to me with a similar problem. We placed the next size (length) implant up and the shifting problem stopped. But, I think the best answer certainly comes after an exam from your plastic surgeon who can identify the problem.

Jeffrey Jumaily, MD · Answer

The permalip implant positioning is critical for symmetry. If it's off center it can look asymmetric. If this is the problem it can be corrected with a minor procedure to adjust the position. This is one of the downsides of these implants.

Philip Young, MD · Answer

If it gets better with pushing it to the other side, it is likely that you have the implant more on one side than the other. I guess that is the obvious answer. The solution would be to correct that side by forcing the implant over a little more to make the lips appear better. I have a lot of experience doing this and I can assure you that you can find a solution to this.

Steven Wallach, MD · Answer

Unfortunately, permanent lip implants are not always the best thing. AS you can see they can fall out of the desired pocket.  You may be better off with fillers.

Jeffrey A. Jones, MD (in memoriam) · Answer

It sounds like the tunnel made for the implant is a little off on that side. Your plastic surgeon should be able to open that side of your mouth and retunnel that portion into the proper position. It is probably on the side where the tunneler pushed through, not where it entered. Sometimes the pocket needs to be adjusted a little if the implants are off.

Francis R. Palmer, III, MD (retired) · Answer

I have used various lip implants for lip augmentation for over 20 years.  The fact that you can manipulate and adjust the Permalip implant shows the implant is moving.

Since neither Permalip nor Verafil implants can be sutured in place they can and will move as the lip muscles contract.

You may consider seeing the plastic and cosmetic surgeon that placed the implant to remove it, wait 3-4 months and place another implant or replace with Alloderm.

Bad Permalip Result - How to Fix Lip Implant Gone Wrong?

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