Can an implant such as permalip be placed above the upper lip instead of in the lip? (Photo)

Question

I have vertical lip lines though I don't smoke, and I've been getting juvy for 6+ years in my vermillion border, but it's no longer addressing those vertical lines and concave features. My PS says it will look lumpy if he injects juvy in that area. Is an implant my next step, and if so, what's the best option? Many thanks.

Peter Lee, MD, FACS · Answer

It is quite understandable that you are bothered by the "smoker's lines" of your upper lip. However, you don't want the cure to be worse than the disease! A PermaLip implant placed above the vermilion border will not only fail to reduce those lines, it may make them more prominent by pushing them forward.  But that will be the least of your problems when you consider that you will look like you have a small earthworm underneath the skin above the white roll of your lips. And it will look stranger still when your lips move as you are talking.You would be better served by taking a graduated approach to the treatment of those lines.  This would include small, distributed injections of botox, the use of a filler thinner than juvederm, such as belotero, resurfacing with a fraxel or CO2 laser, and, finally, dermabrasion, if these modalities have not delivered an improvement with which you are satisfied.

James M. Pearson, MD, FACS · Answer

Thank you for your question. Lip Implants may be a reasonable option for those individuals who are seeking permanent lip enhancement or for those who have not been satisfied with the longevity of effect afforded by hyaluronic acid fillers.
The Perma Facial Implant is an FDA cleared device for permanent facial augmentation. When used in the lip, they are usually intended to augment (add volume to) the red portion of the lip. They would not likely be a good choice to improve the vertical lip lines that you describe. Injectable fillers or skin resurfacing (dermabrasion or laser resurfacing) may be better options for that concern.

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Hi Katia MThanks for your photo and question. It is always helpful for other people to see common problems on RS so it's great that you feel able to share.The implant for Permalip would not be able to be put above the lip as this would not sit correctly and would unsightly. You could try a couple of options first:A superficial peel, sometimes known as a lunchtime peel involves the use of an Alpha-hydroxy acid or another mild acid is used to penetrate only the outer layer of the sin to gently exfoliate it. At Bella Vou we use superficial peel called Obagi Blue Peel Radiance, that has little or no downtime and can be used on all skin types. It provides an immediate improvement and can demonstrate continued improvement with a series of peels. The treatment is used to improve the appearance of wrinkles around the mouth and eyes, mild discolouration and rough skin as well as to refresh the appearance of the face, neck, chest or hands.PRP is an autologous procedure that involves using the patients own blood to extract plasma and growth factor which is then injected in to the target areas. The PRP stimulates and accelerates skin regeneration and collagen production by the injections of growth factors. PRP injections can also be used in conjunction with dermal fillers if additional volume is required. PRP is selectively and carefully delivered in to specific areas with a series of injections. Before the treatment you should be assessed by an experienced medical professional to see if PRP injections are the right treatment for you. Your specialist will then be able to talk you through he procedure and inform you of what the treatment can achieve.Good Luck

Minas Constantinides, MD · Answer

PermaLip is very specifically designed for the lip. Placed above the lip will remove the normal depression that makes the red lip look pretty. Better to use a thin filler like Restylane Silk combined with a little Botox. If not enough, you may consider more aggressive treatments like a deep peel, CO2 laser resurfacing, or dermabrasion.

Can an implant such as permalip be placed above the upper lip instead of in the lip? (Photo)

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