Natural Look Lip Augmentation?

My lips appear to be thinning with age but I don't want to look of fake over plumped up lips.  Tips for natural appearing lip plumping?

Doctor Answers 51

The lips are the only visible sexual organ

The lips are the only visible sexual organ. Their appearance plays an important role in how we feel about ourselves and how others respond to us.

I invented minimally invasive lip augmentation in 1984.

Since that time, we have learned much about the best techniques and the proper points of reference for measurement and adding volume to the lips.

One of the most important things that many physicians do not fully understand is that in order to restore the optimal appearance of full and properly shaped lips, you must also use injectable fillers to restore the structural support of the lower face, which is gradually lost as we age.

When this area is addressed and restored, it pulls the mouth forward. Additionally, you must create a buttress, on top of which the lips sit. This helps restore the lips to their intended position; it is only after this has been done that I add volume to the lips.

Many doctors do not understand this concept, and instead they only inject fillers into the lips to add volume. This creates unnaturally appearing lips, which we have all seen!

It is only through treating the lower third of the face and rebuilding the structural support that has been gradually lost due to aging (not unlike what an architect does to a grand building) that I can create the perfect lip!

Beverly Hills Dermatologic Surgeon
4.8 out of 5 stars 5 reviews

The fear of "fake" looking lip augmentation

The widespread use of lipstick clearly demonstrates the demand for fullness of the lips. Female patients frequently look at celebrities and socialites whose lips are 'over the top' in terms of augmentation, however, and are fearful that they might end up with huge, 'fake' looking lips if they were to undergo injection augmentation.

The truth is that, similar to breast augmentation, patients can choose the degree to which their lips are enlarged. A reputable, experienced facial plastic surgeon will use injectables such as Restylane, Perlane, Juvederm Ultra, or Juvederm Ultra Plus in combination with numbing cream and a dental block, to augment the lips to whatever degree, and in any manner that a patient chooses.

As far as choosing an injectable, I find that Juvederm lasts longer for most patients than Restylane. I also strongly recommend against using Radiesse in the lips, as it definitely has the potential to form firm lumps.

John M. Roesler, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Best options for getting a natural look and feel from lip augmentation

The lips are a very important feature of the face. Whenever we are talking to someone, either consciously or sub-consciously we notice and evaluate their lips. Full lips are a sign of sensuality and youth. There are numerous options today to create soft, natural-appearing lips.

They key point is: NATURAL. Most people do not want others to know they had their lips enhanced. There are several natural proportions that need to be followed so that the upper lips and lower lips look good together.

In general, the upper lip should be 1/3 while the lower lip should be 2/3 of the total size of both lips. A curve and "natural pout" can be created to lift and bring out the border of the lips with the skin, known as the "vermillo-cutaneous" border.

Another important point is that lips must FEEL NATURAL. If material is placed that takes the sensation away or makes the lips lumpy or hard, this can be very traumatic for patients.

Here are some effective, yet natural looking and feeling treatment options:

  • Hyaluronic Acid Gels (a substance we all naturally have in our bodies) - Restylane Perlane, Juvederm - These are great and my preferred in office lip enhancers. If a tiny nerve block is used, along with ice, the discomfort is minimal if at all!
  • Fat Injection - Fat transfer is a very natural and great operative technique. When getting a surgical facial rejuvenation (facelift, eyelid lift etc.), this can easily be done at the same time. Fat can cause swelling for a bit longer than hyaluronic acids. In general, about 50-70% of the fat volume lives and becomes a part of your body.
  • Surgical Lifts - Many times the lips can be lifted directly, either with an incision near the nose, inside the lips, or right on the upper lip border.
  • Alloderm - an engineered skin/soft tissue substite that can be rolled and inserted into the lips. Although, with the above options, the role for this has diminished.

A last point is that aging lips or lack of full lips appear worse when the corners of the mouths form lines and sag, so this area often needs to be corrected also.

Ashkan Ghavami, MD
Beverly Hills Plastic Surgeon
4.1 out of 5 stars 105 reviews

Best products for lip augmentation

I think the best products for lip augmentation are the hyaluronic acid fillers, such as Juvederm, Restylane, and Perlane. They are safe, effective, and have no potential serious complications. Of these, probably Juvederm is the most popular due to its softness. The typical duration of lip augmentation with these fillers is 4-6 months.

Fat injections can also be used in the lips although injected fat does not stay as long in lips as it does in other parts of the face.

Lip implants are also an option for people who want long-term lip augmentation. Gore-Tex lip implants have been used for decades and are proven safe, although hardness can occasionally be a problem. There is a new type of saline-filled lip implant called FulFil, which has great potential for a softer permanent lip implant. One of the advantages of the Fulfil lip implant is that the size can be adjusted at the time of surgery by adding more saline (much like breast implants). The main advantage of lip implants is that they can be removed if necessary.

I think it’s worth mentioning here that use of silicone injections for lips is not recommended due to long-term changes and potential deformities associated with silicone placement into human tissue. Most plastic surgery and dermatology societies consider silicone injections to be unsafe and have recommended against their use by their members. Most insurance companies that insure surgeons do not allow coverage for complications related to silicone injections. Silicone cannot be removed from the lips or other tissue and when there is a deformity from silicone, it must be cut out surgically.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Get a good Specialist

Voluminous lips are more sought after than ever before. Non-surgical cosmetic procedures such as lip filler injections have proved an effective way to provide a more puckered look. Although some lip fillers are permanent or very long lasting, most patients and practitioners prefer temporary Lip enhancement through dermal lip injections which are effective for nearly a year.

Your specialist will assess your case and help you to choose the most suitable type of dermal filler. Prior to injection, local anaesthetic paste is usually applied for approximately 45 minutes and cooling packs are also helpful to minimise discomfort and bruising from the injections. Once the filler has been injected your specialist will massage the injected area briefly to ensure that the filler is spread evenly and this completes the treatment.

You can return to normal activities although you should avoid very strenuous activity for 2 days and avoid pressure, massaging or interference with the treated area for 5 days; this includes sleeping or resting on the treated area so you should try to sleep lying on your back.

Natural Looking Lip Augmentation

I love Restylane or Juvederm for lip plumping. They are hyaluronic acid fillers and they are very malleable, delicate and produce very natrual results if used in moderation. In fact, I always start with re-creating the border of the lip and the Cupid's Bow. It is one of the first noticeable changes in the aging lip. This can often be done with even a small amount of the product. After that, small pillows of product can be placed in the upper and lower lip with care to make sure that the lower lip is slightly larger then the upper. This produces a much more natural look. The pros of using these products is that if you don't like them, we can correct it with a substance called hyaluronidase which dissolves the substance. I beleive that less is more... It lasts approximately 3-4 months although the company reports 6 months. Make sure you do your research and go to someone who is highly experienced with injecting these fillers. Make sure to tell the injector what you want! Ask for a follow up appointment so that any minor touch ups can be made once the swelling subsides (usually swelling lasts a couple of days).

Stacy Chimento, MD
Miami Dermatologic Surgeon
5.0 out of 5 stars 2 reviews

Lip Augmentation is plain and simple

The mistake many patients make (and many physicians too) is choosing to focus ONLY on the lip itself.

Youthful full lips, the ones that people find sexy and appealing, are actually only a part of the package. To get a truly natural lip augmentation you must also consider

  • The philtral column
  • Cupid's bow
  • Lip border
  • Area above the upper lip
  • Corners of the mouth

Another major consideration is the proportions of the face. Overfilled lips look fake and draw negative attention. Balance, projection, proportion of the lower lip to upper lip, how much teeth you show in a smile... The list seems long, but each component must be factored in to get a truly beautiful and natural result.

Rebecca Fitzgerald, MD
Los Angeles Dermatologic Surgeon
4.1 out of 5 stars 21 reviews

5 Elements to Beautiful Lips

Lip Augmentation through facial fillers is technique dependent. In other words, experience counts! At this time, our office only performs lip augmentation with Juvederm hyaluronic acid fillers as they pose minimal risk and provide extraordinary results.

An experienced physician who understands the subtleties of the lip's anatomic subunits should discuss these areas with you.

The five elements of the lips that should be discussed with your physician prior to any lip augmentation are as follows:

  • Cupid's bow
  • Philtral columns (Right and Left)
  • Tubercle
  • Lateral Commissure correction
  • Right and Left High Points

Contact our office for more information regarding these anatomic subunits of the lips. If you have specific questions, we would be happy to address them. Lip augmentation is a wonderful procedure if performed in the right hands. Always choose an experienced physician.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Natural lip augmentation

Most patients seeking lip augmentation today want to achieve more fullness and poutiness, but also to appear natural. This is a much more delicate issue than just pumping filler into the lips.

Facial balance consists of the lips, their maximal natural fullness, and the balance of the tissues around them. The distance from the lip to the nose is important. The balance between the sides of the lips and the central lips is important. The vermillion border and white roll of the lip should be considered. Excessive aubmentation or augmentation with certain fillers (i.e. silicone) blunts this beautiful transition, as though it had been sanded off.

You may not know why, but when you see a patient with "duck lips", no doubt you recognize the lack of harmony in the face. This look is to be avoided. Your doctor should view the face as a whole, and create lip fullness that matches your face, your bone structure, and, most important of all, your natural lips.

Patients with very thin lips who want to look like Angelina Jolie will be disappointed. Their natural lip structure is simply not suited to producing that lip volume without developing a "sausage" apppearance. There is a range within which a patient's natural lips can work. There is actually a maximal amount that can be attained given each patient's lip contours, anatomy and position within the face.

A skilled and artistic surgeon will have a have many tools to offer patients desiring rejuvenation or augmentation of the lips, ranging from simple lip augmentation with hyaluronic acid filler to LiveFill grafts, lip lifts, corner lip lifts, DAO (depressor anguli oris) releases to reduce frowning, augmentation of adjacent areas such as the marionette complex, etc.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 177 reviews

Lip Injections

Lips are one of the easiest areas to treat with fillers. Understanding what makes lips beautiful is helpful in obtaining great results. However, the "ideal lip" as often described in dermatology literature may not be achievable in all patients, so achieving a nice, natural look should be your goal.

For example, ideally the lips should be divided into 1/3 upper and 2/3 lower; that is, the upper lip is slightly smaller than the lower. However, on some faces this may not look natural at all for their facial shape and contour, so be wary of trying to make everyone fit into a single box.

As with any filler injection, combining the artist's eye behind the syringe as well as the patient's eye for what they desire is the key to achieving successful lip augmentation.

Although we are taught that fillers like Restylane and Juvederm last 6-9 months, I find that Restylane actually lasts 1 year to 16 months; new studies will be published to support these findings. Although you never hear this from inexperienced injectors, it is obvious that when injected correclty, this product lasts longer than reported.

Moreover, last week I removed some improperly-placed fillers from a patient's lip (injected by another physician) that was placed 1.5 years ago and still persisted because it was placed too superficially. So be aware that individual results do vary!

  • Please check physician credentials (are they dermatologists/plastic surgeons/ facial plastic surgeons - skin experts and facial experts)
  • Look at photos of real patients injected by your physisican (not the ones the company releases and everyone puts on their websites of the best results the company has ever seen performed by some other injector).

Healthy skepticism and knowledgeable patients will be welcome in any worthy physician's office and will help to ensure successful, great looking filler results!

Shawn Allen, MD
Boulder Dermatologist
5.0 out of 5 stars 1 review

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.