Options For Permanent Lip Augmentation? Are There Any New Methods On The Horizon? (photo)

Since July I get Juv in my vermillion border (cupid's bow) & bottom lip for little bow lips with tooth show. Injections every 2 months cuz it goes so quickly and always 4 days of bad swelling. I was told there'd be build up so it would last longer but... I'm now considering permanent natural looking solutions. Suggestions? Implants? Fat injections? Downtime? Cost? Naturalness? Something new and improved on the horizon? Love Keira Knightley's lip aug. Any guesses what she had done? Thanks

Doctor Answers 14

Best Lip Augmentation

As you can see from the varied answers among experienced responders, there are many ways, but no agreed upon "best" way for long lasting lip augmentation.  Lip shape as well as size are important elements of aesthetics.  Shape is surgically manipulated, volume increased with filler(s) and/or implants.  My favorite long lasting lip augmentation is with Aquamid: 97.5% water and 2.5% polyacrylamide hydrogel.  It feels even more natural than HA fillers, and LASTS.  Can be custom injected for both volumization and shape.  Aquamid is from Denmark, and not FDA approved so I'm unable to use it here in the US but have experience using it in Europe, and it is available in Europe and South America.  Believe it will blow away the US market when finally FDA approved.

My experience with Alloderm and dermal fat grafts is they resorb after a while.  Silicone Oil and Artecoll/Artefill may do well for a while but can get lumpy, and I've seen VERY dissatisfied patients with significant problems after both of these fillers.  Because Aquamid is not approved now, my most common long lasting lip augmentation choice is PermaLip by Surgisil.  It's quick, painless, and easily removed or repositioned if there is a problem.  Definitely stays, and is NOT resorbed.

San Diego Plastic Surgeon
5.0 out of 5 stars 46 reviews

Long Lasting Lip Augmentation

For longer lasting enhancement, there are two options: fat transfer or an AlloDerm graft.
The fat transfer process uses fat taken from another region of the patient's bodyuses the patient's own fat from another area of the body and it is re-injected evenly into the lips for a natural, complication free enhancement. There are no allergic reactions involved. An AlloDerm graft is like a lattice structure that lets vines grow in your garden. It is a piece of skin that has been stripped of its living cells; all that is left is a soft, collagen structure. The collagen structure is inserted into the lip where it allows the patient's own cells to attach and grow, which provides the enhancement. The graft is placed easily through small, inconspicuous incisions in the corners of the mouth. The result is a very natural look and feel for long term enhancement. 

Daniel Shapiro, MD
Scottsdale Plastic Surgeon
4.8 out of 5 stars 107 reviews

Permanent Lip Enhancement

I agree that hyaluronic acid fillers are truly ideal.  No down time, should last months to years.  I am surprised you are only seeing improvement for 2 months.  The plane of injection is really important here.  I also have 10 years experience with solid lip implants and would encourage you to consider a soft implant.  Take a look at Permafacial Implants as one option.  These really are simple to insert, are well tolerated and add fullness in a gentle way.  They can be removed if necessary with no long term problems which is a nice safety net.

My first recommendation would be to try to get another injector and be certain that they are very comfortable injecting your hyaluronic acid product for a long term result.

Thanks for such a timely question.

Dr. Hobgood

Todd Christopher Hobgood, MD
Phoenix Facial Plastic Surgeon
4.9 out of 5 stars 52 reviews

Lip lift

for the past 20  years i have been performing lip lifts with dramatic results. i will see the patient at 10 and 15 year follow up visits, and the results hold up well  

several yaers ago i have added fat injections.  these are more variable in the results , but can work well in the right circumstances

based on the patients goals and physical exam i may perform one or both procedures.  the results are natural in appearence, and do not need repeated visits for filler.  these repeated visits over time can pay for a surgery

David V. Martini, MD
Elkton Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Permanent lip augmentation

I would recommend fat injection.  It can last many, many years and is a safe filler. 

I would run the other way from anything other than Hyaluronic Acid fillers (Juvederm, Restylane, Prevelle, etc) or fat.   Other implants often harden over time (Softform Implants, Alloderm) and I would never, ever let anyone inject silicone into my lips.  A late reaction to silicone can be an absolute disaster. Doctors who are doing silicone injections don't know what they don't know. 

And don't expect your lips to look like anyone elses.  They will look like yours, only fuller.  And don't overdue it.  Remember, it's all about harmony.  Big, pouty lips look ridiculous on many facial types. 

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 72 reviews

Permanent Lip Augmentation

It is very unusual for Juvederm injections to last only 2 months. Over the years I have used various  implants which are permanent but my first choice is to use the patient's own fat which is naturally soft and be injected to fit the contours of each patient. In young people frequently the goal is to increase the lip pout, while in older individuals we want to increase lip volume and treat the vertical skin creases which occur secondary to the aging process.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Lip implants do great for that permanent, natural look.

Many patients switch over to the permanent implants when they get tired of those temporary fillers. There are 3 main types of permanent implants and they are easy to put in and easy to remove for roughly $1500-2000 per implant and done under local anesthesia in about 20 minutes.  Sincerely,

David Hansen,MD

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 42 reviews

Liquid Injectable Silicone (Silikon-1000) Excellent Permanent Filler for Lip Augmentation


In my practice, I use Silikon-1000 (which is an off-label use of Silikon-1000) for permanent lip augmentation. I prefer it to any other filler as it is very precise and yields very natural-appearing results.  Being permanent, it is important that it be injected conservatively and over several treatments to reach desired outcome. Even in very mild lip augmentation cases, I spread it out over two to three treatments.  When done correctly by a well-trained, board-certified dermatologist or facial plastic surgeon experienced in injecting silicone with the micro-droplet injection technique, lip augmentation with Silikon-1000 results in natural-looking, aesthetically-pleasing, enhanced lips. Patients in my practice are highly satisfied.  Click on the link below for before and after photos of lips augmented with Silikon-1000. 

Channing R. Barnett, MD
New York Dermatologist
4.1 out of 5 stars 8 reviews

Options For Permanent Lip Augmentation? Are There Any New Methods On The Horizon?

  I have performed Lip Augmentation for over 22 years and IMHO, the gold standard remains Alloderm Lip Implants.  Alloderm Lip Implants create full, soft lips.  There is however, no inherent magic in Alloderm or any filler used for lip augmentation but rather the magic must reside in the MD's ability to understand and follow the proper aesthetics of facial (and lip) beauty for the creation of soft, naturally beautiful lips.  For instance, in your example, the upper lip is too large compared to the lower lip and even though the lips are full they are not as esthetically attractive as they would be if the proper aesthetic proportion was created.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Silikon-1000 may be used by experienced physicians for permanent, natural-looking Lip Augmentation.

I read your concern and reviewed your photos:

In my practice, I prefer to use Silikon-1000, an off-label filler for permanent lip augmentation. You would likely require several treatments to obtain your desired result.

If you decide you want permanent lip augmentation, you should consult a dermatologist or facial plastic surgeon experienced in the serial puncture, microdroplet technique for administering liquid injectable silicone. When performed properly, Silikon-1000 may result in smooth, natural-looking, larger lips. In my practice, patient satisfaction is very high, and problems like bumps are infrequent (<1%)

I've attached a link to an interview I did for RealSelf about silicone lip injections.

Hope this helps.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 418 reviews

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.