Lip Filler Vs. Permanent Lip Lift for an Uneven Upper Lip

Lip fillers such as juvederm/restylane are great to see what kind of results you want and since they go away in a few months, then you can get the permanent lip implants to correct the problems long term.  Restylane/juvederm cost $550/syringe and lip implants run $1500-2000/implant which can be done all under local anesthesia in a matter of 20 minutes easily.  Sincerely,

David Hansen,MD 

I am strongly against permanent fillers in the lip for multiple reasons.  Permanent fillers can create problems later if the body rejects them and there’s very little that can be done.  You may end up with significant scarring.  Also, if you don’t like the result it is not reversible.  But, the main reason I don’t like them is that your body is not static, it’s always changing.  Permanent fillers don’t change, so as you get older, you could end up with a lip that is not appropriate to your face and is very difficult to correct.  Hyaluronic acid fillers in the lip work very nicely and can be tailored as your face ages. 

Hello and thank you for the question.

In review of your photographs, there is clear lip asymmetry and notably upper vermillion asymmetry.  You need a formal evaluation to determine whether lip surgery versus lip enhancement (very modestly to improve symmetry) will provide you with the best results.  Injectable fillers, such as Juvederm, may provide some "permanence" in results if the correction is done in modest amounts and repeated in a moderate time course. The lips will experience neocollagenesis and this in itself may provide you with a result that is acceptable enough without having to undergo an invasive procedure.  

I recommend highly you consult with a Board Certified Plastic Surgeon or Facial Plastic Surgeon who has experience in lip enhancement and lip surgery.

Kindest Regards,

Glenn Vallecillos, M.D., F.A.C.S. 

A good exam in person I think is key. It also comes down to what exactly bothers you. Do you not like the uneven vermilion border or th elack of fullness of one side. Bear in mind, some asymmetry will be present even after surgery.

When it comes to lip asymmetry, the concept of fillers or augmentation methods do not produce as satisfactory a result as a direct lip lift. The asymmetry is the result of differences in the vertical height or exposure of the upper lip vermilion between the two sides of the lip. More vermilion show can be achieved by a simple vermilion advancement or even an internal v-y mucosal advancement. They can be easily done under local anesthesia. Injectable fillers should only be used as a trial method to demonstrate that they can or can not produce the desired result and as a test that a small surgical procedure is ultimately justified. 

It is true lip fillers do not last long . You should consult with a plastic surgeon to see your alternatives - one might be to try to see how the lip filler looks first knowing that it wont last more than 6 months but might give you an idea of how it may look with correction.

Both fillers to the upper lip border and lip implants (I prefer Alloderm which I have usde for over 15 years) to increase the upper lip volume could be done.