Should I get a Permalip 4mm or 5mm? (photos)

Thank you for your question.  You should discuss this is detail with your surgeon.  I would suggest a 4mm is similar to having 1 ml of lip filler and 5mm is similar to 1.5 ml.  This is dependant on how big you wanted your lip.  The younger patients I normally have will have 5 mm as they like the bigger appearance.  The 5mm still gives a natural result.  All The Best 

Permalip implants are great way to get permanent lip volume.  Permalip, however, are meant to be mild to moderate improvements and are generally understated.I usually recommend the 4mm implants for women who want some more lipstick show and just want to be age appropriate.  For patients in their 20-30's, usually they are looking for some plumpness so the 5mm provides some of that.  Again, the augmentation is milder than that of implants of the past and meant to look more natural. 

Dear MICV123,I perform a lot of lip injections with fillers such as juvederm and it works great. Many times I need to put more in one side than the other to attempt to even out the vermillion border (The red line of the lip). This helps provide more symmetry at times.
Another Option: For patients looking for a more long lasting result, I recommend fat grafting. That is, using your own bodies fat to make your lips naturally look more shapely. The bonus is that the results last many many years.
In general, I avoid using permanent prosthesis because I find that the lips are such dynamic and sensitive structures, the end result is not natural.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery