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

A 4mm Permalip implant is the size I typically use. While a 5mm implant is bit bigger its size in some lips make it harder to place.

I use the 4mm and the 5mm exclusively -- I agree that the 3mm isn't worth the effort.  As you have nice lip volume already, I think the 4mm would be sufficient.  If you change your mind in the future, it is simple to swap them out for a bigger pair.  Good luck!

Hello,I notice you have nice looking lips at present.  This is important to recognize since lip implants or injections don't create "lips from nothing".  It seems somewhat of a cruel joke, but you must have a reasonable amount of pink lip to start with since the implants need to be placed into that pink lip in order to expand it.  It is hard to expand something that doesn't exist.  Secondly, I typically do not recommend 5mm implants.  They are a bit stiffer than the 4mm and have a higher incidence of not sitting evenly and naturally.  I also do not typically recommend 3mm implants since the result is just so subtle as to not be worth the effort.  I do always offer my patients the option to change their lip implant to a different size in the future for just the cost of the implant if they afterwards wish they had gone bigger or smaller.  While the original placement of a lip implant will cause swelling and bruising, changing the size out typically does not.Best Regards,Dr. A