What's your recommendation for Permalip, 5m or 4m? (photo)

I want to get Permalip in December, my PS says 5 m won't fit but I don't think he's right, he is known to be a modest dr. Do I look like I can fit 5m? Also, if I did a mixture of 4 and 5, should the 5m go on top or bottom? I received only half a syringe of restylane 4 months ago, most of it had desolved

Doctor Answers 3

Permalip - what size implant

Thank you for asking about your Permalip implant.
  • You seem to have very full lips to begin with -
  • I suspect your surgeon is concerned about distorting your lips with the larger implant.
  • That said, at least in my experience, the 5 is better for most people because these implants are quite small.
  • They come in different lengths - the correct lenght is important.
  • If the 5 implants are all too long for your lip, that may be the reason for his recommendation.
  • If you have different sized implants, they larger one should go in the lip that you feel needs more volume.
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Permalip size

5 mm is quite large for sure. I have placed both 4 and 5 mm. Usually I prefer to put the large one on the bottom lip. The 5 mm will fit but you may have a very plump lip if you do. 

Henri P. Gaboriau, MD, FACS
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Permalip, 5m or 4m?

 Hi, I have performed many lip augmentation procedures using dermal fillers or lip implants for over 30 years. From the photos, your upper lip is smaller than your lower lip with an approximate 85% volume of the lower.  Following the beauty principles outlined in my book on face and body beauty, the upper lip should be approximately 75 % the size of the lower lip for the lips to appear balanced. 

 The upper lip can be augmented using a dermal filler or a 4 mm Permalip implant while a 5mm can be used in the lower lip.  We typically advise patients to initially use a 3 or 4mm implant and then swap this out for a 5mm in 9 - 12 months once the lips have accommodated the implant.  In your case, the photos appear to show a significantly sized lower lip that might very well tolerate a 5 mm lip implant from the beginning, though the 5mm does have more incidence of side effects which you would need to be aware of and accept.

 Dermal filers and lip implants offer far more reliable volume to augment the lips than permanent fillers or fat injections that are also associated with increased, unwanted, side effects.

Hope this helps.

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

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