I Was Given the Wrong Size Permalip Implant, Now What? (photo)

Question

I wanted fuller lips with a larger cupids bow, so I decided on permalip implants. I asked for the largest size, but was given the medium size. The surgeon said according to his notes, I had asked for the size I have but he didnt show me the notes when I asked. He said he would swap them though, but not give me my money back. But he said I would have to wait a couple months first, because they could look different if I wait and they need to "settle". Is this true and is he being reasonable?

Jeff Angobaldo, MD · Answer

Sorry to hear ypur situation.  Honestly, I only use the medium size implant on all patients. The larger implant has more complications. Discuss your concerns with your Plastic surgeon

J. Timothy Katzen, MD, FACS · Answer

Hi Cape Cod, Thank you for your question about what to do with your Permalip lip implants.  Basically, I would wait for two months after the Permalip lip implants were inserted. Then, I would reassess your upper and lower lips. If your lips are still not to your satisfaction, I would request your plastic surgeon insert the largest (5 mm) Permalip lip implants.  Every plastic surgeon is different. Some plastic surgeons will require full payment. Some plastic surgeons will require partial payment. Some plastic surgeons will we have the surgical fee. Prior to the original Permalip lip implant insertion during the consent for surgery, these situations and scenarios are usually discussed with your plastic surgeon.  Good luck! I hope that i have answered your question about what to do with yourPermalip lip implants.  If you have any further questions regarding Permalip lip implants, please contact my office. Sincerely, Dr. Katzen.

David Hansen, MD · Answer

If you feel you still want fuller lips, then you can add another implant to your lips without removing the original implant.  They are stackable except the saline filled ones such as fullfill/verafill. I would wait 2 months minimum before adding or replacing the implants so the swelling in the lips settles enough to be able to fine tune the results the best.  Unfortunately, there are no quarentees in medicine. If you want a larger lip, then there is a charge for the 2nd implant whether switched out or just added and there never is a refund. We as surgeons make the determination as to what is considered the largest size for each patient individually that we are willing to put in that patient without making them look silly .  It will vary from patient to patient since everyone's lips are so different.  Sincerely,

	David Hansen,MD

Lawrence Kass, MD · Answer

Personally, I wouldn't recommend it. Yes, you could have this implant removed and a slightly larger one placed. But it is not THAT much larger that you would notice a significant difference AND the results of surgery are sometimes not entirely predictable. If you want further augmentation, I would recommend injectables including considering the benefits of Silikon 1000, a truly fabulous permanent filler, particularly in the lips.

Mehdi Sina, MD · Answer

Hi,
Permalip implants come in 3 sizes, 3 mm, 4 mm and 5 mm. The 4 mm implant is the most frequently used implant and gives a very nice and natural result to patients with thin lips. Patients that have decent lip volume but want big, full lips are better candidates for the bigger 5 mm implants. It is reasonable to wait a few weeks before exchanging the implants because you want all the swelling to be completely gone prior to exchanging them. The down side is that as you heal, there will be some scarring that will make precise placement of the bigger implant a little more challenging (and slightly increase risk of infection). It is important to maintain a positive outlook and trust with your surgeon and give him/her an opportunity to give you exactly what you are looking for. 
Best of luck,
Mehdi Sina, MD

Jeffrey Jumaily, MD · Answer

It depends on what you don’t like about it. If you feel it’s not the optimal size, then it can be changed to another size implant. If you feel that you don’t like the feel or general shape of the implant then removal may be the best option. You have to let the swelling resolve before you make the decision as swelling can obscure the true result.

Edward E. Dickerson, IV, MD · Answer

It is true with most any kind of implant that you should give the product time to settle, whether it's lip implants, breast implants, or whatever the case may be.  Usually it takes several weeks for the implant to come to it's final resting spot and for your body to adjust to this foreign object that has been placed inside it.  Once that settling has occurred, you may like the result, and not need further adjustments.  However, if you do need a revision, it is common for the surgeon to replace your implants at no extra cost to you.  However, very unlikely for you to retain a refund for the previous procedure due to the fact that it has already been performed.

Todd C. Case, MD · Answer

Once the swelling resolves over a few months post procedure, you can have the implants changed to a larger size, if you wish.  You can also use injectable fillers further augment the lips in addition to the implants, but this would not be a permanent  solution, but may help confirm your desire to be bigger, or not.

Philip Young, MD · Answer

Sometimes being conservative is a prudent approach. If have the medium size and want bigger, it is not very difficult to change them. The risks are low as well. But I would wait at least 2 months. You could change them earlier after most of the swelling, redness and tenderness has subsided

Robert E. Zaworski, MD (retired) · Answer

Unfortunately the 3 sizes made by Permalip can be ordered with different lengths for different lip lengths, but the small size is to small to make much, if any, difference in the volume of the lip(s). Most women go with the large size and many wish that the company would make larger sizes. I would not recommend putting two implants in a lip as they can roll over each other during lip movement, i.e. kissing. I think that Permalip implants are a great idea and I do not plan on using fillers or fat for lip augmentation ever again. Waiting a month or two for post operative swelling to go down is reasonable. Remember also that 'Cupid's Bow' is the graceful line of your upper lip and that putting a 'filler' in you lip is not going to change the basic shape of this line. Breast implants are only fillers and do not change the basic shape of your breast, that is done by a mastopexy. There are other surgical methods to create a 'Cupid's Bow".

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