What Permanent Lip Augmentation Options Are Available?

Doctor Answers 23

Permanent lip augmentation is a common option with a facelift

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The best way to naturally augment lips permanently is to graft tissue into the lips.  When a facelift is performed, a fibrofatty patch of tissue is a byproduct of the operation.  This is easily inserted into the lips through small poke holes in the inside of the corner of the mouth.  The lips are permanently augmented and look and feel very natural.

Permanent Options for Lip Augmentation

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You can choose either a lip implant OR a surgical lip augmentation.

If you choose a "permanent" implant, there are numerous substances that I commonly use as a graft or implant material in the lips. Each option has its own advantages and disadvantages.

  • AlloDerm is a popular human-donor grafting material that is FDA approved and proven safe in lip augmentation and facial reconstruction. Under a local anesthesia, the material is inserted through tiny incisions made in the inside corners of the mouth. Delicate absorbable stitches that dissolve are used. The material is often absorbed, so that the results are only temporary, lasting from 12-18 months. This procedure takes about 15 minutes in the office under local anesthesia.
  • Advanta and Gore-Tex have been shown to produce reliable and predictable results with few complications. These materials do not shrink and are never absorbed into the body making the procedure permanent. It also remains in place because scar tissue forms on both ends holding it in place. To insert Advanta and Gore-Tex, a small incision is made in the inside of the lip. The material is then made into the shape of a small tube and it is inserted with a needle.
  • Fat grafting produces lasting results in most of the people who try it. Although it is possible that the body will reabsorb it, many people choose fat grafting because they are most comfortable with using the fat from their own body to enhance their lips. The fat is harvested from another area of the body, often the abdomen. It is then prepared and inserted with a needle into the lip from more than one point.
  • SurgiSil is new to the market but promises a safe, definitive solution for permanent tissue augmentation.Surgisil is a patented, FDA approved device designed for tissue augmentation of the lips and has undergone extensive clinical testing to ensure its safety and efficacy. It is made of a soft, solid silicone elastomer using an injection molding process to produce a naturally contoured implant with a smooth, non-porous surface. The implant cannot rupture or deflate, and may be removed at any time. I have see great results with this product.

If you opt for Lip Augmentation through a Surgical Solution, you will certainly have a permanent result.

  • Surgical enhancement of the lips provides a permanent alternative to injections and implants.
  • Surgical enhancement usually takes less than one hour to perform in office under local anesthesia.
  • Careful and fine incisions are created to shape the lips into their desired shape and form.
  • Direct Lip Lifting creates a fuller upper and/or lower lip with imperceptible incisions. This precise procedure allows the patient to state just how full you want your lip and that is where I can place the new lip line.
  • As the lip ages, the corner of the mouth tends to droop. Other procedures such as the Corner of the Lip Lift enable the lip to be reshaped so that the frown can be improved and a youthful upturned lip can be achieved.
  • Local flaps bring material from inside the mouth outside to enhance the lips. Results are permanent. An incision may be made inside the mouth to push the tissue inside the mouth upward, and outward, into the lip, sometimes in conjunction with grafting. Or, an incision may be along the upper lip line. In this case, skin above the lip is removed, and the lip is then stitched along the line of the incision.

Being specific with the result that you are hoping for and consult with a Board Certified Facial Plastic Surgeon to determine what technique will be best for you. Best of luck!

Dr. Clevens

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 124 reviews

Permanent Lip Augmentation

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I have performed hundreds of lip augmentations in the last 20 years of my practice; from permanent fat transfer, to implants, and the artificial fillers such as Juvederm.  I have always gone back to fat due to its natural appearance and feel.  Due to improvements in fat processing, the "take" of fat injections is in the 85% range, up from 50%.   My patients who have had the implants only loved them for a few years when they returned to my practice wishing to have the implants removed due to "shifting" and "banding" over time.  I have removed all of the lip implants I have placed and replaced them with permanent fat grafts.  My patients who have experienced both the implants and now the fat grafts are extremely pleased and notice the difference of softness and improved natural appearance while maintaining the desired size. 

Paul S. Howard, MD, FACS
Hoover Plastic Surgeon

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Your own living tissue is the only GOOD permanent lip enlargement technique.

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Numerous injectable fillers have been used for lip enlargement, usually with temporary results. Foam tubes, Goretex threads, other injectables, and even (not FDA-approved) liquid silicone injections have been tried and mostly rejected as "permanent" lip augmentation methods. The latter can harden, be lumpy, and even become infected and require removal (if possible).

For over 20 years I have been using dermal grafts (which may include tiny bits of attached fat but are mainly a 4-6mm strip of de-epithelialized dermis) from a patient's suprapubic area or from an existing surgical scar. The donor site is numbed with local anesthesia, and a 6mm wide strip of skin adjacent to an old scar (or making a new one if necessary) and about 7cm (close to 3 inches) long has the epidermis removed, and then the dermal graft is removed and rinsed in an antibiotic solution. The donor scar is closed with dissolving sutures. The lip(s) are also injected with local anesthesia, and tiny cuts are made in the corners of the mouth to allow passage of a 4mm blunt probe within the lip tissues. This probe gently separates, but does not cut, the lip tissues, after which the strip of tissue is attached to the probe tip, and the tissue graft seated in the lip tunnel as the probe is withdrawn. Two or three dissolving sutures in the lips and the living graft survives as a soft, permanent, natural lip enlargement. Swelling subsides in a week or so, and the results are beautifully subtle but definitely noticeable. The procedure can be repeated in several months if more enlargement is desired, but large grafts at one setting are not used as these are real living tissue grafts, and must be in contact with living tissue to survive and work. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

What Options do I have for Permanent Lip Augmentation?

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I have never been a big fan of permanent lip augmentation since I feel the risks far outweigh the benefits.  The current options are Silicone, Artefill, some implants, and occasionally fat transfer.  The problem is that not only is the lip a highly visible area, it is highly mobile.   The side effects of permanent augementation include an allergic reaction to the product, lumpiness that cannot be resolved, noticeable areas of product, and worse an infection or the product pushing itself out.  Some of the side effects such as with silicone, may not be noticeable for several years.  A perfect example is a recent celebrity who had plastic surgery to cut out the Silicone in her lips since she had received so many negative comments regarding her appearance.  With temporary products, at least if you don't like it, it can be dissolved with an enzyme or will naturally wear off.

Grace Liu, MD
Newport Beach Dermatologic Surgeon
4.9 out of 5 stars 52 reviews

Silikon-1000 may be used by experienced physicians for permanent, natural-looking lip augmentation.

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Silikon-1000 is a permanent, off-label filler, so your results, good or bad, are permanent. My experience with Silikon-1000 for lip augmentation has been excellent. Several treatments (1-3) are typically necessary to obtain a desired result, and in my practice, problems are infrequent. You must find a reputable dermatologist or facial plastic surgeon experienced with the serial puncture, micro-droplet technique. You should also have a discussion with your doctor about the FDA's position with respect to using Silikon-1000 in an off-label fashion to enhance your lips. Lastly, you should see many before and after photos demonstrating beautiful results before you pick your doctor and proceed.

This is my filler of choice for permanent Lip Augmentation, and in my practice, patient satisfaction is very high.

I hope this is helpful for you.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Lip augmentation, avoid permanent options

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You may be better off with conventional lip augmentation with hyaluronic acid fillers such as Juvederm or Restylane which are completely reversible with hyaluronidase. Even though there are several options for permanent lip augmentation, you may end up with a permanent problem if there is any allergy, infection, or if there is any change of your priority and life perspective about the proportion of your lip volume compared to your complexion.

William Ting, MD
Bay Area Dermatologic Surgeon
4.5 out of 5 stars 14 reviews

Beware of permanent lip augmentation procedures!

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There are great options for lip augmentation (namely, Juverderm, Restylane, fat transfer) that don't involve placing permanent materials that carry additional risks.  The supposed advantage of a permanent technique is a blessing and a curse.  A permanent procedure can't be undone without consequence when you have tired of the procedure, or your lips have aged over time and now the implant is visible.  I blogged about this last year - see my link below.

Permanent lip augmentation is not the best option

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Sometimes permanent is not best, especially when it comes to lips. Implants can be too firm and can move, surgical lip advancement leaves scars. Juvederm or Restylane last 6 months to a year and look and feel more natural.

Susan Van Dyke, MD
Paradise Valley Dermatologic Surgeon
4.6 out of 5 stars 36 reviews

Permanent lip augmentation

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I don't recommend permanent lip augmentation now that we have such wonderful fillers for the lips.  Most lip implants are stiff and can make movement and/or feel weird and unnatural.  Even soft implants like dermis can scar and become calcified and literally as hard as a rock.  These implants can be difficult to remove and can leave scarring. 

The lip is one of the most supple and limber and expressive muscles of the human body.  I would not let anyone put permanent implants in my lips and would not do the procedure for any patient.  I think the ongoing cost of fillers is well worth the benefit of a reversible and predictable procedure and very little down time. 

And also remember, the full lip look was not always in.  Remember Cheryl Tiegs and Farrah Fawcett from the 1970's?   Both thin lipped beauties.  Fashion is fickle. 

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 77 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.