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Hi, all. I started researching a permanent...

Hi, all. I started researching a permanent solution for my aging, thinning lips about six months ago. I tried Juvederm, which wasn't bad, but didn't help all that much or for very long. I thought about silicone injections and had a consult with a local plastic surgeon. I liked his results, but then I found out liquid silicone is not FDA approved for injection into the lips or face, so I decided against that option. The only approved permanent lip augmentation/implant I found here in the US was the Surgisil PermaLip implant. Their website has a list of trained and authorized surgeons and one happened to be in my city. I did a check on him and found out that all he does is facial reconstruction and cosmetic surgery. He brings children here from all over the world to fix their facial deformities, tumors, hemangiomas, cleft palates, etc. So I made an appointment for a consultation. His staff is great and his offices are lovely. After listening to my goals he informed me that an implant would not be an improvement over my disappointing filler experience because I had two problems - a long philtrum (about 2 cm; should be about 1.1 cm for a female), and also since my upper lip was essentially rolled under an implant wouldn't have much of an impact because it is inserted at the wet-dry border of the lip and wouldn't really be seen. He didn't think implants would be worth the cost or down-time.
I had never heard of a lip lift so he spent a great deal of time educating me on the procedure. He told me to research and think about it a let him know what I wanted to do. After looking into it, I realized he was right - I needed a lip lift for sure and decided to have implants as well since a lift doesn't help with volume. I had both procedures done on Aug 30th.
On procedure day the nurse gave me 10 mg valium and 50 mg Nucynta (a narcotic) about 45 minutes prior to my surgery. I was taken to the procedure room, covered, draped with only my face exposed. An automatic blood pressure cuff was placed on my right arm and my face was wiped down with betadine. The surgeon then came in and asked if I was comfortable and ready to proceed. I was kind of loopy by then, so I was like "sure, go for it!". The numbing injections hurt like hell, I can't lie. But I had three different procedures (lip lift, lip implants, chin implant) so that was A LOT of injections. As for what happened after that, I don't really know. They covered my eyes with a soft cloth and I drifted in and out of sleep while he did his thing. The only thing I felt was the scraping of my jawbone for the chin implant pocket - that woke me up for sure. Before I knew it I was done.
I'm now on day 3 and haven't really had any pain from the lift or lip implants. It's just kind of stiff and tight. The chin is another story altogether. And a different review. All in all, it was an easy procedure and I've only taken pain meds for the chin pain. The swelling is not as bad as I anticipated and I have little, if any, bruising so far.
I'm posting pics from before and from the last three days. Good luck to the rest of you and let me know if I can answer any questions. (:

Day 4 - So far so good

So, my surgery was on Tuesday and the new pics are from Friday. I've been counting Tuesday as day 1, but the pics are actually 72 hours post-op. I haven't had any pain and very little swelling or bruising from the lip lift or implants. I think that is because my doc started me on a 6-day Medrol pack and Arnika Forte pre-op. My chin hasn't even bruised and from the reviews I've seen chin implants usually produce some stunning bruising. The chin DOES hurt quite a bit and I have had to take some pain meds for that. All in all, the lips really feel no more painful than the day after a round of Juvederm injections, though the incisions at the corners of the lips are annoying. The subnasal incision from the lift doesn't bother me at all. Here are some day 4 pics (72 hours really). I'm happy to answer questions, so fire away.

Philtrum Length and Chin Implant Explanation

I made a side by side illustration of the difference in philtrum length from the lip lift. You will NOT get this result from implants alone. Implants are placed well below the vermillion border and will not decrease the space between the lip and base of the nose. Implants will project the lip outward, but not upward. I really want to be clear that the results seen in my photos are in large part due to the lift, not implants alone.

The chin implant I had inserted is a pre-jowl implant. If you look at the picture you can see that there is very little material augmenting the chin itself; the implant is meant to fill in the pre-jowl sulcus where bone has been absorbed due to natural aging and creates the look of jowls in the area just behind the prejowl sulcus. I did not want an invasive neck lift (which would have left the prejowl dent anyway) so I opted to fill the depression with an implant instead. Make no mistake, the recovery from this procedure is painful indeed. I did not use pain meds after my breast augmentation (500cc under the muscle) or my lip lift/implants, but I have had to take narcotics for the chin pain and am still taking them 4 days later. Also, I did not have any treatment to the wrinkles around my lips/chin area. Will have to evaluate that situation once all the swelling is gone, but the difference is unbelievable.

Provider Review

Board Certified Facial Plastic Surgeon
2097 Henry Tecklenburg Dr., Charleston, South Carolina
Overall rating
Doctor's bedside manner
Answered my questions
After care follow-up
Time spent with me
Phone or email responsiveness
Staff professionalism & courtesy
Payment process
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I cannot say enough good things about Dr Hochman and his staff. They are warm and caring and friendly and willing to help with anything. His nurse, Kim, really went the extra mile for me trying to sort out pain relief options. I abhor narcotics, they make me violently ill and I certainly didn't need to be vomiting with a mouth and nose full of stitches. Kim did a lot of research and came up with a combo (Zofran and Nucynta) that solves that problem for most people. We did a trial run on a Saturday two weeks before my procedure when I could afford to be ill for a few hours, but the combo worked like a charm. No nausea, no vomiting, no dizziness. She really went the extra mile for me. As for Dr Hochman, the man is brilliant. He's a good listener, very receptive and welcoming, and seems to have a personal stake in creating a perfect outcome. His sutures are tiny, meticulous and even. I will never go to anyone else for facial surgery!