Lips
Why Lips?
In normal conversation, we look from eye-to-eye and then to lips. Next to eyelids, most people notice aging changes that affect the lips and the perioral region the most.
63 Yrs Old with Fat Droopy Eyes
Salt Lake City, UT
Well, the last time I had a picture taken I could hardly see my eyes because of the weight of heavy eyelid. Then I paid attention to how I was actually using my eyes and I really noticed when I was looking at anything especially the computer I was straining my forehead to see better. Since I have had it done I no longer have to lift the forehead and tilt my head to see. It is amazing! I love…
D. Rock
What procedures are available to rejuvenate lips?
Rejuvenation of lips can be achieved using minimally invasive techniques to surgical procedures. A detailed knowledge of the facial and perioral anatomy is vital whenever treating the lips or the perioral region, with surgery or fillers
How are lips assessed?
With great care and attention to surrounding surface anatomical contours and changes
What are the treatment options for lips?
- Fillers: fillers can be used to achieve a number of different effects. In younger patients, creating further fullness to the lips can look very pleasing. In other age groups, fillers are used to recreate the curves and prominences of youth: the philtral columns, the cupid’s bow, the ridge along the lips, upward turning corners of the mouth, and fullness.
- Lasers: with collagen degeneration and thinning of the skin associated with aging (and with smoking), vertical lip lines develop. These can be improved with fractionated or more aggressive lasers.
- Botox: treatment of the depressor angularis orbicularis allows one improve the downturn to the corners of the mouth that develops over time.
- Surgical shortening of the long vertical lip: using well-hidden incisions, the elongation of the distance between the nose and the lip can be reduced. This not only gives the lips a more youthful position, but also improves the pink show of the upper lip.
- Lateral elevation of the angles of the lips may be achieved with surgery resection and repair.
Highly recommended for eye lift surgery
Salt Lake City, UT
I had a excellent eye lift done by Dr. Patel. He knows what he is doing and is very pleasant. Dr.Patel was easy to get an appointment and he works with you. The office staff was very pleasant and made you feel calm.
D. Gull
“I don’t want to look like a duck after lip fillers”?
An aesthetic eye with judicious attention to race, sex, age, the relation of other facial structures, and natural history (of aging) are vital to augment lips and create more youthful lips so that the result is “invisible”to others.
Simply filling the upper and lower lips, especially when done to excess, leaves very undesirable results: no wonder people do not want to be left with “duck lips.”This is avoidable! An understanding of the normal anatomy of the lips and perioral region is vital
Surface anatomy and esthetic landmarks of upper lip 1. Philtral dimple/hollow (central esthetic unit of upper lip), 2. Philtral column, 3. Cupid’s bow, 4. White roll, 5. Tubercle, 6. Dry vermilion, 7. Wet vermilion, 8. Oral commissure, 9. Lateral esthetic unit of upper lip, 10. Cheek esthetic unit.
What kind of lip augmentation will look best on me?
Rejuvenation of lips is a combination of giving some volume, but also creating the ridges, grooves and prominences inherent to beautiful youthful lips. This is where one needs to inject as an aesthete rather than by the numbers. With the help of before-and-after photographs, it is possible to show you what would look best on you, without it looking in any way “fake”. We have enough fake news, as it is.
Remembering the proper proportions of upper and lower lips as shown below is important when designing lips with fillers or with surgery...
What kind of fillers are best for lips?
If you are undergoing any kind of surgical procedure, we often use fat grafts to give you some degree of volume in your lips. This is especially important when performing face lifts, to obtain proper proportions. However, fat will give volume, but is not very good at giving the desired shape. This is where proper fillers give the best results. Hyaluronic acid fillers like Restylane and Juvederm are very good as lip fillers. They are invisible to the feel after a few days, cause the least risk of permanent problemsand are controllable.
What are lip proportions?
Generally, lower lips should be fuller than upper lips. The ratio varies according to age, sex and race. Furthermore, the degree of fullness should not be the same across the full length of the lips.
The upper lips, in Caucasians especially, should be fuller centrally and para-centrally and peter out towards the outer thirds as shown in the photograph.
Frequently Asked Questions
Why can’t I have permanent fillers to the lips?
Permanent fillers can lead to permanent complications. Some permanent fillers are stiff to palpation, resulting in a strange look and feel to the lips. You only have to google to find examples of these, often in movie stars and television actors and actresses. The same applies to aggressive surgical lifting of lips: overly aggressive surgical lifting can result in too much “pink show”which imparts an unnatural appearance. Again, the internet is full of many such examples. Finally, it is almost impossible to remove permanent fillers without leaving prominent irregularities and scars.
How much will lip fillers hurt?
Lips are sensitive! We can use a combination of techniques to reduce discomfort: topical anesthetic creams, ice, and dental blocks. Different patients have different tolerences: we will help you dedice what would be best for you. After the filler has been inserted, there is very little discomfort.
How much bruising will I have?
Again, lips are very vascular areas: some degree of bruising is not uncommon. Ice helps. If the fillers are injected together with local anesthetic “dental blocks”, there is an increased risk of bruising, simply because of the number of injections in the perioral region. I ask all my patients to ice the lips after fillers as bruising sometimes shows a few hours later.
What kind of fillers are best for lips?
If you are undergoing any kind of surgical procedure, we often use fat grafts to give you some degree of volume in your lips. This is especially important when performing face lifts, to obtain proper proportions. However, fat will give volume, but is not very good at giving the desired shape. This is where proper fillers give the best results. Hyaluronic acid fillers like Restylane and Juvederm are very good as lip fillers. They are invisible to the feel after a few days, cause the least risk of permanent problems and are controllable.
Can’t I have facial fillers and lip fillers done at the same time as my surgery?
Injecting fillers when you are undergoing surgery under sedation or general anesthesia greatly reduces discomfort.
What happens if I get lumps or bumps in my lips after injection?
“Lumps or bumps” can be caused by small hematomas which dissipate in a week or so, or by the filler itself. It is important to remember that in order to create the best shapes for lips, the astute surgeon has to sometimes inject little boluses to provide a vertical lift to certain portions of lips: this will invariably give small “bumps”, but these are not palpable after a few days. If any lumps or bumps persist beyond two weeks, it is possible to soften them or even dissolve them: we will guide you.
What happens if I want more filler than you suggest?
Science is about measurement and precision, art and beauty are about judgment and taste. It is always wiser to start conservatively and have further filler as needed. We almost always start with one vial of filler to give shape and some volume to the lips. Further volume can be obtained with a second vial: this is not unreasonable in certain age groups and types of faces and aging. Again, this is best discussed with the help of photographs and examples of possible results.
May I bring photographs of the type of lip shape I would like with fillers?
Absolutely. Even though it is not possible to create an exact replica, photographs help immensely. We can recreate certain angles, curves, grooves and fullness to closely match an example.
Will fillers help reduce the vertical lip lines on my upper and lower lips?
The best way to improve these vertical lines (often called smokers’ lines, even in non-smokers) is to combine fillers with resurfacing lasers. Fillers alone will definitely improve vertical lines, but not completely eliminate them.
Can I have botox for vertical lip lines?
Judiciously administered botox will help reduce vertical lip lines for three to four months. One must not be aggressive with such injections as lips are supposed to move! Again, one can combine fillers with laser and some botox injections, if indicated.
I want my “smoker’s vertical lines” improved and also want fuller lips without looking over-done!
What if I want really (really!) full lips?
Really? Horses for courses, I suppose. Like food, there is no perfect recipe. Buyer beware. All of the following lips were regarded as attractive and desireable by people in the twenties:
I have heard of the vertical threading technique of injecting fillers?
This method is appropriate when one wants an aggressive lift of the lip. It makes the pink part of the lip stand out more and is reasonable for certain lips and faces.
What if I want thinner lips?
I have been asked this question twice: on both occasions, it was an unwise request. By electing to do this, you would have “chosen poorly”, as Sir Lancelot said to Indiana Jones.
