Lip enhancement or augmentation is a very popular aesthetic procedure that can be done either as an office procedure with numbing medicine, or as a surgical procedure under anesthesia. There have been many advances that have made this a highly effective and rewarding procedure.
In-Office lip enhancement
Dr. Hobar prefers to place a local anesthetic block around the mouth and then judiciously fill the lip with Juvederm® Ultra Plus – XC. He has found this produces the most natural and longest lasting results in an office setting. By adjusting the molecular weight of the hyaluronic acid, Dr. Hobar finds that Juvederm Ultra Plus seems to have a longer lasting result than other fillers. Hyaluronic acid is the natural component of fluid found in our joints so is very well tolerated by the body.
Surgical lip enhancement
Dr. Hobar prefers to use Alloderm (collagen or protein tissue like substance derived from skin) when he performs lip augmentation as a surgical procedure. Alloderm always gives good short term augmentation, and has a chance of giving good long term augmentation. Alloderm use in lip augmentation is off label, meaning that it has been thoroughly studied and approved for use as a graft material, but not specifically for lips. It would be impossible to think that once a material or drug is approved, the laborious and extremely expensive process of re-approving it could be done for every single use. Many materials and drugs are used off label because it is the practical approach, once a drug or material has been approved safe and effective. That doesn’t mean you shouldn’t understand the material and drug and the reasons it is being used off label. You should question the doctor and insist on a thorough understanding. Alloderm has been used in numerous patients for lip augmentation for years and has an extremely high safety record. The main drawback with Alloderm is that it doesn’t always last. The only thing that can guaranty a long term preservation of volume is an artificial implant such as silicone or gortex. Dr. Hobar is very opposed to these type of implants.
According to Dr. Hobar,
“The benefits of the current fillers and Alloderm are so good and so safe, and the potential complications of an unnatural implant that can cause scarring or infection make this an easy choice for me. An unnatural implant will always induce scar formation when placed in the body. While this scarring can go unnoticed in other areas of the body, such as the breast, the consequences of noticeable scarring in the lip is not something that one should want to chance. Look in the mirror and notice the extreme changes in length of the lips upon puckering and exaggerated smile. An implant does not change length. Scarring produced from an implant can be unnoticed in a relaxed photo but very noticeable and unnatural with movement. Another natural filler that can be used for lip augmentation is fat obtained from the patient. I am not opposed to fat like I am unnatural implants, but I prefer the smoothness and naturalness of Alloderm over fat.”Just like there are unnatural looking facelifts, there are many unnatural lip augmentations.“While it is true that the top line of the lip (white roll or border) can benefit from subtle highlighting, this is an area that is often way overdone”, states Dr. Hobar.The lip should be augmented centrally to preserve a totally natural shape.