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Lip Enhancement (Lip Augmentation)

Surgical Lip Enhancement: Lip Lift, Lip Implants, Lip Advancement, Etc.

Lip enhancement procedures can add fullness to thin lips, reduce a long upper lip, and decrease wrinkles around the mouth to improve the appearance of your lips. As we age, lips can lose volume like many other areas in the face, causing less projection and red lip visibility. The skin of the lip area may lose elasticity and descend over time changing the contour and length of the upper lip area. Some patients are bothered by an excessive vertical length to the upper lip that may have occurred over time with age or has always been present. A long upper lip can limit the amount of teeth show with a relaxed mouth opening and smiling. There are different surgical and nonsurgical options to improve the volume in the lip, excessive wrinkling, and a long upper lip.

Understanding your Lips:

Lips can be many different shapes and sizes. The key to a beautiful lip enhancement procedure is to maintain appropriate contour and balance between the upper and lower lips and with the rest of the facial features. The lips can be divided into several different areas that can be addressed with surgical and non-surgical procedures.

Youthful and Attractive lips:

  • Defined cupid’s bow and vermillion border
  • Smooth upper lip skin that is typically less than 2 cm from the base of the nose
  • Slight upturn at the oral commissures
  • Red lips are full with the lower lip fuller than the upper lip
  • Subtle amount of teeth show with a relaxed mouth

fuller lips

The goal of lip enhancement procedures is to enhance the features of the lip that make them beautiful and youthful. Lip enhancement procedures performed by Dr. Naderi and Dr. Kulak will add volume to the lips while maintaining the appropriate contour and balance.

Surgical Lip Enhancement:

Lip Lift:

A lip lift is a procedure to shorten a long upper lip in the vertical dimension and improve the contour of the upper lip. When the upper lip skin is reduced, the red lip is lifted up and rolled out to give a fuller appearance of the red lip. The lip lift also pronounces the cupids bow, which is an attractive feature of the lips.

Best Candidate for Lip Lift:

  • Elongated upper lip skin (typically > 1.8cm)
  • Lips that have become shapeless, sagging and inverted.
  • Naturally thin lips that are nearly invisible, imparting an angry expression
  • Patients with limited red lip show
  • Limited teeth show with smiling or relaxed expression

There are several different styles and techniques for a lip lift. One technique is performed by placing the incision along the vermillion border of the lip, which is the junction between the red and white lip, also known as the lip roll. Skin is removed above this incision and the lip is effectively elevated in the vertical direction as the incision is meticulously closed. This technique has fallen out of favor, since it can leave a visible scar in some patients.

Dr. Kulak prefers the subnasal lip lift, which places the incision at the base of the nose. The procedure is easily performed in the office with numbing injections. An incision is made at the base of the nose at the junction of the nose and lip. The skin and soft tissue are excised. A few deep stitches are placed to lift the lip upward and the skin and soft tissue are then meticulously closed in multiple layers to minimize the appearance of the scar. The fine stitches placed in the skin are removed around five days after the procedure. The scar is well hidden, and after the healing is complete can be difficult to detect.

The downtime from this procedure is around one week. At one week, the stitches have been removed and makeup can be used to cover the scar while it continues to heal. The scar will continue to improve over the next six months. Some patients may have some numbness in the area that typically resolves by 3 months after the procedure.

Permalip Lip Implants:

For patients that desire fuller lips or reduction of lip lines with a more youthful contour, permanent lip implantation is a great alternative to injectable fillers. Implants are often ideal for patients who have tried filler injections and are now seeking a more permanent solution. The Permalip implant is placed along the wet-dry border of the lips to give a very natural volume enhancement without a “duck lips” appearance.

Dr. Kulak performs permanent lip implant surgery utilizing Permalip lip implant. Permalip is a soft, flexible, solid silicone implant that is tapered at both ends to nicely match the natural shape of your lip. The Permalip implant comes in several sizes to allow a customized augmentation of your lips. While the lip implant provides permanent augmentation of the lips, the implant can easily be removed or exchanged for a different size if desired.

Dr. Kulak in Chevy Chase and Northern Virginia performs Permalip lip implants in the office using local anesthesia, which is using numbing injections similar to that used in a dentist office to make the surgery painless. The procedure takes less than an hour to perform. There a few stitches hidden inside the corners of the lip that are removed after a week.

Downtime is around one week to allow the swelling and bruising to resolve. The lips are the most swollen 1-2 days after the procedure, which will continue to go down over the next few weeks. Bruising typically resolves after one week. Patients will usually find the lips to be tender during the first few weeks. Once the swelling resolves, the lips feel and look natural.

1 week after lip implant

3 weeks after lip implant

Lip Lines: Laser Resurfacing

Significant lip lines are best treated with a skin resurfacing modality in appropriate skin types. Laser resurfacing around the mouth or a deep chemical peel can significantly soften the wrinkles or “smokers” lines around the lips. To make significant change in the deep lines around the mouth, aggressive resurfacing needs to be performed to effectively tighten the skin and smooth the etched in lines. Either fractionated or traditional CO2 (carbon dioxide) lasers can be used for deep resurfacing. The downtime from laser procedures is around 7-10 days. Laser resurfacing can easily be performed in the office with topical numbing cream and numbing injections.


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