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Monday, March 31, 2008

Lip Augmentation:Things to Consider

Here at The Center for Facial Cosmetic Surgery we get asked a lot about the various lip enhancement procedures that Dr. Clevens performs. We thought it warranted addressing and posting some main points when considering a lip enhancement procedure.

If you are dissatisfied or self-conscious about your lips, lip augmentation surgery can open up new possibilities for you to change your appearance and self-image with full, voluptuous lips.

Dr. Clevens states, “Whether you have always had thin lips, or you want to return your lips to the shape and fullness they had when you were younger, a lip augmentation procedure may provide you with the look you want.”

During the consultation, you will have the opportunity to talk with Dr. Clevens about the changes that you’d like to make in your appearance. He will explain the different options available to you. Some of the options are temporary in nature while others are permanent.

It is important that you explain the results that you would like. Bring photos to show Dr. Clevens what you like and what you don’t like. He will be able to tell you if you are a good candidate for lip augmentation. Think about whether you would like a temporary result that can be achieved with an injectable material like Restylane, Juvederm, Fat or a permanent option that can be achieved with a minor surgical procedure. 

Dr. Clevens is considered an ‘expert’ in lip surgery. He is a frequent invited lecturer and teacher of lip rejuvenation at national and international plastic surgery meetings. He was asked to create a teaching video for the American Academy of Facial Plastic Surgery demonstrating his lip surgery techniques.

Injections involve filling the lip with a soft substance to create a fuller appearance. Restylane, Juvederm, Fat, Collagen and Radiesse are the most widely used injectable substances. Because the body slowly absorbs these products, the results generally last between three and twelve months. The procedure may be repeated as needed. 
 
Fat injections are also placed in the lips with small needles. The fat used is harvested from another area of the body -- most often the abdomen or the thighs -- and is purified before it is injected into the lips. An advantage to this lip augmentation is that there is no possibility of an allergic reaction. The procedure is often performed more than once to achieve desired results. 
 
There are numerous different substances that Dr. Clevens commonly uses as a graft or implant material in the lips. Each option has its own advantages and disadvantages that Dr. Clevens will discuss with you at the time of your consult. 
 
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. 

Surgical enhancement of the lips provides a permanent alternative to injections and implants. Surgical enhancement usually takes Dr. Clevens less than one hour to perform in his 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 Dr. Clevens 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.

Most lip augmentation injections take less than fifteen minutes. Most lip augmentation grafts, implants and procedures take less than one hour for Dr. Clevens to perform. Sometimes procedures take longer than others. Dr. Clevens will be able to tell you how long your procedure is likely to take.

Injections are performed in the office. Procedures are performed in the office under local anesthesia, perhaps with light sedation as well. Whether or not an anesthetic is necessary depends on the lip augmentation procedure. Topical anesthesia is generally used before lip injections, so that the procedure involves no discomfort. Generally, local anesthesia is used in grafting procedures. This makes the procedure painless, although there may be some discomfort afterward. Immediately following lip augmentation, the lips may swell and hurt. Cold compresses should be used for 48 hours to control the swelling. During this time, talking and chewing should be avoided as much as possible. Oral pain medications may be used to control the discomfort. Antibiotics may be given to reduce the possibility of infection. To help avoid infection, it is also important to keep the lips clean. Most people report little discomfort in the days after lip augmentation. However, grafts and flaps usually involve more pain during recovery, and a longer recovery period, than lip injections.  
 
Injections: Most people return to normal, public activities within a couple of days or less of an injection procedure. Bruising and swelling may last as long as a week.  
 
Grafts: People often wait between 5-7 days after graft procedures before returning to their normal routine. During that recovery time, they may experience some problems with drooling. Grafting also may leave the lips feeling unnaturally stiff for 2 to 3 months after the procedure. Any non-dissolving stitches may be removed about 7-10 days after the procedure.

Significant complications from aesthetic lip enhancement procedures are rare and Dr. Clevens has extensive experience with this type of procedure. As with any surgical procedure, however, there is always a possibility of infection, or reaction to the anesthesia. Other possible complications include: numbing, scarring, swelling, and stiffness in the lip. 
 
To reduce the risk of complications, it is important to follow all the instructions you receive from Dr. Clevens before and after the procedure.

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