We had an extensive discussion about lip augmentation and rejuvenation. Full, well-defined lips are tied to youth, beauty, and facial harmony. Lip enhancement can improve naturally thin lips, restore volume lost with aging, refine symmetry, and support overall facial balance. The key to attractive outcomes is a conservative approach. Overfilling any lip technique creates an unnatural result.
How Lips Age
- Volume loss: Lips thin as collagen and fat diminish.
- Upper lip lengthening: The upper lip grows longer vertically, rolling the pink vermillion inward.
- Border softening: The lip outline becomes less defined.
- Perioral lines: Vertical lines form around the mouth.
- Corner descent: Mouth corners may turn downward.
- Reduced tooth show: Less upper tooth show when smiling or at rest.
Why Conservative Treatment Matters
Regardless of technique, starting modestly creates the most natural, attractive appearance. Over-augmentation can cause:
- Unnatural proportions
- “Duck lip” appearance
- Distorted speech or facial animation
- Social stigma from an obvious overdone look
We can always add more volume later. Correcting overfilled lips is much harder.
Why a Facelift Does Not Enhance Lips
A facelift improves cheeks, jowls, and neck by lifting deeper tissues and redraping skin. It does not increase lip volume or shorten the upper lip. If lip enhancement is desired, it must be addressed separately with dedicated procedures.
Temporary Lip Augmentation: Injectable Fillers
Hyaluronic acid fillers are the gold standard for temporary lip enhancement. They can improve border definition and add volume in a controlled way.
Benefits
- Immediate results
- Minimal downtime
- Adjustable over time
- Reversible with hyaluronidase if needed
Limitations
- Temporary, usually 6 to 12 months
- Ongoing maintenance cost
- Does not shorten a long upper lip
Why Lip Implants Are Not Recommended
Permanent synthetic implants have high complication rates such as extrusion, infection, palpability, migration, and unnatural feel. For these reasons, I do not use lip implants.
Preferred Surgical Options
Upper Lip Lift (Subnasal Lip Lift)
This procedure shortens the distance between the nose and upper lip by removing a small strip of skin beneath the nose. It elevates the upper lip, increases vermillion show, and improves tooth display. It is ideal for patients whose lip thinning comes from upper lip lengthening rather than volume loss.
Vermillion Advancement (Upper or Lower Lip)
Vermillion advancement removes a narrow ellipse of skin along the lip border and advances the pink portion forward. It creates more visible vermillion and better definition using your own tissue.
Fat Grafting to the Lips
Fat grafting augments lips using your own fat. Fat is harvested by liposuction, processed, and injected in small layered droplets. Because the lips are mobile and some fat is reabsorbed, the procedure is done with intentional overcorrection. Some patients require multiple sessions to reach their final goal.
Combining and Staging Techniques
Many patients benefit from a staged approach:
- Start with conservative fillers to test volume and shape.
- If maintenance becomes undesirable, move to a surgical option.
- Add a lip lift if vertical length is the main issue.
Recovery Expectations
- Fillers: minimal downtime, swelling for a few days.
- Surgical techniques: about 1 week off work, soft diet early on, swelling improves over 2 to 3 weeks, scars mature over months.
- Fat grafting: more swelling initially, final volume visible by 3 to 6 months.
Potential Risks
- Asymmetry
- Over-augmentation or under-augmentation
- Lumps or irregularities (more common with fillers)
- Scarring (surgical techniques)
- Fat resorption and need for repeat grafting (fat transfer)
Making the Decision
The best approach depends on your anatomy, whether your main issue is volume or upper lip length, and your preference for temporary versus permanent enhancement. Our goal is natural, balanced lips that fit your face, not a dramatic or artificial look.
Photos were obtained, a quote was given, and the patient will return in a week for further discussions if needed.
