What is lip augmentation?
Lip
augmentation encompasses a broad range of procedures from
simple injections to surgical implantation of permanent implants.
Temporary injectable fillers used for lip augmentation include
a wide variety of natural and synthetic compounds (also see
section on dermal fillers)
such as bovine (cow) collagen,
human (foreskin) collagen (Cosmoplast), human (cadaver) collagen
(Cymetra), hyaluronic acid (Restylane), and fat. Fillers such
as silicone and polymethylacrylate (Artecoll) are permanent
fillers sometimes used for lip augmentation. Implants are more
permanent methods of lip augmentation and require surgery. Most
of the implants are made of expanded polytetrafluoroethylene
(ePTFE) and can be removed if needed. Fillers and implants will
be discussed separately.
What are fillers used for during lip enhancment?
Lip augmentation using fillers is an elective procedure
and is used to add volume to the lips.
What does lip augmentation feel like?
The filler is injected into the lip, which can
cause pain. Anesthesia and pain medications are often used to decrease
pain.
How long does lip augmentation last?
The lip augmentation procedure can last from five to thirty minutes,
depending on the number of areas being treated.
How will my lips feel after lip augmentation?
After the lip augmentation procedure, you may experience some pain
and swelling. This usually lasts a few days. In rare cases, the
swelling and redness can persist for up to two weeks.
When will I see results?
Your lips will be bigger after the procedure both
because of the swelling and the filler. You will see the results
of the filler alone after the swelling has subsided in a few days.
How long before I can return to my normal
activities?
You can most likely return to your normal activities
in a few days, after the swelling subsides.
How long do the results last?
The temporary fillers in the lip last 3-6 months
at best.
What are the risks of lip fillers?
Each filler has its own risk profile. In general,
the main risk of animal-derived collagen fillers is an allergic
reaction. Even people who have tested negative to the allergy
test required before treatment sometimes have allergic reactions.
On the other hand, the human-derived collagen fillers appear
to be well tolerated. There are theoretical risks of transmission
of disease from donor tissues although extensive screening of
the tissues are performed. The newer, synthetic, injectable
fillers like Restylane,
Perlane and Hylaform
reportedly have minimal side effects. However, some patients
have reported prolonged swelling and inflammation, and nodules
at the injection sites with Perlane. The permanent fillers (Artecoll
and silicone) carry several risks, including necrosis, granuloma
(a hard, bumpy scar), severe inflammation, extrusion and infection.
You and your physician need to the discuss the risks and benefits
of the different options if you choose to have lip augmentation
with fillers.
Lip Implantation
There are many kinds of lip implants available
today including Advanta, AlloDerm, Dermis grafts, Fascia Grafts,
Gore-Tex, SoftForm, Tendon Grafts, and UltraSoft. Gore-Tex, SoftForm,
UltraSoft and Advanta are made of a foam-like material called expanded
polytetrafluoroethylene (ePTFE). Advanta is porous, allowing your
own tissue to grow within the implant. Alloderm is an acellular
collagen material made from human donor. The material is purified,
freeze dried, than re-hydrated prior to use. The AlloDerm is placed
into the lips and integrates into the surrounding tissue as the
body grows and heals around the graft. Long term studies are in
progress to evaluate how long Alloderm implants last.
Why are lip augmentation procedures performed?
Lip augmentation is an elective procedure used
to add volume and definition to the lips in a more permanent fashion.
How are lip implants performed?
You are first injected with local anesthetic for
pain. These injections are similar to those you might get at a dentist’s
office. After you are numb, incisions are made at each corner of
the mouth (4 total) and the implant is inserted into the lip through
the incisions. The implant is trimmed, the incision sites are sutured,
and the wounds are dressed. Your physician may use absorbing or
non-absorbing suture material. There is usually very minimal bleeding.
How will my lips feel after the augmentation
procedure?
You will have some swelling and pain post-operatively.
Your physician can provide pain medication for you. You may have
difficulty eating and drinking at first. You may experience numbness
in the beginning as well. It takes about one week for the swelling
to subside, and there may be pain with pressure for up to three
weeks. Bruising is usually minimal You will have your sutures removed
in about 5 to 10 days.
How long do implants last?
Most of the implants are considered permanent.
Alloderm is relatively new and its duration is still being evaluated.
What are the risks of lip implants?
Infection is a common, but treatable risk. Other
complications of the removable implants (Gore-Tex, SoftForm, UltraSoft
and Advanta) are less common but include migration, extrusion, decreased
mobility, and irritation from a poor fitting implant. The hollow
implants (UltraSoft) allow your own tissues to grow into them which
decreases the risk of infection, rejection, and mobility. However,
they cannot be removed if there is a complication. Cost is variable
but usually runs about one thousand dollars per implant. All implants
carry the risk of permanent discoloration, scarring, and deformity.
If you decide on implants, you and your physician will need to discuss
the risks and benefits in detail.
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