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A lip augmentation is a procedure designed to improve on the overall appearance and shape of both the upper and lower lips. Some individuals are blessed with lip fullness that provides an adequate show of vermilion (red part of the lip). This allows for an easier application of lipstick or coloring. This amount of aesthetically pleasing vermilion show is not present in everyone. It is also difficult for some individuals to even apply lipstick because of the lip deficiency. The junction of the vermilion to that of the skin should have a slight roll that accentuates the desired lip pout and Cupid's bow. Lip augmentation can be performed to provide fullness and pout to the central part of the lip. It is also evident that with aging there is some decrease in fullness of the lip resulting in less pout and an increase in the fine wrinkles of the upper and lower lips. There are procedures (CO2 laser and chemical peel) that have shown to improve on the wrinkles of the lips. Lip augmentation can also improve on a minimal amount of wrinkles and at the same time enhance the fullness of the lips.
Surgery There are currently several methods that could be utilized to achieve this end. Collagen injection has been performed but the results are very short lasting (usually no more than 6-10 weeks). Fat injection has also been used and the results are variable with loss of the augmentation over 1 year. Gortex has also been used with a longer lasting result, but this material is artificial and not incorporated into one's own tissue. There have also been reports of the Gortex becoming exposed with time. Alloderm (dermal graft) is now used as a graft substitute that with time will incorporate into the body's tissue. It is cadaver tissue that has been treated to remove any of the proteins that could result in a reaction. This material has been used for a variety of reconstructions and is long lasting but a small amount will resorb (dissolve) over time. The results have been very favorable with this material. This is the current method of choice. An incision is usually made along both corners of the mouth to allow introduction of the material into the lip. The incisions are very small (1/8 of an inch) and usually are not even apparent after the procedure is performed. Anesthesia The procedure is performed under local anesthesia in the office and usually requires approximately 40 minutes for one lip. Sedation is usually not necessary and one could return home immediately after. Duration of Surgery The operating time will vary depending on the patient and whether one or both lips are augmented and whether any additional procedures are performed. Generally the time is approximately 1 hour for both lips. Before Surgery Do not take aspirin or products that contain aspirin for at least 3 weeks prior to surgery. Also refrain from any herbal supplements, as some may have an effect on increasing bleeding during the course of surgery. Remove all makeup and mascara from your eyelids. If you wear contacts lenses, it would be preferable that you wear glasses when you arrive to the surgery center.
After Surgery No dressings are necessary and only antibiotic ointment is applied to the entire lip and especially over the stitches. Ice packs are not necessary. There is usually a moderate amount of swelling and very little if any bruising. You should try to sleep with your head and shoulders elevated to help reduce the amount of swelling. You may bathe the day after surgery. The antibiotic ointment should be applied twice daily for one week. Initial discomfort is controlled with oral medication. Stitches are dissolvable and should be gone by one week. You should be careful on eating items that are hard or that have rough or sharp edges (like chips or Doritos). You should be extremely careful about placing items in your mouth as the feeling to your lips will initially be decreased and you may not be aware of injury or burn to your lips. Return to Normal Activity Most people return to their usual activities and to work the following day. It is acceptable to apply lipstick after 2 days. Strenuous sports and other activities should not be performed for 3 to 4 weeks. Photographs Photographs are taken at the time of your consultation. These are important aids in the preparation of surgery and become a permanent part of your record. Post-surgical photographs are also taken. Scars You should expect a scar in front of each corner of the mouth, within the red portion of the lip. The scars are placed in natural skin creases and will fade with time. This usually takes less than 3 months. Scars of the lip usually heal so well that they are usually imperceptible but scars are however permanent. The width, height and color of scars are unpredictable. The lip usually feels somewhat firm in the beginning but will soften with time. Wear a sunscreen of at least SPF of 15 or greater when outside to protect the scars from sunlight during the healing process. Diminished Sensibility As with any surgical procedure, small sensory nerves to the skin surface may be cut when the incision is made or when skin is undermined. Portions of your lip will feel numb or have less than full feeling. The sensibility in these areas gradually returns, usually with 2 to 3 months as the nerve endings spontaneously heal. During the healing process the skin of the lip may become hypersensitive for as period of time. Some diminished sensibility may last indefinitely. Swelling and Bruising Swelling and bruising of the lips or any site following surgery is normal. During the first 1 to 2 weeks your lips will feel and look swollen. The swelling will start to subside after the first postoperative week. It may take as long as 2 months for the last bit of swelling to recede.
Complications HEMATOMA This is the most common complication and occurs when a collection of blood forms under the areas of undermined skin. It occurs in less than 1% of patients. The body will absorb minimal bleeding. A larger collection may necessitate aspiration to drain the collection. Occasionally it will require additional surgery. EDEMA This is a normal consequence of surgery and is best treated simply by elevating the head of the bed. The application of ice packs or cold compresses may be performed but is not necessary. ABNORMAL SCARS A small percentage (less than 1 %) of patient will develop scars that are unacceptable despite meticulous attention to detail both during and after surgery. The scars may widen, stay red or raised. If the scars are problematic a steroid ointment or injection will be used to improve their appearance. In some cases the scars need to be revised surgically. SKIN LOSS This is also a rare occurrence. It may be due to cigarette smoking in the days to weeks before and after surgery, or due to undo tension at the site of the incision which could be compounded by swelling or hematoma. Usually this is managed without the need for additional surgery. INFECTION This complication is also rare. Prevention is the key and antibiotics are given both before and for a period of time after surgery.
I mention these complications not to alarm or frighten you since the usual outcome after this surgery is quite favorable. The majority of patients are very satisfied. I present this information to you to fully educate you on the side effects, undesirable sequelae and complications no matter how remote they may be.
Dr. Morales Recommends Theraderm Skin Products for his patients before and after surgery.
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