Lip Rejuvenation with the use of Injectable Fillers

Full prominent lips are a sign of a youthful face. Look at any high school yearbook or portrait of men and women in their teens and 20’s and one will notice this trait. It is almost universal, regardless of ethnic background, height or weight.

As we age, lips and the surrounding soft tissues atrophy, or lose bulk. This process is different for different ethnic groups. Fair skinned individuals with thinner skin will notice an earlier onset and more rapid progression. This thinning of the soft tissues can also be accelerated in smokers or those with excess sun exposure. It starts to be noticeable in the 30’s and progresses with age. The loss of volume results in visible wrinkling, especially in the skin just above the upper lip.

For decades, Plastic Surgeons focused on the wrinkles only, using techniques such as dermabrasion and chemical peels to resurface the area and smooth the wrinkles. The smoother lips had less wrinkling but still looked aged.

Along came autologous fat injection (injecting the patient’s own fat) in the 1980’s and 1990’s, and for the first time, the issue of volume or bulk loss was addressed. However, harvesting the patient’s fat and re-injecting it is a surgical procedure requiring special instrumentation and setting. It is time consuming. The results are unpredictable and there is usually significant bruising and swelling. Although the results can be permanent, so will any lumps or irregularities that sometimes occur. An abnormally looking fat lip can sometimes result.

In the last few years, the FDA has approved multiple products that help to correct the loss of volume. They come in sterile syringes and are easy to inject with minimal discomfort. Most patients can have it done and return to work the same day. They can treat deep lines and wrinkles all over the face and some of them, not all; can be used on the lips.

We have all seen the TV or movie star or even a friend or neighbor with huge duck-like lips that look terribly overdone and sometimes bizarre; lips that look unnatural and do not fit the face. In my opinion, that injector did not understand the concept of how the aging lips and surrounding soft tissues relate to one another, or how to restore a youthful balance, trying merely to make the lips larger by doing “Lip Augmentation”. 

I believe in doing “Lip Rejuvenation”, or bringing the shape of the lips, and more importantly, the soft tissues around the lip to a shape resembling its appearance at a younger age.

As a member of nearly 40 medical missions to third world countries, as well as in my private practice, I have repaired almost a thousand cleft lips. In doing so, I have learned the characteristics and shape of a normal looking lip, and how it fits in with the surrounding anatomy. This experience has helped me to develop my concepts of Lip Rejuvenation with injectable fillers.

Lip Rejuvenation must re-create the appearance of the lips and surrounding soft tissues as they did when the person was in his/her 20’s and early 30’s. The technique used by the injector must take into account ethnicity as well as gender. The idea is not to make the lips BIG. The idea is to make them look younger and fit the individual’s face.