By Dr Nolan Hetz
It is a common and natural desire to have fuller lips similar to attractive actresses like Angelina Jolie or to have a more outlined-etched looking set of lips like those of Jennifer Aniston. It sounds like you are one of the many women who have experienced some of the pitfalls with over-the-counter lip-plumping creams. Some of these creams can work to a degree, though short-lived, and can be satisfying to the purchasing consumer. Many of these creams contain irritating chemicals, vitamins, and/or herbs, like cinnamon, that cause the lips to swell to produce their increased lip volume, but tend to leave some consumers with sore, dried, and chapped lips by the end of the night.
There are some good options to enhance the lips using the less expensive Hyaluronic Acid skin fillers like Belotero and Prevelle Silk that last approximately 3 to 5 months. These short lasting fillers are especially helpful for those who never have lip fillers or in situations where a person wants to look their best for a class reunion or an upcoming wedding.
Then there are higher concentrated Hyaluronic Acid(HA) containing fillers that last 6 to 10 months which have the trade names Restylane and Juvederm Ultra Plus. These manufactured molecules of HA are the same molecules that are produced by the body that are the skin’s natural moisturizing molecules substrate.
Today’s lip injection techniques are much more comfortable for a number of reasons. I like to pretreat the outer lip, the peri-oral skin surfaces, and even the mucosal surfaces inside the mouth with BTL numbing cream for 15 to 30 minutes. Next, one needle insertion site is painlessly made on each side of the lower face using cold-spray analgesic and a diamond tip 18 gauge needle. All fillers nowadays also contain a small amount of Lidocaine, a lip-skin numbing analgesic, that quickly numbs the inner lip tissues immediately upon being injected. Some patients request a dental-like block directly inside the mouth along the upper gum like that numbs the entire lip and can be useful for further anesthesia especially important if the vermillion line is injected to sharpen the upper lip edge.
These softer HA skin fillers are very appealing to many women since they can provide several months of safe lip enhancement. There is an interesting, very long term option for lip enhancement with the off-label use of the skin filler BellaFill. The use of BellaFill in the lips is best done on individuals who previously had one of the short acting skin filler and liked their new look. BellaFill is best to place in the wet-dry border of the inner lip area since this is a collagen-stimulating skin filler. BellaFill contains beef collagen and a molecule called PMMA. The beef collagen within BellaFill gets totally reabsorbs after 4 to 5 months, and the PMMA molecules are the stimulatory substance triggers the immune system to lays down native collagen fibers. PMMA slowly builds up the lip volume with new collagen as the beef collagen is being slowly being resorbed. BellaFill, at the 5 years post injection mark, has been shown by actual tissue analysis to retain 89% of the volume that was originally injected.
Skin fillers can be injected directly into the belly of the lips at the horizontal “wet-dry” border to increase the lip’s volume and to gently cause the lip belly to move slightly upward and to an outward rotational direction. This injection technique can create an Angeline Jolie-like fuller-lip look. Other women prefer having just the very upper edge of the lip line, called the Vermillion line, filled. This more limited injection technique involves the use of a smaller volume skin filler syringe and is, as a result of the less amount of fillet needed, a couple hundred dollars less expensive per treatment. These vermillion lip edges fill can look a little more like a Jennifer Aniston-like prominent or sharpened lip edge, but not fuller, look.
In some properly selected individuals, the upper lip can be enhanced, and the upper vertical lip wrinkles simultaneously reduced, with a deep ablative and/or fractionated Erbium laser or Carbon Dioxide laser treatment. The laser energy is initially used to vaporize several layers of the skin’s outer epidermal layer. At other laser settings, many microscopic holes are precisely drilled into the superficial dermal layer, causing the stimulation of collagen re-growth. These modern laser energy technologies can almost erase most upper lip wrinkles while simultaneously heating up the deeper skin dermal layers, causing the gradual turning-up of the top portion of the upper lip region over a 2 to 6 month post-op period of time.
The use of one’s own Fat to enhance lip volume is becoming more popular because of the greater potential for achieving a more permanent or very long lasting result. Some fat transfer techniques are more cost effective in the long term since a single treatment may have a 60 % to 80 % change of permanency as long as the fat mixture is combined with a small volume of the client’s blood plasma and the commercially available matrix-producing substance called Selphyl or Regen. Combining one’s harvested fat cells with one’s blood plasma and with one of these two Platelet Rich Plasma injectable cosmetic-volume-enhancers, Selphyl, and Regen, has been suggested to result in a higher percentage of fat survival, and a longer lasting volume correction, than the injection of just a pure fat cell solution. There is a very expensive technique on the fringes of technology called a Fat Stem Cell transplant into body areas needing more permanent volume enhancement. However, we are a couple of years away from having this stem cell retrieval technique perfected and cost-effective enough to justify its use
Dr Nolan Hetz is a Certified Aesthetics Consultant and is also a board certified surgeon. If you have a question about a woman’s health or beauty topic for consideration in a future “Ask the Doctor” column, please submit it to firstname.lastname@example.org or call 920-683-1800.