Lip Aesthetics, Lip Injections, and Lip Cosmetic Surgery

Indications for and results of lip filler, lip lift, corner of lip lift.

Hello. I'm Dr. Steve Laverson of Feel Beautiful Plastic Surgery in San Diego, California.

Let's talk about lips today. For doctors to create beautiful lips, we must know what beautiful lips are, and what people generally agree upon as elements of beauty; what features are universally accepted as appealing for women and men at all ages and regardless of ethnicity.

Three important elements for alluring lips are, in order of aesthetic importance, position of lips on the face and relative to teeth, size and proportion of upper and lower lips, and shape of the lips. Symmetry between right and left sides of the lips is never perfect, but is an additional feature that must be within acceptable range for nice lips.

Position of the lips is an important marker of youth and cannot be sacrificed to augment lip volume. Lips must be positioned so that when upper and lower lips are gently parted and relaxed, about two to five millimeters of upper central teeth are showing, but preferably no lower teeth.

Regarding size of the lips, upper lip, skin between nose and the red vermilion border of the lip is vertically short. Vermilion of the upper and lower lips have full volume and proportion of the lower lip to the chin is attractive. Upper lip vermilion may be about two thirds as full as lower lip vermilion, up to equally as full as the lower lip.

The shape of the lips is the most flexible of the important features. However, definition of Cupid's bow, a gradual or curvaceous tapering of lips from center to sides and subtly upturned corners amplify the lips and communicate pleasant emotion. Downturned corners are sad, angry, worried, aged, or hostile.

How does this affect treatment decisions? Size and shape of the lips can be adjusted with injectable fillers, tissue grafting, implants, or a combination. If lips are thin but in good position, filler augments size and is a good nonsurgical choice. Restylane, Juvederm, Belotero, fat, silicone, collagen, dermis, Aquamid and other biological and synthetic materials have been used for lip augmentation.

However, if augmentation enlarges larges a vertically long or low upper lip, so upper tooth show is lost or covered by the large volumized upper lip, the injection becomes aesthetically detrimental. Remember, lip position is more important than size. If the upper lip is vertically long and there's not much upper to showing, increased lip size with filler further covers upper teeth for an aged appearance. Filler is contraindicated, and the best choice as a lip lift.

Position, the most important aesthetic of the lips, can be adjusted by surgical procedures only. Skilled surgeons can also adjust size and shape of the lips permanently. Lip lift vertically shortens the upper lip, can increase upper lip vermilion fullness permanently, and may also enhance lip shape.

Here's an example of upper lip lift only, with no filler. Notice vertical shortening of the upper lip from before to after. Here's another upper lip lift. Note how this procedure lifts and vertically shortens her upper lip, and the aesthetic impact of lip position. Volume and shape of the upper lip are improved, as well.

Downturned corners of the lips imply a frown and communicate grief, disappointment, misery and other disturbing emotions. Gravitational settling of cheeks with aging often drag the lip corners down. This aging change is cruel because others read the status of our feelings in our facial expressions. Downturned corners inadvertently cause pleasant people to appear sad, indifferent, less approachable, or mean. If corners of the lips are sad and downturned, they also can be lifted in an office procedure to improve shape of the lips.

These examples of lip lift and corner lift without filler injection are good demonstrations of the expected results. Note the changes from before to after in lip position, size, shape, and the resulting change in emotion to a more youthful, pleasant expression. These minor procedures when indicated and when skillfully planned and accomplished, have as much impact as major aesthetic operations. Other methods to change size and shape of the lips are common, safe plastic surgery office procedures.

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