eMedicine Specialties > Plastic Surgery > Head/Neck

Lip Augmentation

Author: Jorge I de la Torre, MD, FACS, Professor of Surgery and Physical Medicine and Rehabilitation, Residency Program Director, Division of Plastic Surgery, University of Alabama at Birmingham; Director, Center for Advanced Surgical Aesthetics
Contributor Information and Disclosures

Updated: Nov 12, 2008

Introduction

Cosmetic lip augmentation consists of the enlargement and reshaping of otherwise normal lips to improve their dimensional relation with the patient's nose, teeth, and surrounding facial structures. The appearance of the lips is determined by the spatial relation of the lip structures with the teeth in a 3-dimensional space and by their function during animation and speech.

For news, CME, and expert viewpoints on aesthetic procedures, visit Medscape’s Aesthetic Medicine Resource Center. For information on other lip procedures, see eMedicine articles Lip Reduction and Lip Reconstruction.

History of the Procedure

Augmentation of the lip has been performed for cosmetic reasons for a long time. Women of all ethnic and social backgrounds have applied cosmetics to their lips to define or alter their appearance since the Stone Age. Tribal ceremonies involving the introduction of various materials in the upper and lower lip to alter their shape, usually with the intent to enlarge them, have been practiced in African tribes for centuries.

Problem

Cosmetic lip augmentation is defined as the procedure designed to augment and improve the shape a lip that is not affected by trauma or congenital deformity. Typically, the upper lip is treated more frequently and to a greater degree than the lower lip.

Etiology

Cosmetic deformities of the lips include both congenital and acquired etiologies. Some patients never develop adequate fullness in the lips; others develop atrophy of the soft tissue of the lips as they age.

Presentation

Cosmetic indications refer to lip size and shape.

An accurate physical examination determines the specific area of deficiency or desired enhancement. Specifically, evaluate the patient's occlusion, maxillary-mandibular relations, and aging pattern. A general evaluation of the relation between the upper lip and the incisors reveals the appropriate course of action. Dr Bahaman Guyurion summarized the following algorithm approach to physical evaluation prior to lip augmentation:

  • Optimal incisor show - Conservative augmentation by fat transfer or dermis fat graft
  • Excessive incisor show - Augmentation by fat transfer or dermis fat graft
  • Inadequate incisor show, long lip - Lip shortening and lift with incision at nasal base ("buffalo horn") in young patients with acute columella-labial angle or incision at vermillion border in older patients with perioral rhytids
  • Inadequate incisor show, normal lip length - Maxillary lengthening with possible lip augmentation

Indications

Cosmetic indications include patients who desire a fuller or more shapely upper or lower lip and who are otherwise in good health.

Relevant Anatomy

Lip augmentation consists of the reshaping and/or enlargement of the visible portion of the lip, the vermillion. Alteration of the shape of the Cupid's bow and of the relation between the vermillion and the skin underlying the nasal columella also fall within the category of lip augmentation.

Also important is to consider the relationship between lip height and incisor show in the anatomic analysis. Evaluate possible maxillary hypoplasia and protrusion and consider the patient's occlusion status.

Contraindications

Contraindications for cosmetic lip augmentation include facial nerve disorders, recurrent herpes simplex lesions, diabetes, severe hypertension, history of multiple allergies, and/or autoimmune disorders.

More on Lip Augmentation

Overview: Lip Augmentation
Treatment: Lip Augmentation
Follow-up: Lip Augmentation
References
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References

  1. New Image. Lip Plumpers. NewImage.com. Available at http://www.lipaugmentation.com/lip_plumpers.htm#34. Accessed 6/18/08.

  2. Godin MS, Majmundar MV, Chrzanowski DS, et al. Use of radiesse in combination with restylane for facial augmentation. Arch Facial Plast Surg. Mar-Apr 2006;8(2):92-7. [Medline].

  3. Kanchwala SK, Holloway L, Bucky LP. Reliable soft tissue augmentation: a clinical comparison of injectable soft-tissue fillers for facial-volume augmentation. Ann Plast Surg. Jul 2005;55(1):30-5; discussion 35. [Medline].

  4. Sclafani AP. Soft tissue fillers for management of the aging perioral complex. Facial Plast Surg. Feb 2005;21(1):74-8. [Medline].

  5. Bagal A, Dahiya R, Tsai V, et al. Clinical experience with polymethylmethacrylate microspheres (Artecoll) for soft-tissue augmentation: a retrospective review. Arch Facial Plast Surg. Jul-Aug 2007;9(4):275-80. [Medline].

  6. Ersek RA, Beisang AA 3rd. Bioplastique: a new biphasic polymer for minimally invasive injection implantation. Aesthetic Plast Surg. Winter 1992;16(1):59-65. [Medline].

  7. Gryskiewicz JM. Alloderm lip augmentation. Plast Reconstr Surg. Sep 2000;106(4):953-4. [Medline].

  8. Seymour PE, Leventhal DD, Pribitkin EA. Lip augmentation with porcine small intestinal submucosa. Arch Facial Plast Surg. Jan-Feb 2008;10(1):30-3. [Medline].

  9. Trussler AP, Kawamoto HK, Wasson KL, et al. Upper lip augmentation: palmaris longus tendon as an autologous filler. Plast Reconstr Surg. Mar 2008;121(3):1024-32. [Medline].

  10. de Benito J, Fernandez-Sanza I. Galea and subgalea graft for lip augmentation revision. Aesthetic Plast Surg. May-Jun 1996;20(3):243-8. [Medline].

  11. Niechajev I. Lip enhancement: surgical alternatives and histologic aspects. Plast Reconstr Surg. Mar 2000;105(3):1173-83; discussion 1184-7. [Medline].

  12. Mutaf M. V-Y in V-Y procedure: new technique for augmentation and protrusion of the upper lip. Ann Plast Surg. Jun 2006;56(6):605-8. [Medline].

  13. Wilkinson TS. Lip enhancement. In: Practical Procedures in Aesthetic Plastic Surgery: Tips and Traps. 1994:117-44.

  14. Guerrissi JO. Surgical treatment of the senile upper lip. Plast Reconstr Surg. Sep 2000;106(4):938-40. [Medline].

  15. Jacinto SS. Ten-year experience using injectable silicone oil for soft tissue augmentation in the Philippines. Dermatol Surg. Nov 2005;31(11 Pt 2):1550-4; discussion 1554. [Medline].

  16. Barnett JG, Barnett CR. Silicone augmentation of the lip. Facial Plast Surg Clin North Am. Nov 2007;15(4):501-12, vii-viii. [Medline].

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Further Reading

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Keywords

lip augmentation, lip filler, lip fillers, lip injection, lip injections, collagen, collagen injection, restylane, restylane injection, radiesse, lip rejuvenation, lip implant, lip reconstruction, lip roll, lip lift, lip advancement, lip enlargement, lip enhancement, lip surgery, lip plastic surgery, cosmetic lip surgery, plastic surgery lips, lip plumper, dermal filler

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Contributor Information and Disclosures

Author

Jorge I de la Torre, MD, FACS, Professor of Surgery and Physical Medicine and Rehabilitation, Residency Program Director, Division of Plastic Surgery, University of Alabama at Birmingham; Director, Center for Advanced Surgical Aesthetics
Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Medical Association of the State of Alabama
Disclosure: Nothing to disclose.

Medical Editor

Lawrence Ketch, MD, FAAP, FACS, Head, Program Director, Associate Professor, Department of Surgery, Division of Plastic Surgery, University of Colorado Health Sciences Center; Chief, Pediatric Plastic, The Children's Hospital of Denver
Lawrence Ketch, MD, FAAP, FACS is a member of the following medical societies: American Academy of Pediatrics, American Association for Hand Surgery, American Association of Plastic Surgeons, American Burn Association, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Society for Surgery of the Hand, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Plastic Surgery Research Council
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

R Edward Newsome, MD, Program Director and Chief of Plastic Surgery, Henderson Chair in Surgery, Assistant Dean for Graduate Medical Education, Tulane University School of Medicine
R Edward Newsome, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Society of Plastic and Reconstructive Surgery, American Society of Plastic Surgeons, and Louisiana State Medical Society
Disclosure: Nothing to disclose.

CME Editor

Nicolas (Nick) G Slenkovich, MD, Practice Director, Colorado Plastic Surgery Center at Swedish Medical Center
Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Deepak Narayan, MD, FRCS, Associate Professor of Surgery (Plastic), Yale University School of Medicine; Chief of Plastic Surgery, West Haven Veterans Affairs Medical Center
Deepak Narayan, MD, FRCS is a member of the following medical societies: American Association for the Advancement of Science, American College of Surgeons, American Medical Association, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Indian Medical Association, Plastic Surgery Research Council, Royal College of Surgeons of Edinburgh, and Royal College of Surgeons of England
Disclosure: Nothing to disclose.

 
 
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