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Lip Service

Updated on February 11, 2009

"The lips are full, and so is the heart..." (Anon.)

It has been said that the lips are the messengers of the heart. Certainly, your lips can reveal, or betray, your most intimate thoughts and feelings without so much as a word. And, as you express emotions, your lips project clues about your personality and sexuality. Even small changes can have a tremendous impact on the way we are perceived by others. Not surprisingly, many people are interested in a subtle (and sometimes not-so-subtle) enhancement of their lips.

As the director of the Maryland Plastic Surgery Center, I have patients who come to me concerned that the size and shape of their lips are changing due to both the aging process and environmental influences. As we age, the tissue around the lips tends to flatten and thin out -- smoking accelerates this process. Interestingly, whether you were born with thin lips, or if you have lost some fullness in your lips over time, the addition of extra volume creates more youthful, attractive lips.

Men and women, twenty-somethings and octogenarians all are eligible for lip-augmentation procedures. Unlike other cosmetic procedures, nearly anyone can be a candidate for lip enhancement. Lip enhancement procedures are useful not only for those seeking larger lips, but also to correct any asymmetries or crookedness.

Although lip enhancement procedures have been available for decades, the techniques and materials have been improved tremendously in the past few years, making this a safer, more predictable and comfortable procedure. In fact, lip enhancement procedures are now easily customized to individual desires, lifestyles, and budgets. You may be surprised to learn that the spectrum of procedures for lip enhancement range from a simple office procedure with immediate return to social activities, to procedures in the operating room with about a week of swelling. The advantage of these more aggressive procedures is that the results can be much longer lasting, and in some cases permanent.

Simple procedures are performed with injectable filler substances. In the hands of an experienced plastic surgeon, the lips can be plumped up in about 15 minutes with no pain, bruising or swelling. The results typically last several months, although new filler substances may last up to a year. The most commonly utilized filler substances contain either hyaluronic acid or collagen. As one of the few surgeons who participated in the FDA clinical trials for soft tissue fillers, I have had the opportunity to perform thousands of these injections. Patients are always excited after the procedure because they can see amazing results immediately after their injection.

I strongly recommend against the use of a permanent injectable filler substance in the lips as experience has shown that there is a significant risk of clumping, nodules and irregularities that can appear over time, especially as the lips change with aging.

More invasive procedures involve the implantation of a natural or synthetic material. Natural materials include the use of your own tissue (eg. fat or fascia) or processed tissue. With rare exception, the natural materials are absorbed over time, typically disappearing completely within two years. The most commonly used synthetic material is Gortex®, which is available in a variety of shapes and sizes. This has been used for permanent lip augmentation in many patients, with good success. A slight firmness of the lips may be noted with these implants, and rare complications of implant migration can be treated with removal or repositioning of the implant. Occasionally, a slight restriction in lip movement can occur with these implants.

New implants that are filled with saline have been approved by the FDA for facial soft tissue augmentation (Verafil™). Similar to breast implants, they come in a variety of sizes. After implantation, they are filled with saline to achieve a soft, supple feel. Unlike other permanent implants, the saline implant does not shift, bunch or fold -- since it is soft and stretchy it will not restrict movement. Having participated in the curved design of these implants, I am pleased to note that patients have reported excellent results.

Other surgical procedures are available to provide more fullness to the lips without injecting or implanting any device. For example, specialized plastic surgery procedures can provide more fullness to the central part of the lips, lift the top of the lips, or turn-up the corner of the lips. In addition, some patients choose new cosmetics or even have permanent lip liner applied after their lip augmentation procedure. Finally, many patients have their pesky lip lines removed with filler injections or laser treatments in conjunction with or after their lip augmentation procedure.

Because there are so many different lip enhancement technologies available, and because creating beautiful lips is a very precise process, it is very important to be evaluated and have your procedure performed by an experienced board certified plastic surgeon with a good esthetic sense.

If you are interested in achieving soft, full lips, schedule your appointment with Dr. Summers today. Dr. Adam Summers is a clinical assistant professor of plastic surgery and he is certified by The American Board of Plastic Surgery, Inc. Dr. Summers created Maryland’s first medical spa, The Medical Spa & Cosmetic Surgery Center, and his artwork has been featured in the National Library of Medicine. Dr. Summers has pioneered many innovative procedures, such as the One-Hour Facelift and the Laser-Chemical Peel. For more information, visit his website at or call the Maryland Plastic Surgery Center at 410-553-9444.


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