Although significant attention has been directed toward lip augmentation, there is one situation in which lip augmentation alone may actually make the lips look worse.
In youth, the distance from the nose to the upper lip is generally fairly short, although the length varies significantly from person to person. With age, this distance increases. As the distance increases, the upper teeth are covered by the upper lip. Furthermore, the "pouty" aspect of the lips where the edges of the lips (the vermilion border) evert, diminishes with time, so that the lips appear flatter. Of course, the overall size of the lips also decreases.
Based on these observations, simply enlarging the lips by injecting a filler (e.g., fat, Restylane, Cosmoplast) addresses only one aspect -- the actual size -- of the aging lip. If a young patient already has a nice pout and has a short distance between the nose and the upper lip, simply increasing the size of the lips is all that is needed. However, if an older patient has a lost that pout and the distance between the nose and the upper lip is too long, just increasing the size of the lips may look strange. In fact, many of the odd-looking lips that one sees these days is the result of a doctor augmenting lips that really needed more than just a filler.
An ideal procedure for many of these patients is the
lip lift. The lip lift involves a small incision placed where the nose meets the upper lip skin. The incision extends from one nostril to the other and is hidden quite well in the natural crease where the nostrils meet the face. The incision dips into each nostril, where it is easy to hide the incision. Because of the shadowing effect created by the nose, in the vast majority of cases the scar is virtually imperceptible.
I always perform the lip lift procedure in conjunction with a filler. The combination of a shorter upper lip, a poutier upper lip and fuller lips creates the youthful appearance that patients want. Because the lips are also lifted slightly, the upper teeth become more visible, also contributing to the youthful appearance.
When properly executed, the lip lift is an excellent procedure for many patients.
