Frequently Asked Questions About Lip Augmentation

[rajiv]

1. How many techniques are there to augment the lips?
2. What types of injectables are out there and what are the differences?
3. Are there any permanent options in lip augmentation?
4. How is lip augmentation with lip implants performed?
5. Where are the incisions made?
6. What should I expect post-operatively?
7. Is it quite painful? Is there much bruising?
8. Will I have to pre-medicate for dental work?
9. When will I be able to see the results?
10. What are the risks of lip augmentation?
11. What is Arnica montana or Bromelain, I have heard that these homeopathics reduce swelling and bruising? Which is the best kind to take?
12. I have heard that the risk of infection is quite high with lip implants, is this true?
13. How are lip implants comparable with injectables?
14. Is lip augmentation reversible?
15. Will my significant other be able to feel it when we kiss?
16. Will the movement of my lips be hindered or look "odd" when animated?
17. What is the best lip implant or procedure for me? Which do you recommend?

[uneedme]

1. How many techniques are there to augment the lips?

A lot. Seriously, there are so many that you should read this website in its entirety. Such options are...
Lip implants:

* Advanta
* AlloDerm
* Dermis grafts
* Fascia Grafts
* Gore-Tex
* SoftForm
* Tendon Grafts
* UltraSoft
* Plus a few more

Injectables:

* Artecoll
* Aquamid
* Bio-Alcamid
* Bovine Collagen
* Human Collagen
* Particulated Dermis
* Perlane/Restylane
* Porcine Collagen
* and many, many more...

[uneedme]

2. What types of injectables are out there and what are the differences?

The benefit of an injectable is the volume it can give the lips. The poutiness it can give is significant compared to the implants which gives a more subtle, defined lip. The downfall is, you really need an experienced injector. This is imperative, especially with the permanent products!

Most available injectables are temporary. Collagen, which has been the industry leader for a very long time, usually lasts only 3 to 4 months months and requires a skin/allergy test. Fascian lasts a little longer although not by much. In theory, Fascian sounds wonderful, it is made up of fascia lata, strips of the tough covering that surrounds the outer thigh muscle. It is harvested from cadavers. It reportedly lasts longer than collagen, although I have not had the chance to test it out myself. But, I must say I have received many reports of lumpiness and inflammation and unfortunately -- high prices, considering it is cheaper to purchase than collagen.

Cymetra is a particulated, Injectable version of AlloDerm. LifeCell's product, AlloDerm (cadaveric dermis graft) seems to last a lot longer itself, but the injectable is somewhat "broken down" already. Unfortunately, everyone I have spoken to who has used it for lip augmentation has said says Cymetra only lasted a short time for them and that it was very expensive. I heard from the company that it is supposed to be layered over a 2 year period for best benefits but who has 2 years and a second mortgage to spare for that??

There are a few injectable products which are permanent, such as Artecoll, Aquamid, Metacrill, Silicone oil (Silikon 1000, Adatosil 5000 which are used off-label), etc. Artecoll is made from PMMA (polymethylmethacrylate) beads suspended in bovine (cow) collagen. The polymethylmethacrylate is formulated into microspheres (extremely small round balls) and suspended in a mixture of with 0.3% lidocaine for comfort and bovine collagen (3.5%) as well. The method of operation is that the PMMA is delivered into the dermis by the collagen vector, the collagen is then broken down by the body over time, yet the PMMA microspheres are left behind to be encapsulated by the body's own collagen. These microspheres are "networked" together by your body's collagen structure, therefore creating augmentation.

Aquamid, Bio-Alcamid, Argiform, and other polyacrylamide implants are made from a polymer that holds moisture. This type of product has been used in medicine and also in agriculture for decades. If you have every seen the bluish or clear Jell-O like gelatinous globs that plants are grown in or used to separate particles from water, it very well may have been polyacrylamide.

[uneedme]

3. Are there any permanent options in lip augmentation?

There are permanent and reversible options like Gore-Tex which I have, SoftForm, UltraSoft and Advanta soft tissue augmentation implants made from expanded polytetrafluoroethylene (ePTFE). These implants are made from a white material which could be described best as a foam-rubber type of material. ePTFE has been used for decades in the body for all sorts of applications. These are the most popular and the only FDA approved, synthetic implants which are considered permanent, yet they possess they benefit of being removed in the event of a problem. The risks are infection, extrusion, palpability and lessened mobility of the treatment areas.

Of course, there are permanent injectable permanent options which can create that poofy, Angelina Jolie look. These include, Artecoll, Metacrill, Aquamid, Silicone oil (off-label use), etc. The downfall with these implants are their permanent nature, the risks can also include necrosis, granuloma, nidus, severe inflammation, palpability, extrusion and infection.

[uneedme]

4. How is lip augmentation with lip implants performed?

The surgery is not at all complex nor does it take a substantial amount of time to perform. You re injected with local shots of Lidocaine for pain relief and epinephrine, a vasoconstrictor, to restrict the amount of bleeding an bruising. After making the necessary 4 incisions at each corner of the mouth, the surgeon inserts the implant using either an implant pre-threaded on trocar or using a pair of alligator forceps. After insertion, the surgeon cuts the implant to the size best for the patient's individual lip and trims the ends of the implant if necessary. The incision areas are then sutured with a thin, either dissolving or non-dissolving suture material and you are cleaned up.

There will be only the smallest amount of blood, miniscule actually, during the procedure due to the injections of epinephrine. The patient may have a drop or two inside of their mouth mixed with the patient's excess saliva that may appear to be a lot of blood when it really isn't. Trust me on this one, when I woke up I drooled a bloody mess but saw that it was mostly saliva.

[uneedme]

5. Where are the incisions made?

In a lip augmentation procedure with lip implants, the incisions are made right before the corner where the lips meet, on each side resulting in 4 small incisions and little or no scarring. I depicted the placement with red lines for ease of understanding. The lips tend to heal quite fast as long as you don't mess with them. These means NO TOUCHING or picking at your incisions! Infection is already a risk, try not to increase your chances of it. I think my lips are bruised from an injectable procedure LOL!

[uneedme]

6.What should I expect post-operatively?

You should expect to be swollen, tender and very full-lipped post-operatively. You may also difficulty drinking or eating without spilling as well. There will be pain, especially to pressure. You may feel numb in the lips for several days from the swelling putting pressure on the nerves in your lips. You should be thankful for this, because when the numbness dissipates you may feel more discomfort. Your pain relievers prescribed by your doctor should alleviate any discomfort.

You will have your sutures removed in about 7 to 10 days. It may sting a bit during removal, especially if your skin gets nipped my the small scissors. The swelling will be apparent, but you had the surgery for augmentation, didn't you?The swelling will subside, probably a little more than you would like it to. You will be accustomed to the extreme swelling and once this swelling subsides you may wish fir a little more poofiness -- this is normal. For a reality check, compare your befores with an updated after before passing judgment.

[uneedme]

7. Is it quite painful? Is there much bruising?

It takes about a week for most of the swelling to subside, although it will be sensitive to light to medium pressure for about 3 weeks. There is really not too much bruising with average cases, although it should be looked upon as individual. Some patients are prone to bruising more than others. Some doctors suggest that you use Arnica montana or Bromelain. You may also be instructed to use a topical arnica ointment as well. These three products are thought to decrease both bruising and swelling in all procedures and in most cases have shown a significant decrease in both complaints.

[uneedme]

8. Will I have to pre-medicate for dental work?

It is quite possible that you will have to pre-medicate to prevent infection in the cavity where the lip implant (or any implant for that matter) is located.

It is thought by some surgeons that plaque and bacteria are set free during dental work, or even a routine cleaning, and will enter into the blood stream via minute lacerations in the mouth. The bacteria searches for weaknesses in your body to latch itself onto and may do so, causing an infection. Besides, $12. isn't much to spend on the salvation of your $2,000 - $4,000. lip implants.

However, this is controversial and some surgeons believe that the same type of bacteria is released during routine flossing. I have personally never had a problem after the initial healing period -- although I did have an infection which occurred several months post-operatively which required the removal with my first set. Ironically my dentist may have caused the infection by irritating my newly implanted Gore-Tex with his overly large hand in my mouth. I think the next time I get dental work I will ask for antibiotics.

Incidentally, premedicating and following up for 3 days of antibiotic use is often recommended for the first year after breast implants, and for every treatment in those who have pace makers and synthetic hip joints.

[uneedme]

9. When will I be able to see the results?

The results are usually immediate. For implants, fat grafting and most injectables, your lips will be quite large and swollen and you will see a difference in the swelling as it subsides in the first week post-operatively (or post-injection). The swelling will more than likely subside more than you would like as you will become accustomed to their enormous size and think that your lips are small in comparison. You should take photos before and after to compare and look back on your old lips' size. After viewing the before and after photos you should be able to appreciate a change in the lip volume.

With implants which require stimulation of your own collagen (Artecoll, Metacrill, Isolagen, and Silicone oil) you may notice swelling at first, the swelling will subside, but growth will occur in the weeks following injection. Patience is a virtue with these types of procedures. Over-correction is not recommended. Please know that adding is a lot easier than removing.