"My
lips, two blushing pilgrims, ready stand To smooth that rough touch
with a tender kiss."
William Shakespeare Romeo and Juliet, I.V.
Ah!
yes, lucky Juliet. But what about the lips which need a little help?
Fortunately there are a variety of cosmetic surgery options to add
some pout and pucker. Lip enhancement can be done through injections
of fat or collagen or with grafts made from synthetic material or
the patient's own tissues.
Role of Fat Injections In Lip Enlargement
Thin
lips can be injected with fat taken from other areas of the patient's
body. This is usually done in an office setting with local anesthesia.
Mild discomfort and early postoperative swelling can be expected.
Although this method can produce a satisfying result, some resorption
of the fat invariably occurs, with loss of more than 50 percent after
the first 6 months. For this reason, overcorrection is usually done
initially and many patients undergo repeated injections.
Collagen is a naturally occurring protein that provides support to
various parts of the body. Injectable forms of collagen (also known
as Zyderm or Zyplast) can be injected into the vertical lip lines
and along the edges of the lips to produce more fullness. These injections
can be done quickly and can produce pleasing results. Infection, sores,
skins peeling or lumpiness can occasionally occur. Allergies to the
traditionally used bovine (cow) collagen are seen in up to 3 percent
of people, making pre-treatment allergy testing necessary. As with
fat injections, some resorption occurs over time and in many patients
repeated injections are done every 3 to 6 months.
Newer forms of collagen are now available for injection. Several ways
to use a patient's own collagen have been developed. Skin biopsies
can be sent to a laboratory, where the collagen can be extracted and
prepared for re-injection as Autologen. Similar skin samples can also
be used to clone and grow additional collagen for injection as Isologen.
These methods have not gained widespread popularity because of the
need for additional skin incisions, a delay between procedures and
additional cost. Patients who require additional surgeries such as
facelift or tummy tuck prior to lip treatment can utilize the skin
removed at the first surgery. Other injectable forms such as Dermalogen
(human collagen combined from multiple sources) can eliminate the
need for additional incisions or allergy testing.
Role Of Grafts And Collagen
Pieces of tissues (grafts) can be taken from a patient and placed
in the lips to enlarge them. Dermis or combinations of fat and dermis
from the abdomen are used most often. Other tissues such as tendon
and fascia are occasionally used. Small incisions are made at the
inner corners of the lips, a tunnel is made and the graft is inserted.
The procedure takes less than an hour and can be done under local
anesthesia. Patients experience minor discomfort and swelling for
several days and may have some stiffness in the treated lip for a
few weeks. These grafts generally provide a more pronounced and lasting
effect than fat injections.
AlloDerm is a material made from human cadaver dermis that has been
sterilized and prepared to inhibit immune response and rejection.
AlloDerm was initially developed for use in burn victim treatment,
but applications in cosmetic surgery such as lip augmentation have
emerged. This type of implant maintains its dimensions over time similar
to dermal grafts from the patient and better than fat or collagen
injections, but does not require additional incisions. Sheets are
trimmed and rolled to the appropriate dimensions. The placement is
similar to that of dermal grafts. A "micronized" injectable
form of human cadaver dermis is also now gaining popularity.
Several other types of implants have been used to enlarge thin lips,
including Gortex and ePTFE (SoftForm). These synthetic substances
are cut to the appropriate dimensions and placed into pre-made tunnels
in the lips. The risk of infection and extrusion, although low, is
higher than with the grafts previously mentioned. Technological improvements
in this area continue to produce implants with a more natural feel
and shape.
The improvements being made in lip enhancement are providing a variety
of safe and effective options to a large number of patients. Anyone
interested in learning more about lip enhancement should have a consultation
with a plastic surgeon experienced in this area to see what option
is right for him or her.
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