Lip Augmentation
| Lip Augmentation Cost
Approximate Cost : $250 – $2500 |
A lip lift is a cosmetic surgical procedure that attempts to improve the appearance of lips by reshaping to advance the vermilion border or give the lips have what is perceived to be a more pleasing shape. Lip lift is to be distinguished from lip enhancement, another name for lip augmentation, which is often performed as a non-surgical procedure.
History
According to the American Society of Plastic Surgery, despite a declining economy, there was 3% increase in the total number of cosmetic procedures performed in patients aged 55 years and older in 2008 (3.2 million). With the rising popularity of facial rejuvenation techniques, surgeons have noted that if the majority of the face is rejuvenated but the lips are not, it creates a very discordant impression that undermines the effect as a whole. The ideal of youthful lips is often described as a lozenge shape with a pronounced Cupid’s bow and significant fullness in the upper and lower lips. However, with aging, the lips tended to shrink and lose definition.1They may also begin to sag and reduce the amount of teeth revealed with a relaxed smile.
With collagen as the only available filler material, and that proving a very unsatisfactory option, many surgeons in the 1980s sought to develop a surgical alternative that would increase the size of lips and give them a more youthful contour. Several techniques were developed, and, as yet, there remains no standard technique for the lip lift.
Variations on the Technique
One way to achieve advancement of the vermilion is the gull wing lift. The gull wing lift removes skin (and sometimes other tissue) directly from or above the white roll–the white line of skin that borders on and sets off the vermilion. In this technique, often complicated incisions are used to remove one or more cuts of tissue that significantly alter the shape of the lips by moving up the vermillion from both peaks of the Cupid’s bow out toward the side of the lips (the commissure). Incisions are also made below the lower lips to move more vermilion out on the bottom lips. This is described as a short procedure (20 minutes), with swelling that lasts 1-2 weeks and lip tightness that requires 2-4 months to resolve. Asymmetry, undercorrection, and hypertrophic scarring are listed as complications.
Another variation, called the subnasal or sometimes bull horn lift, involves the removal of an oval or wavy oval of tissue from directly beneath the nose. Skin is pulled up and securely stitched to advance the vermilion.This can sometimes lead to an exacerbation of drooping commissures, and therefore is commonly accompanied by what is known as a corner lift.
In the corner lift (or external angle oral commisuroplasty), triangles of tissue are removed from above the commissures to elevate the corners of the mouth.A descending wedge of tissue can also be removed to add contour to the Cupid’s bow or to reduce “bulky” lips.
In another variation of the procedure, an incision is made inside the mouth to loosen the mucosa and vermilion, which are then advanced and secured, leaving an exposed portion inside the mouth, which may take 2-4 months to completely heal.
Another variation uses a “W” incision inside the mouth to create several “V” flaps, which are then used in a V-to-Y plasty technique to advance the vermilion of either or both lips. 2This procedure leaves no exposed area inside the mouth, but can be painful and have a lengthy recovery period.
Another variation is the thread lift, in which a square stitch is placed from one nostril to the other and down to the peaks of the Cupid’s bow. This variation has fallen out of favor because the results are short-lived.
Results and Complications
Although many surgeons report satisfaction with their procedure to be “high,” the variation in procedures and the controversy over them suggests that no one variation has sufficiently high satisfaction to become the accepted procedure.7 Most of the procedures result in a visible increase in the amount of vermilion visible, but so far qualitative data only exists for the V-Y lip augmentation, which did result in statistically significant increases in upper vermilion height and surface area.
Complications listed for the lip lift procedure varied, but included:
Numbness
Stiffness
Pain
Parasthesia
Lip distortion
Lip lengthening
Smile deformation
Speech impediment
Visible scarring
In particular, the technique of removing skin at or directly above the white roll has been singled out as resulting in unfavorable scarring and stiffness in the lips.
Advancements and improvements in nonsurgical fillers available for lip enhancement has reduced demand for the lip lift procedure.
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