The key is subtlety, not overkill! A beautiful, sensual pair of lips is a very attractive facial feature and this can be enhanced by using injectable gels like Restylane, Perlane and Juvederm Ultra, or using fat fills, the former being quick office procedures and the latter requiring a minor operating room at least.
Few procedures have received as much bad press as lip enhancement, principally because it is regarded as easy to perform and is very often overdone, making the patient look decidedly odd, rather than anything approaching attractive.
The upper lip comprises a central fullness called the
tubercle, and a lateral lip element of either side of
it, often with a small junctional groove. There are 2
philtral columns that extent from the cupid's bow
apices up to the nostril sills. The upper lip volume
is usually no more than 2/3 of the lower lip volume.
The lower lip has 2 halves, each with slight fullness, and often with a small central groove. The white roll is a light reflex which outlines both upper and lower lip, and is more or less obvious in most people.
The ageing lip and peri-oral region tends to lose volume, hydration and pout and develop fine lines around the mouth area in general. The mouth corners also deflate somewhat, giving a down turned appearance. The upper lip also appears to lengthen over time, obscuring the upper teeth when smiling.
Each patient is assessed individually to see where
the lip might be best enhanced – there is no standard
way to do this. I most often use Juvederm Ultra Smile,
which is packaged as 2 x 0.55cc syringes and contains
a local anaesthetic. Areas that may be enhanced
include the white roll, the philtral columns, the lip
corners and the vermillion (red part). To turn the
vermillion out to increase pouting, the gel is
injected in small amounts on the inside of the lip,
not along the free order of the lip, as is often done.
I rarely use more than 1cc to enhance both top and
bottom lip – in this case, less is really more!! The
lips should appear moist and well hydrated, slightly
fuller / plump and ideally the proportion between top
and bottom lip should be respected, not distorted!
Fat grafts are another useful option for lip enhancement, but then require the patient to be in the operating room – this is often done as part of another procedure, e.g. facelift or eyelid surgery.