1) I have very thin lips. Can you make them bigger (fuller)?
Lip enlargement is achieved through a variety of procedures including fat injection, dermal fat graft, Alloderm® and V-Y lip advancement. Each approach has advantages and disadvantages. Details about each enhancement surgery are listed below. Determining which approach is best for you is achieved by learning a little about each alternative and clarifying your objectives. Consulting with a board certified plastic surgeon for his or her evaluation and expert recommendations will help reveal the plan that is best for you.
Fat Injections

  • Some patients receive fat injections when the goal is to treat multiple areas, such as the lips and smile lines. Advantages of fat injections include a natural donor (from patient’s own body), unlimited availability and a very small donor site.
  • The fat is obtained from another area of the body (typically the abdomen) through a very small, hidden incision. Therefore, the minimal donor site is cosmetically acceptable and healing time is minimal.
  • Unlike collagen, which is totally resorbed in six to eight months, 30-50% of the fat injected is permanent. Although uncommon, in some patients the fat can be totally resorbed. Rarely is the fat resorbed asymmetrically

Dermal Fat Graft

  • In a dermal fat graft procedure, a thin strip of skin and fat is threaded through a tiny incision at each corner of the mouth. This approach is typically used if there is skin left over from a simultaneous procedure such as a facelift. However, a dermal fat graft can also be performed as an independent procedure (typically a low abdomen donor site) and is sometimes requested if fat resorbed from a previous fat injection.
  • The advantage of this approach is again a natural donor (from your own body) and increased permanency when compared to collagen injection. With a dermal fat graft more of fat survives because the dermis (skin) acts in a similar fashion as a skin graft and nourishes the fat. Therefore, the likelihood of the fat surviving long-term is better. Disadvantages include a separate donor incision if not performed simultaneously with another procedure where skin is left over.
  • Unfortunately, dermal fat grafts are contraindicated in people with thick, heavy hair growth in donor areas. Dermal fat grafts can also have upwards of 30-50% resorption when final results are evaluated at one year’s time.

Alloderm

  • One advantage of Alloderm®, a soft, pliable, artificial implant (not from the patient’s own body), is that there is no donor site, therefore, no secondary incision. AllodermR also has the advantage of safety because it is processed human skin where all the cells are removed and therefore, can not transmit disease.
  • Because of its pliability, it is easily threaded through the lip incision at the corners of the mouth. Like dermal fat grafts, AllodermR provides moderate augmentation and can resorb 30-50% over one year’s time. Rarely, as in the case of fat injections, Alloderm can be completely resorbed.

V-Y Lip Advancement

  • V-Y lip advancement is typically reserved for patients who want the maximal amount of result with a permanent correction. In this procedure, small incisions are made inside (under) the lip and then closed in a fashion that rolls the lip outward a bit as demonstrated in the illustrations.
  • One advantage of this procedure is no donor site. Patients are educated ahead of time to a temporary disadvantage; the lips can feel tight for several months. Also temporary is the numbness that is associated with V-Y lip advancement. V-Y lip advancement procedures result in more swelling, which takes about four weeks to resolve.
  • As with all lip augmentation surgery, final results are assessed at one year. Determining which lip augmentation procedure is best for you requires expert recommendation from your cosmetic surgeon.

2) Will lip augmentation help with the wrinkles around my mouth?
Lip augmentation or reduction is a change in the size of the lips. To improve the wrinkles and lines around the mouth, one would more apt to be thinking of a skin resurfacing procedure. Skin resurfacing is the removal of the outer layer of the skin – using abrasion, chemicals or a laser – resulting in smoother, younger-looking skin with less wrinkles such as crows feet, face lines, lines around the mouth and laugh lines. Skin resurfacing is one of the most popular rejuvenation procedures because often the results enhance one’s natural beauty. Skin resurfacing results in a more youthful appearance. See our before-and-after skin resurfacing photographs.
Other options for patients who want improvement in their lips but aren’t ready for cosmetic surgery can be found in the Lindsay House Medical Spa. Botox and Collagen implant are just two of the many ways to maximize your beauty temporarily until you are ready for cosmetic surgery.

3) My lips are too big. Can you make them smaller?
Yes, most of the time we can reduce the size of the lips with a brief, outpatient surgery. While every patient’s request is unique, looking at some Before and After Photos is a good place to start.
Requests for lip reduction can be a result of congenital disease such as Melkerson Rosenthal Syndrome and most commonly as a result of an asymmetry of the lips, typically the lower lip larger than the upper lip. In this situation, lip reduction can be a challenging reconstructive surgery.
Reduction generally involves an elliptical incision where the wet lip meets the dry lip (along the mucocutaneous junction). The incision is well camouflaged and the results are quite satisfying. Patients are aware prior to the procedure that swelling can be excessive in the first week but then settles. Results are typically presentable by two to three weeks postoperatively. Sutures are removed on the fifth postoperative day. Activity restrictions include refraining from three weeks of athletic activity. Due to refinements that take place as the body heals, the final result is not to be determined for one year.

4) I want to dramatically change the appearance of my lips. Can I do that?
This is an excellent question because it leads to evaluating realistic expectations. This question can only be answered on an individual basis. A sign of a good facial plastic surgeon is one who can tell the difference between realistic and unrealistic expectations and one who will be truthful about meeting each patient’s desires. Our biggest referral source is from satisfied patients – ones who have had realistic expectations and were satisfied with results.

5) Will I be awake during surgery?
Using IV sedation (medicine administered through an IV) and a local anesthetic (numbing medication administered in the operating room), patients are asleep during surgery. Patients do not hear or feel anything and are comfortable during surgery. Patients wake up very soon after the operation is completed. Intravenous sedation is a type of anesthesia; therefore all patients must have a responsible adult to stay with them through the night following surgery. Patients may not drive for 24 hours after their procedure and this time may be longer, depending on the procedure.

6) Is it painful?
After any surgical procedure, some discomfort can be expected. All patients are provided with prescriptions for pain medication. Patients typically use the prescription medication after surgery for a few days and then switch to Extra Strength Tylenol. It is uncommon for patients to report unmanageable pain after surgery.

7) How long does my surgery take?
The length of surgery depends on several factors including the size, location and complexity of the underlying anatomy. Many patients who have previously had facial plastic surgery are referred to the Lindsay House for revision surgery. Revision surgery can take a little longer because of corrections that need to be made as a result of the initial surgery.

8) Can I drive myself home after surgery?
NO. Because of the effects of anesthesia, patients are not able to drive themselves home after the surgery. Transportation and a responsible adult at home following surgery is required.

9) How long will bruising and swelling last?
Postoperative bruising and swelling begins to resolve at the end of the first week. Full resolution of swelling and puffiness may take two to four weeks. Any residual bruises camouflage fairly easily at seven to ten days with make-up.

10) When can I go back to work?
Most patients take one week off work but patients who are more concerned with privacy return after two weeks. Return to work depends on many factors including the nature of your occupation and your general state of health. Patients are asked to avoid any heavy lifting, bending and straining for two weeks following surgery.

11) When can I “work out?”
Aerobic activities should be avoided for two weeks following surgery and heavy weight lifting or more strenuous workouts should be avoided for three weeks postoperatively. As we mentioned above, it’s important to avoid bending, lifting or straining during the postoperative period as these activities can increase swelling and delay healing.

12) I really want to do this but I’m nervous. What if I get stressed?
It’s ok to be nervous. (Frankly, we would be nervous if you were taking this step lightly!) One of the best ways to deal with nervousness is to see what other patients have gone through. Contact Us to talk to a patient who has had the procedures you are considering or to talk to one of our experienced staff members. As you learn in Selecting a Surgeon an educated patient knows when and if the time is right for cosmetic surgery.