|
Lip Augmentation / Restylane®
|
|
| |
|
Overview
|
|
Lip augmentation
has recently become very popular. The reason is probably
because people have begun to realize that full and pouty lips
are obtainable without much downtime. A major advancement in lip augmentation is hyaluronic acid (Restylane®, Captique®). |
|
Hyaluronic acid became approved by the FDA on December 12, 2003 for treating wrinkles around the nose and mouth. Currently, it is being used for the entire face. The lip is the most common site. Prior to hyaluronic acid collagen was the only FDA filler approved. The limitation of Collagen is that usually goes away after about 3 months. Restylane® and Captique®, on the other hand last about twice as long. Dr. Cruise still uses Collagen in the form of Cosmoderm®. Cosmoderm® is excellent for treating fine wrinkles. Hyaluronic acid, however, is more appropriate for lip enlargement.
|
FAQ
How does Hyaluronic Acid work? |
Restylane® and Captique® are hyaluronic acids. Hyaluronic acid is part of the structure of normal, healthy skin.The role of hyaluronic acid is to deliver nutrients, hydrate the skin by holding water, and to act as a cushioning agent. It diminishes with age. Adding Restylane® or Captique® adds structural volume similar to what is naturally found in the lips and skin. |
|
What is the difference between Restylane® and Captique®?
Both Restylane® and Captique® are non-animal stabilized hyaluronic acids. Dr. Cruise uses both extensively and, quite frankly, does not see a significant difference. The company that makes Restylane® claims its product lasts a little bit longer. The company that makes Captique® claims Captique® has less swelling and bruising.
How long does it last?
Here is another question that is hard to get a straight answer. The reason is that if you listen to the makers of Restylane® or Captique® you will certainly get an inflated amount of time. In reality, to maintain your lips you should expect to repeat the augmentation every 4-6 months.
Can I have just one lip done?
Yes. If, for example, your lower lip is already pouty you can have just the upper done. One caveat, it is important to make sure you get enough of the product. By only doing a little amount most patients do not get the ideal result they are looking for.
How much is enough?
When discussing volumes you must talk in terms of cubic centimeters or cc's. This is how all soft tissue fillers are packaged. Captique® comes in 3/4 cc tubes. Restylane® comes in 0.4 cc and 1 cc tubes.
1/2 cc per lip. This will produce a small result and but usually is not enough. It is good for touch ups. Remember, you must double the amount if you have both lips done.
3/4 cc per lip. This will provide a very nice result and is usually enough for patients who do not want to be too dramatic. 3/4 cc per lip is probably the best amount to start out with until you determine what volume is best for you.
1cc per lip. This will normally produce a more dramatic look. Conservative patients should not start out with 1cc per lip-it may be too much.
1.5 cc per lip. This will provide a dramatic enlargement of the entire lip. With this amount both the central lip and corners of the mouth can be enlarged.
Should I augment the corners of the mouth or just the center of the lips?
It depends. This stuff is expensive. Therefore, if money is a concern your best result would
be to do mainly the central portion. The central portion provides the most dramatic effect. Augmenting the corners, however, provides a great look as well. If you do 1cc per lip then you usually have enough to do the corners as well. Some people who want a dramatic look for both the central lip and the corner of the mouth ask for 1 to 1.5cc per lip.
|
| Should I augment the lip border (vermillion border)? |
Most people do not. If you have it done, make sure it is by an experienced physician. If it is placed too high above the lip border it does not look good. Dr. Cruise likes Cosmoderm® to highlight the lip border. Cosmoderm® can be placed very accurately and defines the lip roll very nicely. Cosmoderm®, however, does not last as long as Restylane® or Captique®. It lasts about 2-3 months. |
|
| |
|
Do I need local anesthesia to have my lips enlarged?
No. Dr. Cruise, however, prefers to numb his patients but many physicians do not.
When can I go out in public after lip augmentation?
Often, people will go back to work the next day without a problem. However, it takes a day or two for the swelling to go down. So, if you are very concerned and do not want to be obvious, give yourself about 2-3 days out of the public eye.
What about fat to enlarge the lips?
The major advantage of fat is that it is permanent. The problem is that it does not survive predictably within the lips because the lips move so much. This can leave lumpiness. Another disadvantage is that it creates serious swelling that takes about 3 weeks to go away. For these reasons it is not used often for lip augmentation.
What about the other fillers such as Radiesse® and Sculptra®?
Both Radiesse® and Sculptra® are relatively new fillers that show promise of having greater longevity than hyaluronic acid. Currently, they are not approved by the FDA for facial soft tissue filling but are being used world wide for this purpose.
Radiesse® is made of very tiny, smooth calcium hydroxylapatite micro spheres. When injected into the body the micro spheres form a scaffold into which collagen grows. The results may last greater than a year. The feel, however, can be firmer than what a lip normally feels.
Sculptra® ia a poly-L-lactic acid. It is a compound that has been used in surgery for many years and has been shown to be safe. It requires a series of injections usually 6 weeks apart. It actually degrades but the dermis has been shown to thicken after it is degraded. Time will tell how effective it is as a soft tissue filler but is not a good option for lip augmentation.
|
|
|
 Dr. Cruise's philosophy regarding Lip Augmentation
 The lip is a unique body part. First of all, because it is in the center of the face it is highly visible. Its unique qualities stem from its dual function. More so than any other part of the face, It had both a functional role as well as a sensual role. Recently, the plump, pouty lip has become very popular because it exudes both youth and sensuality.
I find lip augmentation very satisfying as the results are quite predictable and can be adjusted to the patient's satisfaction. In addition, the down time and cost are less than other plastic surgery procedures making it available to just about anyone who wishes to have it.
The typical patient who desires lip augmentation already knows a fair amount about the procedure. They often have friends, or family members who have had it. The most important information I need to know is how dramatic of a look they desire. This dictates the amount I inject. In addition, it is important to know if the patient wants the corners augmented as well. This will require a little more Restylane®/Captique®.
I like to numb the lips prior to injecting so that the patient does not experience discomfort. Also, this allows me to place the Restylane®/Captique® more accurately.
I place the Restylane®/Captique® at the junction of the wet and dry vermillion. This part of the lip expands better than the other areas and provides the most natural yet dramatic look.
Afterward, patients leave the office immediately. Some go back to work. Others, who are very concerned about the swelling do not go out in the public until the next day.
Once again, what I like most about lip augmentation is its versatility and very short down time. Patients who just start off are usually best served by injecting 3/4 cc into each lip. This is a good starting point.
Some of my patients want a more defined lip border. For these patients, I use Cosmoderm® to plump up the borders. Cosmoderm® is the best at defining borders and getting rid of fine wrinkles around the lip. The only down side is that it lasts 2-3 months. The most long term improvement of fine wrinkles around the mouth is dermabrasion. By this, I mean dermabrasion; not micro-dermabrasion. This, however, has more down time.
I hope you find this information helpful.
Dr. Cruise
Benefits
The benefits of full, pouty lips are
obvious. They represent sensuality and attractiveness. Also,
the fuller lips represent youth and as we age our lips become
thinner. Lip augmentation, therefore, creates not only a
more attractive but also more youthful appearance. Some of
the benefits of lip augmentation are outlined below:
- Creates
fuller and Poutier lips.
- Rejuvenates thin and old appearing
lips back to where they were during youth and maybe even
a little bit fuller.
- The procedure is predictable and can
be adjusted easily.
- The procedure is relatively quick
and low-cost.
- It has no or very little downtime.
- It also improves wrinkles and age
lines around the mouth.
Possible complications
Lip augmentation complications are rare in Dr. Cruise's hands but they must be discussed. The most common complication is that the results diminish over time. This is not really a complication as it should be expected. Other possible complications are inadequate volume, lumpiness. Very rare complications include infection and wound healing problems, asymmetry, and allergic reaction.
Are
you a good candidate?
Good candidates
for lip augmentation are simply people who desire fuller,
Poutier lips. There are 2 categories of people that qualify
as good candidates for lip augmentation. The first type is
the person who was born with essentially normal lips but would
like to have them larger to create a more sensual and attractive
appearance. This is an excellent indication to have the procedure
done as it does provide a very predictable way of achieving
this.
The second type of person is the somewhat
older person who has noticed that her lips have thinned over
time. It also has become more noticeable that the distance
between the bottom of her nose and the upper lip may have
lengthened. This all contributes to a more aged appearance. This is another good indication for lip augmentation. Lip augmentation will correct, or at least improve, many of
the characteristics of the aging lip. Not only will it provide
a fuller and more sensual lip, but it will go a long way to
reducing the fine wrinkles around the mouth.
Prior to Injection
The nice thing about lip augmentation is that it can be done on almost anyone. Dr. Cruise, however, discourages taking aspirin within 1 week of the treatment.
Anesthesia
Lip augmentation is typically done under
local anesthesia or no anesthesia at all.
After
the procedure
Immediately. Right after the procedure you will notice a big improvement
within your lips. In fact, you will be able to look at yourself in the mirror to determine
if the desired augmentation has been achieved. Ice will be
applied to your lips to minimize swelling. Most people get
up immediately and are able to drive themselves home or back
to work. Anyone who looks at you will know that something
is different but may or may not be able to pinpoint exactly
what it is. If local anesthetic is used your lips will be numb for about 2 hours.
That evening. There are no specific recommendations except that it is a
good idea to sleep that evening with your had elevated to
minimize swelling. Do not touch your lips too much.
First
48 hours. There will not be that much swelling but
the little you have will resolve within 2 or 3 days.
Recovery
time
With Restylane® or Captique®, you are able
to go back to work almost immediately. If you do not want anyone to see the swelling then it is best to wait 24-48 hours. It is best to have the lip augmentation done a week or two before a big event such as a wedding or party, simply because you may bruise.
|
Join Our Resources Exchange 
