LIPS, BOTOX AND FILLERS

There are many procedures available to enhance the lips, which usually means that no single method is ideal. Broadly, these procedures involve removing skin, unrolling muscosa, or adding something to the lip.

In our practice, we have chosen injectable fillers (e.g., Restylane) as our procedure of choice for most lip enhancements. Because of its simplicity and versatility, the injection is performed as an office procedure and portions of the lip may be selectively enhanced depending on patient desires. There are limitations; however, and these should be carefully understood before undertaking lip enhancement.

BOTOX

Our most popular procedure, Botox is a temporary muscle paralyzing agent that allows selective improvement in dynamic (moving) facial expression lines. It doesn’t make resting lines go away; resting lines may require a filler.

Botox is a protein derived from a bacterium and is administered with a tiny needle directly into the muscle that requires treatment. It typically lasts three or four months, but with repeated use sometimes last longer.

DERMAL FILLERS 

Many fillers are currently available and more are on the horizon. The original fillers were Zyderm and Zyplast, collagen products derived from cowhide. Collagen typically lasts for 3 months. Because the protein in cow collagen is slightly different from human collagen, some may be allergic so testing is required prior to treatment. Recently, Cosmoderm and Cosmoplast were released. They are both human collagen and therefore do not require skin testing.

In 2003, Restylane, a hyaluronic acid derived from bacteria, became available in the United States. With a duration of about twice that of collagen, this product has soared in popularity and is now the most common filler used. Its use has expanded beyond the original FDA approved use (treating the nasolabial folds) to lip augmentation, tear troughs, the brow and the pre-jowl areas. Because hyaluronic acid is identical across species, testing is not necessary. Perlane, a sister product to Restylane, was FDA approved in May of this year. Its larger particle size allows for more robust augmentations.

In 2006, the FDA approved three other fillers which we currently use: Juvederm, Radiesse and Sculptra. Juvederm is another hyaluronic acid product derived from bacteria, much like Restylane. Its duration is similar to Restylane. Radiesse is a suspension of bone mineral. Radiesse may last a year or more. Sculptra is polylactic acid, a biodegradable polymer that stimulates the production of collagen. The filling effect of this product is not immediate, but it may last up to two years.

All fillers are administered in the office either with topical anesthesia or with an injectable anesthesia.