Leading dermatologist discusses various methods for plumping, shaping and reducing wrinkles and lines

New York, NY , April 2008 – Lip augmentation and other procedures to improve the appearance of the lips are not just the province of celebrities anymore. According to the American Society for Aesthetic Plastic Surgery, more than 8,700 surgical lip augmentation procedures were performed last year alone, and the American Society of Plastic Surgeons reports that lip-related injectible procedures have risen steadily in recent years. So, too, has the availability of countless injectible fillers and other methods for achieving the ideal lip look, leaving many patients wondering which process is right for them.

“Interest in lip augmentation has burgeoned in recent years, largely because the procedure creates a very dramatic and pleasing result quickly and safely,” says Joshua Fox, MD, founder of Advanced Dermatology and a spokesman for the American Academy of Dermatology. “The variety of fillers and other methods available to plump and shape lips, as well as to reduce the appearance of lines, folds and wrinkles around the mouth, each have specific benefits and purposes that can be tailored to the needs of individual patients,” he explains.

Where injectible Fillers are Most Popular Choice for Lip Augmentation

Dr. Fox notes that most lip augmentation procedures involve injectible fillers, because of their versatility in correcting fine lines, moderate wrinkles and deep folds around the mouth, as well as loss of fullness or definition in the lips themselves. The fillers can also recreate the lip line which helps prevent lipstick from “bleeding”. Certain patients like different shapes of lips. I usually ask patients to bring in a picture of someone’s lips that they like. We have tremendous flexibility in shaping various aspects of the lips. The corners of the lips are also revealing. If as you age the corners of the lip may curve down – people think of you as sad or tired. We can push the lip corners up – which people associate with happiness.

“Injectible fillers can be broken down into three different types, and determining which type is appropriate varies based on patient needs and the goals of each individual procedure,” he adds.

  1. COLLAGEN FILLERS use the body’s natural support structure to plump fine lines or moderate wrinkles, and to redefine the border of the lip, counteracting the signs of aging around the lips. There are two types of collagen replacement therapy: human collagen (CosmoDerm, CosmoPlast) and bovine collagen (ZyDerm & ZyPlast). “CosmoDerm and CosmoPlast are the only FDA-approved human collagen replacement products available, for which there is no skin test required,” Dr. Fox notes. Bovine collagen treatment, which is both safe and effective, requires one or two four-week skin allergy test prior to the initial procedure, since a small percentage of patients have a negative reaction to the bovine collagen and need to be treated with another method. Collagen replacement therapy commonly lasts for about three months before needing to be augmented.
  2. HYALURONIC ACIDS, a more recent addition than collagen, are also made from a naturally-occurring substance in the body that acts as a lubricating and cushioning agent. Different types of hyaluronic acid fillers are available, depending on the treatment goals. For instance, Captique, Hylaform and Hylaform Plus are the older less effective treatments for deeper wrinkles around the lips and mouth, such as the smile lines between the nose and mouth (nasolabial folds) and the “marionette” lines at the corners of the mouth. Captique is also sometimes used in conjunction with ZyPlast collagen replacement therapy to extend the lifespan of treatment. Juvederm, Juvederm Plus and Perlanenow as the newest hyaluronic acid treatments. Restylane and Juvederm are best for the bleeding lip lines and for filling of the lip, while Parlane and Juvederm Plus are thicker hyaluronic acids, lasting longer and serve as better support for nasolabial folds and holding up the lip corners.  Since Restylane and Perlane are non-animal based hyaluronic acids they may be more appropriate for patients with sensitive skin. In addition, they can be used to plump the body of the lips. Hyaluronic acid procedures tend to last longer than collagen, for three to six months even up to a year.
  3. SYNTHETIC FILLERS offer less of a risk of allergic reaction. Radiesse is a filler made of calcium hydroxylapetite, a thicker substance which will show up on x-rays, it is best for the nasolabial folds to the sides of the lips. It can last up for 9 months to 2 years with dramatic natural results. It is slightly more painful than the hyaluronic acids with more temporary bruising. Radiesse is not usually used for plumping lip tissue, however, as it has been shown in rare instances to separate or clump. “The hyaluronic acids provide the most natural appearance for the interior of the lip,” Dr. Fox confirms.

In addition to fillers, Dr. Fox notes that other procedures can also improve the appearance of the lip area. “Some laser-based approaches, such as Thermage, Fraxel or Erbium Lasers can stimulate natural collagen production in the treated areas, leading to the plumping of fine lines and lessening wrinkles around the mouth,” he notes. In addition, surgical implants are available for patients whose lip area requires a more dramatic approach. FulFil, for example, is a saline-based implant – similar to breast implants, but on a smaller scale – that is expected to gain FDA approval soon. This procedure would usually be performed by plastic surgeons.

“As with many aesthetic procedures, lip augmentation is a fairly simple procedure, yet preparing for it and choosing the right approach for each patient is crucial to its success and to the patient’s health, safety and satisfaction,” Dr. Fox concludes. Dr. Fox notes that he had a case recently where a patient put permanent filler in the lips and the lips have become uneven. This may now require surgery to fix. He does not recommend putting permanent or long term fillers in the lips such as artecoll, silicone or sculptra. He adds, “it’s critical that patients see board-certified dermatologists to discuss the variety of options available, and to choose the one that is right for them.”

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