What Can You Achieve with Lip Augmentation?

Most people are not born with perfect lips. Lips come in a range from paper thin to so puffy that they look too big. The “perfect” lip is in between, and on the side of puffier than not. So, if you get material injected into your lips, it will make the lips look bigger, no doubt about it. However, most patients and most surgeons want a better result than just “bigger”. If “a lot bigger” is all you care about, the ultimate result may be lips that look not just different than normal but frankly unnatural, lips that stick out too far from your face, lips that are so full that the overlying skin is stretched to the point that the natural creases are stretched out, lips that look like tubes of sausage because the natural hills and valleys were not preserved, lips that are not able to move and flex in a natural way because the filling material is so dense that it is too stiff. In my practice, there is no way that I will do that intentionally to a person’s lip…even if they want it.

Let me start by saying that lip augmentation is one of my favorite things. I love lips. I love the complex three-dimensional structure of the natural full lip. A fuller lip is always beautiful in a woman, so if it’s done in a careful and thoughtful way, almost every woman can benefit from some degree of lip augmentation, especially as they age, and the lip becomes thinner. I derive a lot of joy from finding ways to focus my technique so that individual subunits of the lip are preserved and accentuated. That being said, the patient must understand that just because I have a very good understanding of what is needed to produce a beautiful lip, the patient’s ideal lip is NOT always attainable.

The final result is limited by the original lip. Take Angelina Jolie’s lips. Her lips are actually natural. They were big when she was 13. They are supple when she moves them (because they are not stiff from fillers) and they have plenty of skin creases (indicating that they are not stretched from fillers inside). It is impossible to go from paper thin lips to Angelina’s lips (meaning big lips that are supple and look natural). If you inserted enough filler to get them that big, your lips would be stiff and wouldn’t move and the skin would be stretched out and would look like sausages. My point is, it is critical that the patient have realistic expectations.

Furthermore, there are people whose lips are not paper thin, but the various landmarks are not naturally developed enough to easily increase up to the ideal dimension. For instance, in some people, the central tubercle is flatter than ideal which makes the lip look less curvy and straighter. I try to accentuate that central tubercle but sometimes I am not able to produce as much accentuation as I would like to produce a “perfect” result because the lip just won’t play along. But, regardless of the fact that I, as the artistic surgeon, am limited by what your natural lip shape gives me, nearly EVERY single woman (and many men) can benefit from some degree of lip volume augmentation.

Some things to expect if your lips are augmented:

  • The procedure will hurt, as all injections do. Lips are pretty sensitive, and I work hard to try to minimize pain. Pain is temporary and is inevitably worth it in this case.
  • Furthermore, lips SWELL. That’s just what they do. You give them an excuse to swell, and they will. (The same amount of injection into the cheek would not cause nearly as much swelling.) They swell in response to injury, and the injection is technically an injury (needle is going back and forth through the tissue). Now, just realize that this swelling is TEMPORARY. The evening after the injection, the lips are going to look bigger than they did at the time of the injection. The increase in size is not because the filling material multiplied inside you, it’s because your tissues are puffy in response to the injury…just like if you sprained your ankle, your ankle would be bigger 3 hours later compared to right after the injury. This is a temporary event. The typical response is for the patient to panic the night of the injection and then to still be a little freaked out the next day, too. But often by 3-4 days later they are thrilled. 2 weeks later or are wishing that the lips had stayed big because when they got accustomed to the big lips, they came to kind of like it.
  • One final thing to understand about lip augmentation. Lips are flexible and “squishy”. If you take your own lip and pinch it between 2 fingers and roll your fingers back and forth, you’ll realize that the tissue is pretty thin and very soft and pliable. When you put a filler in there, regardless of the type, the filler is an ADDITION. You are ADDING something that did not used to be there. The material does not dissolve or blend in with surrounding tissue immediately. It just sits there taking up space so that the volume of the lip appears bigger to the outside world. After the injection, you are going to be able to FEEL it. After the tissue swelling goes down, you will probably be able to feel lumps or thick spots under your tongue when you rub your tongue back and forth on the inside of the lip. What time, the material does integrate and becomes less noticeable even to you. The goal of augmentation is to impact the APPEARANCE of the lip. I would never want to produce a VISIBLE lump, but the patient has to understand that even though the rest of the world may not be able to see this hard spot, you may be able to feel it when you massage your lip with your tongue or press your lip between your fingers, and that is OK.

Every lip can be augmented to some degree.  And, in my opinion, most women will derive benefit if this is something they chose. In the right hands, there is absolutely no need to fear that you’re going to be stuck with a set of duck bills just because you took the chance to be augmented.

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