With age, volume loss occurs in not only face and hands but also the lips. The upper lip lengthens with a drooping of the cupid’s bow. The lips loose volume and become more flattened. This causes the mouth to appear wider and the corners of the mouth droop.
Here’s how it looks:
Filling of the lips is an artform. Too much in the wrong place and one can look ducky. But placed correctly, it gives an instant facelift, giving a younger youthful appearance immediately.
Besides adding volume to the red part of the lip, the upper lip skin needs to be addressed first, as this is where the lift comes from. The lengthening of the upper lip has to be shortened, the cupid’s bow has to be restored and the philtrum rebuilt. After this, the red of the lip can be slightly inflated. It is natural for the upper lip to project slightly beyond the lower lip. The lower lip needs equal attention to match the upper.
Fillers such as Juvederm UltraPlus XC, Restylane, Perlane and Voluma are great choices for lips. They are made of hyaluronic acid (sugar polymer) which is naturally occurring in our skin and is hydrophilic (attracts water). This gives a good plumpness and longevity of at least 1-2 years. We have found that lip fillers tend to hold much longer than fillers applied to other parts of the face. The same is true for under eye fillers, which also tend to last longer than injections elsewhere on the face.
Treatment is performed with a tiny needle. A nerve block or topical numbing can be applied ahead of time. However, I find this is usually not necessary. Many patients don’t like the numb feeling that can persist after a nerve block for a few hours. Topical numbing is not overly effective. Recently a patient who had filler by another physician insisted on topical numbing cream. I told her to try without, and she actually found it less painful with my technique. And, of course, she loved the results! The products we use all have local anesthetic mixed into the formula, providing increased comfort for the patients.
There will be some immediate swelling and possible bruising. This can be minimized by icing afterwards, taking arnica montana tablets, and avoiding aspirin, ibuprofen, fish oil, and garlic supplements prior to the procedure. Most patients, however, love the swollen appearance, and wish it would stay just so! After a few days to a week, the swelling will settle down, revealing new plump lips. If more volume is desired, it can always be added in at this point. I recommend starting with a minimal amount and building up gradually to the final desired appearance. Each patient’s desires and end goals are different and being in tune with that goal is extremely important to achieving the right result for each patient. It is truly one of the most enjoyable and rewarding aspects of my work.