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Most people don’t have naturally beautiful lips. Those that do usually need some help as time goes on. In our thirties, our lips begin to age. Our lips are mucus membranes. The mucus membrane covers a muscle that is surrounded by the vermilion border. When you are young, the vermilion border and the outside surrounding area is full because of fat. When we get older the fat and muscle atrophy. That’s one of the reasons why we see those little vertical lines, which is why your lipstick begins to bleed. Also as we age, the corners of our mouth begin to droop and the cupid's bow, which is the V-shaped area of the lip, begins to flatten out. The upper lip elongates and the lower lip drops. Thanks to today's many medical advances there is help for lip rejuvenation and enhancement. There are many options available for lip enhancement, which include injectable fillers, lip implants and surgery.

Injectable fillers range from temporary to permanent. Temporary fillers are products that usually last anywhere from a few weeks to 9 months; possibly longer depending on the individual, product and injector. However, there are newer products that may last up to 2 to 6 years after injection. They come from animal sources, donated human sources (yours or someone else's), or are completely synthetic.

Today our FDA approved temporary injectable fillers include Zyderm® and Zyplast® bovine collagen, CosmoDerm™ and CosmoPlast™ human collagen, Fascian and an injectable AlloDerm®, called Cymetra®. It used to be that bovine collagen injections were the only option that people had to enhance their lips. There are some people who are allergic to bovine collagen, therefore if you decide to use bovine collagen, it’s very important to get two skin tests one month apart to make sure that you are not allergic to it.

On the down side, these injectables are not permanent, so you will probably need touch-ups. However, if you don’t like the look, you only have up to a few months to wait it out. If you live in Canada, Australia or Europe, you have access to hyaluronic acid products such as Restylane, Hylaform or Perlane. These injectables are made from hyaluronic acid, a sugar-based gel, which is naturally present in the skin and joints of all living organisms. In some people the results can last a few months longer than collagen; in others the results are about the same as collagen. Since this substance is naturally occurring a skin test is not required. On December 12, 2003, the Food and Drug Administration (FDA) approved the wrinkle filler Restylane. In April of 2004, the FDA granted market approval for Hylaform.

Radiance is a long-lasting soft tissue filler that lasts up to 3 to 5 years and is currently FDA approved to treat human vocal cord paralysis only and is in the investigational stages for cosmetic use in the US. Radiance consists of calcium hydroxiapatite (CaHA), a primary component of teeth and bones. This injectable does not require skin testing, however there have been some reports of lumping in the lips.

There are probably 25 different types of permanent injectable fillers. These injectable fillers work by stimulating collagen around the filler,  which acts to plump up the area that is injected. This may sound like a wonderful idea for plumping up lips however there are permanent risks involved. Lumpiness, firmness, inflammation and even migration of the material may occur. The most common permanent injectable fillers today are Artecoll and silicone. FDA approval is pending for Artecoll and silicone is not FDA approved for cosmetic purposes but some physicians are using it off-label for cosmetic soft tissue augmentation.

Fat grafting also known as fat injections involves suctioning small amounts of fat, usually from the abdomen or thighs, processing it in a centrifuge to separate the fat from other substances, and then injecting the fat into the lips. Retention in the lips can range from 0% to 60%. Because of the continued movement of the lips retention in that area is not as high as compared to other parts of the face. There is no chance of an allergy with fat since it comes from your own body.

There are risks with all of these procedures. It is very important that you discuss risks and possible complications with your physician when you go in for your consultation.

In part 2 of this 2-part article, I will discuss the other options for lip enhancement.

Continue to Part 2