Full lips give the face a youthful and sensual appearance. Through injections or surgical procedures for lip correction, the lips are sculpted, get more volume and smaller wrinkles are smoothed. Narrow lips or lips framed by wrinkles make a face look austere and do not correspond to our ideal of beauty. Here, volume building measures can help to harmonize the facial features. Conversely, lips that appear too bulging can be reduced by surgical measures.
Indications (areas of application)
- Harmonization of facial features
Contraindications
- General medical findings that prohibit a surgical procedure.
- Growth not completed (childhood and adolescence).
Before the procedures
In a detailed educational interview, the various procedures and the associated risks are explained. In particular, the possibility of visible scarring after a surgical procedure is pointed out. A facial analysis contributes to the decision for a specific procedure, as does an allergy test, which is indicated when certain materials are used, such as collagen as a filling fluid. Furthermore, you should not take acetylsalicylic acid (ASA), sleeping pills or alcohol for a period of seven to ten days before the procedure. Both acetylsalicylic acid and other painkillers delay blood clotting and can lead to unwanted bleeding.Smokers should severely limit their nicotine consumption as early as four weeks before the procedure to avoid jeopardizing wound healing.
The procedures
Depending on the severity of the procedure, lip correction surgery is performed under local anesthesia (local anesthesia) or general anesthesia.
I. Injection with collagen foreign to the body
Collagen is a component of animal connective tissue. Specially prepared bovine collagen is used for injections. The manufacturing technique is intended to minimize allergic reactions. Nevertheless, allergy testing is indicated four weeks before the planned procedure. To add volume to the lips, the collagen is injected directly with a fine cannula under local anesthesia. Since the collagen is gradually broken down by the body, the success of the treatment is limited to about one year. After that, the procedure can be repeated at any time.
Possible complications
- Allergic reactions
- After bovine collagen implantation, patients are more likely than the average population to develop collagenoses such as dermatomyositis or polymyositis. Disease symptoms develop up to 24 months after the procedure. The disease course is similar to that of a progressive autoimmune disease. The risk-benefit ratio thus appears questionable.
- Necrosis (demise of tissue) – especially with poor circulation, e.g., in smokers.
II. injection with autologous fat
To avoid reactions to tissue foreign to the body, volume building of the lips can be done with autologous fat. For this purpose, liposuction is first performed on a suitable part of the body, such as the hips or abdomen: under local anesthesia, autologous fat is aspirated and specially prepared before further treatment. The FAMI technique (facial autocraft muscle injection, non-invasive reconstructive autologous fat implantation technique) has proven successful for injecting (inserting) the fat. Unlike classic lipofilling (autologous fat filling), which uses sharp cannulas, the FAMI technique uses blunt cannulas with side openings and inserts them deep into the tissue. For better distribution of the filling material, the tissue at the injection site is loosened with the help of the blunt cannulas. In this way, the fat is incorporated into the tissue compound of the cells and the connective tissue is induced to form collagen fibers, which means that the treatment result remains stable over a longer period of time. Own fat is used to model the lip contour and intensify the lip red. The duration of the treatment success cannot be predicted. It is possible to repeat the treatment at any time.
After the procedure
In addition to limiting facial expressions during the postoperative week, patients should avoid physically strenuous activities, sunbathing, etc. for up to four weeks.
Possible complications
- Swelling
- Hematomas (bruises)
- Inflammations
- Erysipelas (acute skin infection often accompanied by fever and chills).
- Sensory disturbances
- Slippage of the fat pad when the facial muscles move too violently in the days following the procedure
III. injection with hyaluronic acid
Injection of hyaluronic acid, a polysaccharide and natural component of connective tissue, has been equally successful. It is both derived from animal tissue and produced synthetically (NASHA gel: non-animal stabilized hyaluronic acid), virtually eliminating allergic reactions. Hyaluronic acid serves as a moisture reservoir, allowing the skin to build up more volume. With hyaluronic acid, wrinkles can be smoothed out and more volume can also be added to the red of the lips. The procedure takes only a few minutes. The success of injections, which are performed under local anesthesia, lasts for about half a year, because hyaluronic acid is gradually broken down by the body. However, about 20% of the gained volume is retained as additional connective tissue is newly formed.
After the procedure
After the treatment, strong heat exposure should be avoided for a few days (sauna, sunbathing).
Possible complications
Hyaluronic acid treatment is considered a very well-tolerated procedure. Nevertheless, the following complications may occur:
- Redness
- Swellings
- Hematomas (bruises)
- Infection (inflammation)
- Hypersensitivity reactions (very rare).
- Up to months delayed onset nodule formation.
IV. Injection with poly-L-lactic acid
Poly-L-lactic acid (synonym: polylactic acid; English : polylactic acid, short: PLA) is produced synthetically and is biocompatible. A prior allergy test is not required. The filling procedure is also known as Liquid Lift/-ing. Like the first three filling materials mentioned, polylactic acid (Sculptra) is gradually broken down after injection, but stimulates the production of connective tissue and regeneration of collagen fibers, leading to volume increase. Injections are performed at a maximum of three appointments of about half an hour each, at intervals of four to six weeks each, to wait for connective tissue regeneration in the intervals. Treatment success is expected to last up to two years.
After the procedure
- Cool for the first 24 hours to reduce swelling.
- Massage the treated areas several times a day for the first few days
- Avoid sunlight and artificial UV light
Possible complications
- Redness
- Swellings
- Infections
- Nodule formation
V. Injection with silicone oil
A responsible surgeon will strongly advise against liquid silicone as a filling substance. Firstly, it does not remain stationary at the injection site, but migrates uncontrollably into deeper skin layers and causes inflammatory hardening, and secondly, it can no longer be surgically removed. Silicone oil is therefore prohibited as a filling fluid.
VI. implantation of contour sutures
Implantation of a contour thread made of polytetrafluoroethylene (GoreTex, SoftForm) leads to a permanent treatment result because the material is not degraded by the body. Conversely, the contour thread can be removed at any time.
Indications (areas of application)
- Permanent lip augmentation by contouring the lip-red-lip-white border.
- Bypassing materials for injections
- Bypassing surgical lip augmentation
The procedure
A very small incision is made at the sides of each corner of the mouth, and a tubular contour thread is tunnelled under the deepest layer of skin at the border of the red and white of the lips. The incisions are supplied with fine sutures.
After the procedure
Mimic movements must be restricted for a few days. Suture removal can be done after about five days. Sports activities, sunbathing, etc. can be resumed after ten days.
Possible complications
- Severe swelling for up to one week
- Hematoma (bruise)
- Infection (inflammation)
- Fistula formation
- Formation of wound secretions (wound water)
- Hardening – The contour threads are enclosed by a connective tissue capsule. In a few cases, the material is palpable and palpable after healing.The initial hardening may recede after several weeks.
- Wound healing disorders with the need for implant removal.
- Insufficient or excessive volume buildup
- Rare: Hypersensitivity reactions to the implant material.
VII Surgical lip augmentation
The procedure
The incision is made along the red of the lip. A second incision is made parallel to it at a distance of a few millimeters, depending on the desired surgical result. The intervening area of skin is removed, and the edges of the wound are joined together in a concealed manner using the finest suturing technique. In this way, the red of the lips is puckered outward and visually widened. The method demands a perfect suturing technique from the surgeon, as scars along the upper lip are very noticeable.
After the procedure
During the healing period, which lasts about ten days, facial expressions should be restricted. If a visible scar remains after the healing phase, concealment with permanent makeup by an experienced professional cosmetician provides good results.
VIII. Sclera grafting
This method is suitable for lengthening lips that appear shortened. For this purpose, autologous skin must be harvested from a site that largely matches the color and texture of the facial skin surrounding the lips. Through small incisions (cuts) in the corners of the mouth, the transplanted skin is inserted to achieve an aesthetically pleasing result.
After the procedure
One week after surgery, the sutures are removed and follow-up or follow-up appointments are scheduled.
Possible complications
- Inflammation of the surgical area
- Allergic reaction to injection fluids
- Permanent numbness
- Scarring
- Swelling and redness
