Throughout history men and women alike have been attracted to ample, full and pouty lips. Full and defined lips impart a sense of youth, health and beauty. Like many facial features, as the lips age, they become less attractive. The hallmark sign of ageing lip is the volume. As the lips lose volume, they become thin and flat and lose their shape. The lines which result from repeated dynamic movement take permanent residence and the corners of the mouth begin to turn inward, which reduces the width of the mouth.
PATIENT EVALUATION –The general health and medical condition of the patient is evaluated. History of prior lip augmentation (and filler used) is very important. Lip dimension is measured. The expectation of the patient, from the procedure is ascertained. The patient is explained the plan for surgery and the surgeons recommendation. Photographs are important in both pre, per & post operative periods. The patient should not be in medications that interfere with blod clotting. A prior history of labial herpes requires prophylactic coverage with appropriate antiviral medications.
SURGERY PRINCIPLES & TECHNIQUE -- Different materials are used for lip Enhancement Surgery. The Hyaluronic acid products have proved exciting materials which work superbly in soft tissue augmentations. Hyaluronic acid are a naturally occuring polysaccharide found in the dermis and through the cross linkage process, a greater tissue residence time has resulted. Use of Fat for injection is one of the latest advances in field of lip augmentation. Fat has a lot of advantage over other filler material available in the market. As fat is harvested from the patients body, so there is no risk of hypersensitivity reaction. The results of surgery are much more long lasting, than the other fillers available from market. Fat can be easily harvested, from a part of body with surplus fat deposits like abdominal wall & medial thigh under local anaesthesia. Prior to injection in the lips, suitable anaesthesia is adminstered. To place the fat the infiltration cannula is attached to a 1 ml Luer Lok syringe filled with the refined tissue and the fat is distributed into the area as the cannula is withdrawnn. The patient is injected from right to centre and then from left to centre. Fat is grafted in the upper lip to create fullness in the upper lip ; specially to create fullness in the white roll, the central tubercle and the smaller lateral tubercles.The preservation of cupids bow is critical, because it is the defining aesthetic of the upper lip. In the lower lip it is important to emphasize the central cleft, more lateral tubercles, and eversion of the vermillion. Furthermore, the lower lip is injected not as rounded wheel mass, but instead to produce central rollout or pout.
POSTOPERATIVE CARE & COMPLICATIONS -- Lip Surgery is a minimally invasive procedure. Immediately post procedure ice applications are encouraged. Some patient report very slight discomfort post procedure, while other reports no discomfort, so pharmacologic pain management is not compulsory. Patient can return to normal activities post procedure but a rest for couple of days is advisable. But it takes a few weeks for the inflamatory edema and bruising to subside & the result to completely obvious. Complications of procedure rarely include bleeding / haematoma, which can be minimised by use of a blunt cannula. Sometimes placement of too much or too little material, may give rise to disapointment with the procedure.