Overview of Lip Implants
Having full lips is often seen as a sign of youth and attractiveness. As we age, our lips can naturally become thinner. This is where lip augmentation, or lip enhancement, comes into play. Lip augmentation is a procedure that enhances the appearance of the lips by increasing their fullness, softening wrinkles and lines around the mouth, and making the lips look more proportional to the rest of the face. The best lip augmentation procedure should look and feel natural, be reversible or replaceable, easily adjustable, and have a low risk of complications.
There are many ways to augment or enhance the lips. Some methods don’t involve injections or fillers, like a lip lift or advancing the inside layer of the lip. Other methods involve fillers, like injecting substances into the lips, using fat from another part of the body, or inserting implants. Nowadays, hyaluronic acid, a substance naturally found in the body, is often injected into the lips to increase their fullness.
However, another technique is getting a lip implant, which uses artificial implants. This method is cost-effective compared to constantly getting injectable filler treatments. It also offers long-term results and can improve the aesthetic look of the lips with few complications. This discussion will focus on lip augmentation using these permanent artificial implants.
Anatomy and Physiology of Lip Implants
The lips can be divided into two components, which have historically been referred to as the “red” and “white” parts. The “red” part of the lip is actually the wet and dry areas of the lip, which can vary in color depending on a person’s genetic makeup. The “white” part of the lip refers to the skin-covered part of the lip, which again can vary in color.
The line where the “red” and “white” parts of the lip meet is known as the vermilion border. The “red” lip portion itself is further split into a dry part, which is visible when the mouth is closed, and a wet part, which is inside the mouth. The upper lip has a central dipping area known as the philtrum, surrounded by two ridges and the edge of the “white” lip.
A muscle around the mouth, known as the orbicularis oris, helps keep the mouth closed. It attaches to parts of the upper lip and contracts to tighten the lip. As we age, the skin on the lip can become looser, which can cause the lip to lengthen and appear flatter. This can also lead to less prominence of the red part of the lip.
On the other hand, the aging process often doesn’t affect the lower lip to the same extent, and it typically doesn’t thin out as much over time. Enhancing the volume of the lip can help restore a more youthful, fuller look.
Why do People Need Lip Implants
Lip augmentation is a cosmetic procedure that is commonly sought by people who have naturally thin lips or whose lips have become thinner due to aging. To make the lips look fuller, a substance like hyaluronic acid can be injected into the lips. However, this method is temporary and needs multiple injections over time to maintain the full look. Therefore, individuals who are afraid of needles or who are searching for a long-lasting and cost-effective alternative might prefer what is known as a lip implant using an alloplastic implant.
Lip implants can address different issues like:
* Reduced fullness or height of the colored part of the lip (vermilion)
* Reduced pout, which refers to the lips not covering the teeth when relaxed
* Lines or wrinkles around the mouth
* Reduced volume due to loss of fat and muscle
* Too much visibility of the teeth when the face is relaxed
While lip augmentation can improve the appearance of the lips, it’s crucial not to go overboard. Overly augmented lips—often referred to as “duck” or “sausage” lips—can look unnatural. Here are some tips to ensure a desirable appearance:
* The overall surface area of the lips should ideally increase about 50% from their original size. The lips should cover about 10% of the lower third of your face.
* The height of your lips when viewed from the front should obey a specific ratio: the lower lip should be between 1.6 times and twice as tall as the upper lip.
* The front-to-back projection of the lips when viewed from the side should observe a certain measure: the upper lip should jut out 3.5mm beyond the line from the base of your nose to your chin, with the lower lip 2.2mm out, or approximately a 1.6:1 ratio.
* The width of the lips should be about 40% of the width of the lower face.
When a Person Should Avoid Lip Implants
Lip implants can enhance your lips, but they won’t correct uneven lips that already exist. In such cases, hyaluronic acid fillers are a better choice. Also, people with very thin lips might find lip implants unsuitable. This is because thin lips might not have enough tissue to sit the smallest implants.
For people with thin lips, there is a risk where the implant can become visible as it may stretch the inner lip lining. This may increase the risk of implant coming out or causing infection after the operation. If you have lips that are particularly long and thin, and you want lip augmentation with implants, the doctor will first perform a lip lift or advance the inner lip lining. This procedure will usually happen 3 to 6 months before the lip implant operation.
Equipment used for Lip Implants
For certain types of plastic surgery, the doctor typically uses a specific set of tools and materials. These might include a marking pen to guide the surgery, a paper ruler for accurate measurements, a precise blade and small scissors for cutting, a device called a tendon passer, forceps for gripping, and special threads (sutures) made of absorbable materials, such as “Chromic” or “Vicryl”.
Sometimes a surgery might involve inserting an implant. These could be natural, made from the patient’s own tissues (autogenous), or man-made (alloplastic). The most appropriate option depends a lot on the person being treated and what the surgeon thinks is best.
Natural implants can be made of extra body fat, usually taken from the face, neck, or body during the same surgery. The fat is placed using a technique similar to applying filler substances, using an injection or thin tubular instrument (cannula). However, using fat can sometimes cause prolonged swelling, unevenness and a lumpy appearance, because it’s often absorbed unpredictably, especially in areas of the face that move a lot, like the lips.
Other types of natural implants include tissues harvested from specific areas of the body. This might be the superficial musculoaponeurotic system (SMAS), which is a layer of tissue covering and connecting the facial muscles and is usually taken during a facelift operation. The postauricular fascia is another option, which is a tissue layer from a muscle in the temples. Lastly, surplus scar tissue can be used if available, often taken from previous facelift or neck lift surgeries.
Man-made implants can include an assortment of materials, such as extended polytetrafluoroethylene or silicone. The silicone implants come in different sizes and lengths, with the 4mm wide prosthesis being the go-to choice for most doctors.
To enhance the aesthetic results and reduce complications, the surgeon will carefully choose the correct implant size. They will use a flexible ruler, such as a paper one, to measure the length of the lip’s border where it transitions from the moist inner part to the outer dry area. This is done from one corner of the mouth to the other, with the lips slightly apart. It’s important not to measure with the mouth wide open though. The ideal implant length should be a few millimeters less than this measured distance. Because the upper lip has a different curve compared to the lower lip, it’s not uncommon for the implant sizes to vary between the two.
Who is needed to perform Lip Implants?
While it’s not always required, having help during surgery can be beneficial. This helper is often a type of surgical assistant known as a ‘surgical scrub technician’. These assistants are trained to hand the correct tools to the surgeon during the operation. They can also assist by moving or holding tissue out of the way (this is called ‘retraction’) if the surgeon needs it.
Preparing for Lip Implants
Before a cosmetic procedure, patients are usually asked to stop smoking and avoid any medicines that make the blood thinner about 1 to 2 weeks before the procedure. Some doctors may also ask patients to take antiviral medicine starting from the day before the procedure and continuing it for ten days after it. This helps in avoiding any herpes-related skin eruptions, especially in those patients who have had a history of zoster, also known as shingles.
The first step the doctor will do is to measure your lip. This is important to decide the proper size of the implant. They will measure from one corner of your mouth to the other along the line where the wet inner part and the dry outer part of your lip meet. If the implant is too short, it may not reach the corner of your lips, which will be noticeable.
Usually, lip implantation can be done under general anesthesia, but many doctors prefer to use a local anesthesia. This is a type of anesthesia that is applied only to a specific area of your body, in this case, the lip area. They start by giving a regional block to dull the nerves in the lower face. This is done by injecting a numbing solution. The same solution is also used to numb each corner of your mouth. Then, the doctor will inject an anesthetic into the deep inner lining of the lips along the previously marked line, but they will be careful not to go too deep in order to avoid the muscle that controls the movement of the lips.
How is Lip Implants performed
We’re discussing a procedure for lip surgery, using a type of artificial lip implant. This procedure is an efficient and simple process, with little to no downtime. It’s well received, safe, and produces natural-looking and feeling lip results.
Once everything is clean and sterile, the surgeon will make small cuts of about 4 to 5 mm near the corners of your mouth using a sharp knife. By preventing the cuts from drifting towards the middle, the corners of your mouth will maintain a natural look. Then they will use small straight scissors to create a uniform pocket under the skin in your lip. This pocket goes from the corners of your mouth towards the middle of your mouth. It’s vital to create this pocket at a consistent depth along your lip to have an even appearance. If the pocket is too close to the surface, the ends of the implant may become visible, which doesn’t look natural.
Once the pocket is created, a special tool called a tendon passer is used to guide the implant from one end of the pocket to the other. The implant is then passed through the pocket until both ends are sticking out. The implant is then adjusted or “flossed” from side to side until equal lengths of the implant stick out on either side of your mouth. This ensures a uniform and balanced appearance in the lips. Some experts recommend using shorter implants that don’t extend the whole width of your lips to stop migration (meaning, the implant moving from its place).
The ends of the implant are then embedded under the tiny cuts at the corners of your mouth. If the surgeon is also giving you lower lip implants, they will do the same thing, using the same cuts. Once the implants are in place, the surgeon will use dissolvable stitches (either chromic gut or Vicryl) to close the cuts. These stitches dissolve on their own, so you won’t need to get them removed later. To prevent the implant from slipping or moving (migration), deep layers of skin and muscle tissue are sewn in with each stitch.
Please note, the technique mentioned here is suitable for both types of implants, artificial and autogenous (made from your own tissue).
Possible Complications of Lip Implants
Getting lip implants is a popular and long-lasting way to enhance the appearance of your lips. Patients are generally pleased with the results, but there are a few risks they should be aware of before undergoing this procedure.
The most common issue following a lip implant surgery, affecting 7 to 10% of patients, is called ‘malposition’. This occurs when the implant isn’t located properly within the lip, usually due to uneven placement or surgical tunneling.
In less than one percent of surgeries, the implant may even push through the skin, a complication known as ‘extrusion’. This can happen if the implant is too big, if the wrong surgical techniques are used, or if the patient doesn’t rest their mouth enough in the days after surgery.
Some patients might need revision surgery or size adjustments of the implant, and this happens in about 1 to 10% of cases.
A particular type of implant, expanded polytetrafluoroethylene, is noted to have a chance of shrinking and changing shape over time, leading to an irregular lip contour. Because of this, they are less popular.
Infections are rare, occurring in less than 1% of surgeries. They can usually be treated with antibiotics, but the implant might need to be removed if the infection gets severe.
Sadly, approximately 1% of patients are unsatisfied with their lip implants and 4% end up needing theirs removed due to dissatisfaction.
Many patients will experience swelling and bruising after surgery, but these side effects typically go away within one to two weeks.
So, before deciding to get a lip implant, it is important to consider and discuss these risks and requirements with your doctor.
What Else Should I Know About Lip Implants?
Getting a lip implant is a fast, safe, affordable, and low-risk choice for anyone looking to enhance small or thin lips. When done by a skilled and experienced surgeon, the results can be impressive and long-lasting, leaving people very satisfied with how their lips look.
