Aesthetic procedures on the lips are often seen in a negative light because everyone can think of some extreme cases of very obvious cosmetic surgery. The excessively silicone-injected, caricaturesque, swollen lips or “trout pout” should never be seen. The surgery should always remain natural. These cases come from treatment errors that involve injecting more and more into a lip that tends to droop. The more you inject, the more the lip is weighed down and droops; it’s a vicious circle that can lead to catastrophic morphological results.
There are currently four techniques available to modify the appearance of the lips:
- Absorbable injections of hyaluronic acid (silicone, collagen and other non-absorbable materials are prohibited)
- Lipofilling (autologous fat transfer)
- Silicone implants (permalip)
- The upper lip lift or lip lift
First, let’s look at hyaluronic acid.
Hyaluronic acid is a molecule found naturally in the body. Thanks to its hydration properties, hyaluronic acid preserves the skin’s firmness and elasticity.
Over time, the lips naturally tend to dry out or lose volume which gives them a finer appearance and less definition.
Hyaluronic acid injections helps make your lips plump again by:
- Redrawing the outline of the mouth to enhance the definition and the lip line.
- Redefining the area of the philtrum (Cupid’s bow).
- Increasing the volume of the lips for better symmetry.
- Moisturizing the lips.
A hyaluronic acid injection session can be performed in isolation, but can also complement surgical techniques such as eyelid surgery (upper and / or lower blepharoplasties), a facelift, rhinoplasty etc. It can also be done in parallel with Botox injections aimed at reducing the tone of certain muscles responsible for the appearance of wrinkles or a surface peel with fruit acids.
For all women wishing to combat the effects of aging, hyaluronic acid is the ideal aesthetic product. It is completely biodegradable in the body, acts over a very long period of time and offers immediate results. Demand is increasing year after year. Your specialist cosmetic surgeon, Doctor Vincent Masson will be able to advise you in more detail. In any case, the guiding principle of the treatment is that it must not fall into the caricature of outrageous silicone lips, the “trout pout”.
Before the treatment
During your consultation, Doctor Masson will ask you about your medical history and will carry out a clinical examination in order to assess the areas to be treated and to determine any contraindications.
It is at the end of this examination that your specialized plastic surgeon will be able to communicate the fees applicable to you according to the areas to be treated and the quantity of product required.
You do not need to fast on the day of the injections, however, it is recommended to not drink any alcohol or to expose yourself to the sun in the hours preceding the treatment.
For women, you should plan to come without makeup. Otherwise, it will be removed immediately before the injections.
It is very important to minimize the risk of bleeding from the treated areas by avoiding taking aspirin or anti-inflammatory drugs for the 8 days preceding the injections and the 5 days following them.
For optimal comfort, it is advisable to apply an anesthetic cream (EMLA cream 0.05% sold in pharmacies) 1 hour before the session to the areas to be injected. This white cream quickly penetrates the skin tissue becoming invisible and allows you to receive anesthesia while maintaining your usual activities.
It is also recommended to take the homeopathic treatment that you have been prescribed three days before the treatment session (Arnica 5CH, three pills three times a day). This treatment also helps limit the risk of swelling or bruising after the injections.
Hyaluronic acid injections to increase the volume of the lips
Most of the time, hyaluronic acid injections are given during a consultation, in the office.
The lip is richly innervated, so we always perform contact anesthesia by applying an anesthetic cream 30 minutes to 1 hour before the injections. In addition, we inject a hyaluronic acid containing lidocaine (a powerful local anesthetic), to reduce pain as the modeling of the lip progresses.
Due to its mobility and high vascularity, the lip is an area where hyaluronic acid is quickly absorbed.
The lip requires a product adapted to these constraints.
We therefore use a highly cross-linked hyaluronic acid in order to obtain a product that is more resistant to resorption in order to guarantee an optimal duration (8 to 12 months).
The injections are made using micro-needles or micro-cannulas.
After disinfection of the lips, we proceed to the treatment itself:
- to redefine the vermilion border (the “edge” of the lip): hyaluronic acid is directly injected into the line separating the red lip (vermilion) from the white lip.
- to plump the lips: the injections are made into the red lip intramuscularly and intraorally into the submucosa to recreate volume.
It is important to achieve a natural result and therefore not to swell or inflate the lips, which is very unsightly. The goal is to create luscious, fuller-looking lips and provide hydration with hyaluronic acid. Hyaluronic acid makes it possible to recreate a fuller shaped mouth: redefine the vermilion border by redrawing the outline of the lips (make the Cupid’s bow more sensual) and plump the lips to make them more shapely.
It is also possible at the same time to correct the little vertical lines above the upper lip (the classic “barcode” lip lines) or the wrinkles located at the corners of the mouth (known as the bitterness folds). The result of the increase in the lips is immediate and is visible in the office, just after the injections of hyaluronic acid.
It actually takes a few days to assess the final results of the hyaluronic acid injections. This is the time it takes for the reaction swelling to subside.
In practice there are several injection techniques and Dr. Masson will use a method which is specific to him and which he adapts to each case to obtain the best results.
The quantity of product required (the number of syringes) is variable and depends on many different factors. It will be evaluated as precisely as possible beforehand.
When several zones are treated in the same session, the results are:
- More visible: an overall rejuvenation
- More harmonious: there are fewer differences between the different parts of the face
- The face will remain more balanced during absorption of the injected products.
After the lips have been increased by injections of hyaluronic acid
After the injections, the surgeon takes care to massage the treated areas well in order to optimize the result. For the first six hours after the injections of hyaluronic acid, it is recommended that you remain calm, rest, and refrain from any strenuous effort.
For a few days afterwards Dr. Masson recommends avoiding alcohol, aspirin and anti-inflammatory drugs.
Intense exposure to the sun and the use of saunas or steam rooms is strongly discouraged for two weeks after the injections of hyaluronic acid.
You can resume normal activity after the treatment.
The postoperative care is simple. The lips can be swollen from 48 hours to a maximum of 6 days.
Applying ice helps reduce swelling.
The resumption of social and professional activities is immediate. No time off work is needed.
If you wish, you may re-apply makeup immediately after the injection session has ended.
The effects of the hyaluronic acid are visible immediately. At the end of the session your lips are already fuller but the optimal result is achieved 10 days after the procedure. This is the time it takes for the body to fully assimilate the hyaluronic acid.
Hyaluronic acid is an absorbable molecule. Its effects on the lips are therefore temporary and last on average 6 to 8 months, 12 months in the best case. The results are different from one person to another and differ according to age, the area treated, smoking habits, and the degree of sun exposure.
Possible unwanted side effects
Any medical procedure involves a certain number of risks. By choosing a qualified practitioner trained specifically in these injection techniques you will limit these risks, especially since hyaluronic acid is a very well tolerated product. Doctor Vincent Masson himself ensures the follow-up of his patients.
Here are the possible adverse reactions or side effects:
- There can be local reactions after the injections leading to swelling, redness, pallor, unevenness, tenderness, itching, and bruising. These are all temporary reactions.
- Outbreaks of cold sores in susceptible individuals
- An inflammatory reaction
- A granuloma: a very rare localized inflammatory reaction
- Extremely rare complications localized at the injection site such as an abscess and skin necrosis
Another possibility of lip augmentation is the placement of a silicone prosthesis or implant (Permalip)
Three sizes of Permalip lip implant are available, the procedure takes place under local anesthesia during a short hospital stay, the scar is invisible in the labial mucosa, the postoperative care is relatively simple (allow one week off work), the results natural and the implant can be easily removed if needed. The cost of the procedure is usually between 1,500 and 2,500 Euros.
Another possibility is to inject fat (lipofilling or fat transfer)
The fat is removed in very small quantities, purified and then reinjected into the lips. The operation takes place under local anesthesia during a short hospital stay, the scar is invisible, the postoperative care simple and the results natural if the technique is well mastered. The price is usually between 2,000 and 2,500 Euros. The advantage of this technique is that the fat, once taken, does not dissolve unlike hyaluronic acid.
Finally a last possibility consists in lifting the upper lip
The principle is to make a mini, hidden, incision under local anesthesia in the nostrils and the nasal threshold and to remove a part of the excess skin in order to raise the red lip upwards, curl it, and to make it more sensual. This procedure (known as a lip lift or Bullhorn lip lift) is performed more and more frequently today.