Lip Augmentation: Background, History of the Procedure, Problem (2024)

Sections

Lip Augmentation

  • Sections Lip Augmentation

  • Overview
    • Background
    • History of the Procedure
    • Problem
    • Etiology
    • Presentation
    • Indications
    • Relevant Anatomy
    • Contraindications
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  • Treatment
    • Medical Therapy
    • Surgical Therapy
    • Preoperative Details
    • Intraoperative Details
    • Postoperative Details
    • Follow-up
    • Complications
    • Outcome and Prognosis
    • Future and Controversies
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  • References

Overview

Background

Cosmetic lip augmentation consists of the enlargement and reshaping of otherwise normal lips to improve their dimensional relation with the patient's nose, teeth, and surrounding facial structures. The appearance of the lips is determined by the spatial relation of the lip structures with the teeth in a 3-dimensional space and by their function during animation and speech.

According to a study by Popenko et al, which sought to establish the most attractive lip measurements in white women by using focus groups to evaluate facial images, the dimensions judged to have the greatest attractiveness included a lip surface area making up 9.6% of the lower third of the face and an upper/lower lip ratio of 1:2. [1]

For information on other lip procedures, see Medscape Reference articles Lip Reduction and Lip Reconstruction Procedures.

Lip Augmentation: Background, History of the Procedure, Problem (1)

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History of the Procedure

Lip augmentation has been described at least as far back as the early 20th century. Miller describes a procedure to evert the lip with multiple small incisions, giving it the appearance of increased size. [2]

Women of all ethnic and social backgrounds have applied cosmetics to their lips to define or alter their appearance since the Stone Age. Tribal ceremonies involving the introduction of various materials in the upper and lower lip to alter their shape, usually with the intent to enlarge them, have been practiced in African tribes for centuries.

Lip Augmentation: Background, History of the Procedure, Problem (2)

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Problem

Cosmetic lip augmentation is defined as the procedure designed to augment and improve the shape a lip that is not affected by trauma or congenital deformity. Typically, the upper lip is treated more frequently and to a greater degree than the lower lip.

Lip Augmentation: Background, History of the Procedure, Problem (3)

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Etiology

Cosmetic deformities of the lips include both congenital and acquired etiologies. Some patients never develop adequate fullness in the lips; others develop atrophy of the soft tissue of the lips as they age.

Lip Augmentation: Background, History of the Procedure, Problem (4)

Presentation

Cosmetic indications refer to lip size and shape.

An accurate physical examination determines the specific area of deficiency or desired enhancement. Specifically, evaluate the patient's occlusion, maxillary-mandibular relations, and aging pattern. A general evaluation of the relation between the upper lip and the incisors reveals the appropriate course of action. Dr Bahaman Guyurion summarized the following algorithm approach to physical evaluation prior to lip augmentation:

  • Optimal incisor show - Conservative augmentation by fat transfer or dermis fat graft

  • Excessive incisor show - Augmentation by fat transfer or dermis fat graft

  • Inadequate incisor show, long lip - Lip shortening and lift with incision at nasal base ("buffalo horn") in young patients with acute columella-labial angle or incision at vermillion border in older patients with perioral rhytids

  • Inadequate incisor show, normal lip length - Maxillary lengthening with possible lip augmentation

Lip Augmentation: Background, History of the Procedure, Problem (5)

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Indications

Cosmetic indications include patients who desire a fuller or more shapely upper or lower lip and who are otherwise in good health.

Lip Augmentation: Background, History of the Procedure, Problem (6)

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Relevant Anatomy

Lip augmentation (see the image below) consists of the reshaping and/or enlargement of the visible portion of the lip, the vermillion. Alteration of the shape of the Cupid's bow and of the relation between the vermillion and the skin underlying the nasal columella also fall within the category of lip augmentation.

SoftForm lip implantation. Gore-Tex (W.L. Gore & Associates) makes both solid implantable threads in different sizes and SoftForm, which is hollow down the length.

The upper lip extends from the base of the nose superiorly to the nasolabial folds laterally and to the free edge of the vermilion border inferiorly. The lower lip extends from the superior free vermilion edge superiorly, to the commissures laterally, and to the mandible inferiorly. Around the circumferential vermilion-skin border, a fine line of pale skin accentuates the color difference between the vermilion and normal skin. For more information about the relevant anatomy, see Lips and Perioral Region Anatomy.

Also important is to consider the relationship between lip height and incisor show in the anatomic analysis. Evaluate possible maxillary hypoplasia and protrusion and consider the patient's occlusion status.

Lip Augmentation: Background, History of the Procedure, Problem (7)

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Contraindications

Contraindications for cosmetic lip augmentation include facial nerve disorders, recurrent herpes simplex lesions, diabetes, severe hypertension, history of multiple allergies, and/or autoimmune disorders.

Lip Augmentation: Background, History of the Procedure, Problem (8)

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References
  1. Popenko NA, Tripathi PB, Devcic Z, Karimi K, Osann K, Wong BJF. A Quantitative Approach to Determining the Ideal Female Lip Aesthetic and Its Effect on Facial Attractiveness. JAMA Facial Plast Surg. 2017 Jul 1. 19 (4):261-7. [QxMD MEDLINE Link].

  2. CC Miller. Operations about the mouth. Cosmetic Surgery. Philadelphia, PA: FA Davis Company; 1924. 20.

  3. New Image. Lip Plumpers. NewImage.com. Available at http://www.lipaugmentation.com/lip_plumpers.htm#34. Accessed: 6/18/08.

  4. Guida S, Mandel VD, Farnetani F, et al. Permanent implants for lip augmentation: Results from a retrospective study and presentation of tips and tricks. J Plast Reconstr Aesthet Surg. 2017 May. 70 (5):699-704. [QxMD MEDLINE Link].

  5. Godin MS, Majmundar MV, Chrzanowski DS, et al. Use of radiesse in combination with restylane for facial augmentation. Arch Facial Plast Surg. 2006 Mar-Apr. 8(2):92-7. [QxMD MEDLINE Link].

  6. Kanchwala SK, Holloway L, Bucky LP. Reliable soft tissue augmentation: a clinical comparison of injectable soft-tissue fillers for facial-volume augmentation. Ann Plast Surg. 2005 Jul. 55(1):30-5; discussion 35. [QxMD MEDLINE Link].

  7. Jackson L. Is it Really Bye Bye Collagen?. Consulting Room: The Cosmetic Guru. Available at http://www.consultingroom.com/Blog/129/is-it-really-bye-bye-collagen?. November 25, 2010; Accessed: January 18, 2023.

  8. JUVÉDERM® VOLBELLA® XC. FDA. Available at http://www.allergan.com/NEWS/News/Thomson-Reuters/JUV-DERM-VOLBELLA-XC-Approved-By-U-S-FDA-For-Use-I. June 1, 2016; Accessed: January 18, 2023.

  9. Brooks M. FDA Okays Juvederm Ultra XC for Lip Augmentation. Medscape Medical News. 2015 Oct 1. [Full Text].

  10. Bogdan Allemann I, Baumann L. Hyaluronic acid gel (Juvéderm) preparations in the treatment of facial wrinkles and folds. Clin Interv Aging. 2008. 3 (4):629-34. [QxMD MEDLINE Link]. [Full Text].

  11. Chopra R, Graivier M, Fabi S, Nestor M, Meuse P, Mashburn J. A Multi-Center, Open-Label, Prospective Study of Cannula Injection of Small-Particle Hyaluronic Acid Plus Lidocaine (SPHAL) for Lip Augmentation. J Drugs Dermatol. 2018 Jan 1. 17 (1):10-16. [QxMD MEDLINE Link].

  12. Rho NK, Goo BL, Youn SJ, Won CH, Han KH. Lip Lifting Efficacy of Hyaluronic Acid Filler Injections: A Quantitative Assessment Using 3-Dimensional Photography. J Clin Med. 2022 Aug 4. 11 (15):[QxMD MEDLINE Link]. [Full Text].

  13. Dickinson BP, Roy I, Lesavoy MA. Temporalis fascia for lip augmentation. Ann Plast Surg. 2011 Feb. 66(2):114-7. [QxMD MEDLINE Link].

  14. Tansatit T, Apinuntrum P, Phetudom T. A typical pattern of the labial arteries with implication for lip augmentation with injectable fillers. Aesthetic Plast Surg. 2014 Dec. 38 (6):1083-9. [QxMD MEDLINE Link].

  15. Gryskiewicz JM. Alloderm lip augmentation. Plast Reconstr Surg. 2000 Sep. 106(4):953-4. [QxMD MEDLINE Link].

  16. Seymour PE, Leventhal DD, Pribitkin EA. Lip augmentation with porcine small intestinal submucosa. Arch Facial Plast Surg. 2008 Jan-Feb. 10(1):30-3. [QxMD MEDLINE Link].

  17. Trussler AP, Kawamoto HK, Wasson KL, et al. Upper lip augmentation: palmaris longus tendon as an autologous filler. Plast Reconstr Surg. 2008 Mar. 121(3):1024-32. [QxMD MEDLINE Link].

  18. de Benito J, Fernandez-Sanza I. Galea and subgalea graft for lip augmentation revision. Aesthetic Plast Surg. 1996 May-Jun. 20(3):243-8. [QxMD MEDLINE Link].

  19. Tabrizi R, Shafiei E, Danesteh H. Dimensional Changes of the Upper Lip Using Dermis Fat Graft for Lip Augmentation. J Oral Maxillofac Surg. 2015 Oct. 73 (10):2030-7. [QxMD MEDLINE Link].

  20. Niechajev I. Lip enhancement: surgical alternatives and histologic aspects. Plast Reconstr Surg. 2000 Mar. 105(3):1173-83; discussion 1184-7. [QxMD MEDLINE Link].

  21. Mutaf M. V-Y in V-Y procedure: new technique for augmentation and protrusion of the upper lip. Ann Plast Surg. 2006 Jun. 56(6):605-8. [QxMD MEDLINE Link].

  22. Wilkinson TS. Lip enhancement. Practical Procedures in Aesthetic Plastic Surgery: Tips and Traps. 1994. 117-44.

  23. Guerrissi JO. Surgical treatment of the senile upper lip. Plast Reconstr Surg. 2000 Sep. 106(4):938-40. [QxMD MEDLINE Link].

  24. Richardson MA, Rousso DE, Replogle WH. Long-term Analysis of Lip Augmentation With Superficial Musculoaponeurotic System (SMAS) Tissue Transfer Following Biplanar Extended SMAS Rhytidectomy. JAMA Facial Plast Surg. 2017 Jan 1. 19 (1):34-9. [QxMD MEDLINE Link].

  25. Jacinto SS. Ten-year experience using injectable silicone oil for soft tissue augmentation in the Philippines. Dermatol Surg. 2005 Nov. 31(11 Pt 2):1550-4; discussion 1554. [QxMD MEDLINE Link].

  26. Barnett JG, Barnett CR. Silicone augmentation of the lip. Facial Plast Surg Clin North Am. 2007 Nov. 15(4):501-12, vii-viii. [QxMD MEDLINE Link].

Media Gallery

  • SoftForm lip implantation. Gore-Tex (W.L. Gore & Associates) makes both solid implantable threads in different sizes and SoftForm, which is hollow down the length.

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    Lip Augmentation: Background, History of the Procedure, Problem (9)

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    Contributor Information and Disclosures

    Author

    Jorge I de la Torre, MD, FACS Professor of Surgery and Physical Medicine and Rehabilitation, Chief, Division of Plastic Surgery, Residency Program Director, University of Alabama at Birmingham School of Medicine; Director, Center for Advanced Surgical Aesthetics

    Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, American Society for Reconstructive Microsurgery, Association for Academic Surgery, Medical Association of the State of Alabama

    Disclosure: Nothing to disclose.

    Specialty Editor Board

    Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

    Disclosure: Received salary from Medscape for employment. for: Medscape.

    Chief Editor

    Gregory Gary Caputy, MD, PhD, FICS Wound Healing Consultant, Advantage Surgical and Wound Care

    Gregory Gary Caputy, MD, PhD, FICS is a member of the following medical societies: American Society for Laser Medicine and Surgery, International College of Surgeons, International College of Surgeons US Section, Wound Healing Society

    Disclosure: Nothing to disclose.

    Acknowledgements

    Mario Diana, MD Consulting Staff, Department of Plastic Surgery, Clinica Diana

    Disclosure: Nothing to disclose.

    Lawrence Ketch, MD, FAAP, FACS Head, Program Director, Associate Professor, Department of Surgery, Division of Plastic Surgery, University of Colorado Health Sciences Center; Chief, Pediatric Plastic, The Children's Hospital of Denver

    Lawrence Ketch, MD, FAAP, FACS is a member of the following medical societies: American Academy of Pediatrics, American Association for Hand Surgery, American Association of Plastic Surgeons, American Burn Association, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Society for Surgery of the Hand, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, andPlastic Surgery Research Council

    Disclosure: Nothing to disclose.

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    Lip Augmentation: Background, History of the Procedure, Problem (2024)

    FAQs

    Lip Augmentation: Background, History of the Procedure, Problem? ›

    History. Around 1900, surgeons tried injecting paraffin into the lips without success. Liquid silicone was used for lip augmentation, starting in the early 1960s but was abandoned thirty years later due to fears about the effects of silicone on general health and long term aesthetic outcome.

    What is the history of lip plumping? ›

    The origins of lip fillers can be traced back to the early 20th century when cosmetic procedures were rudimentary and often risky. In the 1900s, pioneering physicians experimented with paraffin and silicone injections to enhance lip volume.

    What are the complications of lip augmentation? ›

    Getting lip fillers poses some risks, including: Bleeding and pain at the injection sites. Cold sore reactivation. Discoloration or tenderness.

    How long have lip implants been around? ›

    Lip augmentation has been described at least as far back as the early 20th century. Miller describes a procedure to evert the lip with multiple small incisions, giving it the appearance of increased size.

    Why do people get lip augmentation? ›

    First, as mentioned, even a small amount of filler in the lips can help your mouth appear younger looking. Others are seeking out lip filler to correct asymmetrical lips. Some people are frustrated with an overly thin upper lip (in comparison to the bottom lip), for example.

    What is the history of lip augmentation? ›

    History. Around 1900, surgeons tried injecting paraffin into the lips without success. Liquid silicone was used for lip augmentation, starting in the early 1960s but was abandoned thirty years later due to fears about the effects of silicone on general health and long term aesthetic outcome.

    What is the history of lip makeup? ›

    The use of lipstick dates back to early civilizations such as Sumer and the Indus Valley Civilisation, and was popularized in the Western world in the 16th century. Some lipsticks contain traces of toxic materials, such as lead and PFAS, which prompted health concerns and regulation.

    What is the difference between lip augmentation and lip fillers? ›

    Lip fillers aren't the only option for lip augmentation. Fillers are temporary, providing volume to the lips for about six months. Patients who want a longer-lasting solution may be interested in lip implants. Much like a breast implant, a lip implant is a medical device surgically placed into the lip.

    Is lip augmentation a surgery? ›

    Lip augmentation uses different nonsurgical and surgical techniques. For a fuller look, your plastic surgeon may inject fillers with hyaluronic acid or your own fat into your lips. Or you may opt for a lip implant or lip lift to permanently plump up your lips.

    What are the risks of lip surgery? ›

    Rare complications include asymmetry, severe or prolonged bruising, tissue ischemia, and infection. Lip augmentation with implants is associated with surgical risks such as bleeding and infection, but these too, are rare. Occasionally, the implant will become displaced or encapsulated and may need to be removed.

    Are lip implants FDA approved? ›

    Dermal fillers, also known as injectable implants, soft tissue fillers, lip and facial fillers, or wrinkle fillers are medical device implants approved by the FDA for use in helping to create a smoother and/or fuller appearance in the face, including nasolabial folds (the lines extending from the sides of the nose to ...

    Are lip implants safe? ›

    Lip implants are generally safe, but as with any cosmetic surgery, there are some risks. These may include: bleeding. infection.

    Are lip implants expensive? ›

    Because lip implants are considered to be cosmetic procedure, they are not covered by medical insurance. The average cost for the procedure can range from about $2,000 to $4,000 based on various factors. While lip implants are more expensive up front, they last far longer than any other lip augmentation solution.

    Can you reverse lip augmentation? ›

    These products work to add volume both instantaneously and over time, with full results noticeable after about four weeks. Hyaluronic acid fillers are completely reversible. If you are not thrilled with your lip augmentation results, they can be reversed with a simple hyaluronidase enzyme injection.

    What is the most natural looking lip augmentation? ›

    What is the most subtle lip filler? The lip filler that is designed to provide patients with subtle, natural-looking results is the Restylane Kysse lip filler. Created with cross-linking XpresHAn technology, Restylane Kysse has the smallest particle size of any of the Restylane fillers to fill the lips delicately.

    What are the benefits of lip augmentation? ›

    With lip injections, you have naturally fuller lips and this fullness helps tighten the skin around your lips. Hence, your mouth looks firmer and more youthful because wrinkles and fines lines are reduced. There are numerous smokers who end up developing severe wrinkles in the mouth area over a period of time.

    What is the history of lip liner? ›

    History. Liner pencils have been in use since the 1920s in a variety of ways. Actresses to adopt the use of liner include Clara Bow, Marlene Dietrich, and Marilyn Monroe. In the 1990s, people started using dark brown liner with lighter lipstick.

    Who started the big lip trend? ›

    The “big lip” trend began in 2006 after Angelina Jolie took the title of the “World's Most Beautiful Star” with her big full lips being praised.

    Why is everyone plumping their lips? ›

    Wanting a Sexier, Younger Look

    Perhaps the most common reason women want to try lip injections is natural when you think about it. As we age, our lips thin out naturally. We develop wrinkles above our mouths, and this can make our lips look puckered and cause lipstick to bleed.

    Is lip plumper healthy for your lips? ›

    "Plumping lip glosses are generally safe to use unless you are allergic to any of the ingredients in it," says Jaliman. When it comes to lip glosses that contain spicy extracts (like cinnamon, menthol, and capsaicin), they aren't dangerous per se but be wary of not overdoing it.

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