Question:

My lips are disappearing over the last several years!!! I am getting older – I was expecting some wrinkles but I am surprised that my lips are getting smaller. Is there anything that I can do to get my lips back?

Answer:

Lips – the final frontier or just a beginning for optimal facial esthetics? Within all races and cultures, certain features of the female physique have been considered to be attractive. Certainly, in addition to larger upper face, smaller lower face and petite nose, one of those features are large, full lips. No wonder that our fascination with lips continues to this day. Since the beginning of time, women used covering agents and, more recently, lipstick to enhance the appearance of this compelling esthetic unit. These methods are here to stay as their success has proven their role in beauty allure. At the same time, the quest for the perfect lip continues. More recently, volumetric lip rejuvenation has entered to a mainstream approach for achieving optimal esthetic lip with natural feel and appearance.

  Eyes are the window to a person’s soul but the lips are the central feature of the lower third of the face and when full and well defined, they portray a sense of youth, health, attractiveness and sexuality (Figure 1). It is critical to understand the lip architecture – ever so important balance of shape and fullness and its place and proportions within the facial contours. These aspects need full understanding for anyone contemplating lips enhancement services.

Lips reach their fullness in our late teenage years or early twenties. From that time, as the lips age, they lose volume and become thin and flat. The appearance of lips is also affected by a multitude of other structures including skin, fat, muscle, teeth and bones. Aging changes affect all these components and contribute to the less attractive lip appearance. With advancing age, skin becomes less elastic and the sun damage contributes to the loss of lip edge definition, wrinkles and irregular pigmentation. The facial fat changes with respect to the amount and its distribution and combined with changes in muscle, loss of jawbone and teeth height result in loss of lip support. These support structures frequently need addressing to prevent or correct the down turning of lip corners (the sad look).

Volumetric lip enhancement to the rescue - What has started in 1981 with the introduction of collagen for enhancing lips has become an evolution of excellent treatment modalities ever since. Injectable collagen lip therapy continued to evolve with new, longer lasting products available today. In addition, the introduction of hyaluronic acid (HA) products heralded a new era in the ever-expanding choices for soft tissue augmentation. HA products (e.g. Restylane^®, Juvederm^®, Teosyal^®) are exciting class of materials that offer flexibility of use, safety and natural feel of the tissues treated.

The need for understanding the proper esthetic characteristics of the lip can not be overemphasized. It is not only the fullness that counts but also the shape and contour of the lips that are critical for an optimal esthetic look. Some patients only require a small adjustment rather than overcompensation whereas some patients can benefit from rebalancing of the lips such as enhancement of the upper or lower lip alone. Frequently, volumetric restoration of the lips can not be accomplished successfully without addressing the support structures surrounding this important cosmetic unit. The lips should be full and well defined but the vermilion border (the boundary between the white/skin part and red part of the lip) can not be blunted.