What Filler Is Right For A Lip Augmentation?*

There is no one filler that is right for a lip augmentation. Indeed, there are many to choose from, and a patient should consult their plastic surgeon to determine which one is right for them. Here are some lip fillers to consider:

Hyaluronic Acid Fillers

Hyaluronic acid is a natural sugar that is found in all living things. It forms a gel in the spaces between the collagen and elastin in the skin and helps the skin stay hydrated. It also helps transport nutrients from the blood to the skin cells and lubricates the joints and cartilage. Hyaluronic acid is plentiful when a person is young, but they begin to lose it with age. Synthetic hyaluronic acid is an excellent temporary filler to define and add volume to thin lips. Because they do not contain human or animal DNA, these hyaluronic acid fillers are hypoallergenic and many newer types are cross-linked. This means molecules of hyaluronic acid have been linked together in the lab to increase their power of hydration. They are also thicker than regular hyaluronic acid. Cross-linked hyaluronic acid acts as an antioxidant, so it has the added benefit of protecting the skin from free radical damage.

Products that contain hyaluronic acids include Juvederm, Belotero and Restylane. These products are injected into the lips by fine needles. Though newer versions of dermal filler have pain killer in them, the doctor may give the patient a topical anesthetic around their mouth followed by a dental block in the gum line.

The amount of filler injected depends on what the patient wants for their lips. Some patients want a fuller upper lip, while some may want a fuller lower lip. Afterwards, the doctor feels the lips to make sure there are no lumps. The entire procedure lasts no more than a half an hour.

After the procedure, the patient’s lips are soothed with a gel made with arnica and given a warm compress. They are told to apply a warm compress to their lips to ease any discomfort when they get home. There is swelling that is at its worst the few hours after the injections. Then, the bruising fades, and the lips finally settle into their new formation. The new, fuller lips can last as long as a year and the patient is free to return for touch-ups. When they do return, they will not need as much hyaluronic acid as they had their first time. This appears to be true for all types of dermal fillers.

Collagen Fillers

Some people claim that collagen fillers are the best type of lip fillers. Collagen is an essential protein that is found all over the human body. It makes up a springy layer beneath the skin and is found in bones, muscles and tendons and helps support the skeleton. Like hyaluronic acid, collagen is abundant when a person is young but is lost over time. Brands of collagen fillers include Zyderm and Zyplast, which are made from collagen collected from cows. Because of this, a patient needs to be tested before they have these dermal fillers. This requires a skin test, and the patient is followed for a month to make sure they are not allergic to the bovine collagen.

Zyplast is the choice of many dermatologists and cosmetologists for a lip filler. Like fillers made from hyaluronic acid, the substance is injected via fine needles. The results last from three to six months and, again, the patient can return for touch ups.

Semi-permanent Fillers

Semi-Permanent fillers last longer than temporary fillers. Some can last as long as 18 months. The difference with these fillers is that they stimulate the body into making its own collagen. Brands of these types of fillers include Radiesse and Sculptra. Sculptra is especially useful for adding volume to thin lips. It is made of poly-L-lactic acid, which is also used in dissolvable stitches. Poly-L-lactic acid is nontoxic and breaks down over time. Because it needs time to make the body produce its own collagen, the results aren’t seen right away, and the patient needs to return for about three sessions of injections. After that, they might not see results for a month or longer. Like the other dermal fillers, the patient can return for touch-ups. There are patients who claim that the filler worked so well that they don't need touch ups even years after the initial treatment.

Another type of filler used to plump lips is polyalkylimide. This is a biocompatible polymer. It isn’t biodegradable, but can be removed through aspiration if the patient has problems with it. It too stimulates the body to create collagen. In this case, the collagen moves into the lips and surrounds the polyalkylimide. This action walls it off from the body and basically turns it into a type of prosthesis for the lips. Another interesting thing about polyalkylimide is that X-rays can see through it though it is not invisible to ultrasound. Brand names include Aquamid, which probably got its name because the solution in a pre-prepared syringe is about 96 percent water and 4 percent polyalkylimide.

The Patient’s Own Fat

The patient who wants fuller lips can also opt for injections of their own fat. The fat is harvested from another procedure such as liposuction, cleaned then reinjected into the lips. Though there is very little chance of the body rejecting or being allergic to this lip filler, there may be more bruising, swelling and discomfort than there are with other dermal fillers, and the fat may migrate.

Calcium Hydroxylapatite

Like collagen and hyaluronic acid, calcium hydroxylapatite is found naturally in the body. It makes up some of the bones and the teeth. In this case, microscopic spheres of the substance are injected into the lips, and like poly-L-lactic acid, it stimulates the body to send collagen to the area.

Dr.Stephen Weber, MD is a double board certified Facial Plastic Surgeon and a Diplomate of the American Board of Otolaryngology and Head & Neck Surgeons, the American College of Surgeons and the American Board of Facial Plastic & Reconstructive Surgery.

*Contributed by Dr Weber.

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