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Lip Service

By Peter Schmid, DO
Posted On Sep 02, 2016
Lip Service
The key to the perfect pout? Finesse, ‘naturally’


Age, sun exposure and bad habits (such as smoking) can take away your lips’ youthful fullness. On the other hand, some of us are just born with thin lips. Either way, take heart! Plumper, more defined lips are only a filler away.

At age 35, Nicole Foret wanted slightly fuller lips. “I liked my lips, but I was curious how they would look plumped up. I wanted to be able to tell the difference but still look natural,” Nicole says. Nicole sought out board-certified cosmetic facial and maxillofacial surgeon Joe Niamtu, III , DMD, who practices in Richmond, Va., and liked the experience so much that she has since gone back to have temporary filler re-injected.

“It really made a difference for me.…my husband and mother couldn’t tell, so, I got exactly what I asked for—a little fuller but very natural,” she says.

Art Meets Medicine

Anyone who has leafed through a tabloid magazine has seen bad examples of lip augmentation (aka, lip enhancement). “I call this the Hollywood phenomenon,” Dr. Niamtu says. “Some of the worst looking and most unnatural results come out of Hollywood.”

Astute lip practitioners, he says, are surgeons who have extensive experience enhancing different aspects of the face and an artistic eye for what is natural. After all, natural, voluptuous lips never go out of style. True success with lip augmentation requires that physicians visualize and appreciate normal anatomy, and recognize each patient’s deficiencies in order to correct them.

“No two patients really need the same lip treatment,” says Dr. Niamtu. “Some women simply need air in the tires, or a little volume. Others need an enhancement of the outlines of their lips, which can range from a touchup of the Cupid’s bow to a reconstruction of the depression right under the nostril.”

Tools Of The Trade

Cosmetic surgeons use different types of injectable fillers, as well as fat, to plump lips and restore their youthful, elegant outline. Dr. Niamtu’s favorite: hyaluronic acid (HA ) fillers, because they are not generally associated with adverse reactions, and, while they are temporary, they tend to last longer (at six months to year) than collagen alternatives.

“Another big benefit of hyaluronic acid fillers is they are reversible,” Dr. Niamtu says, which means that if you don’t like your results, it’s easy to restore your original shape and size.

What To Expect

Lip injections for enhancement should take about 15 to 30 minutes. The procedure is done on an outpatient basis, in the physician’s office. Prices are variable. Patients report a range of prices, with most being in the ballpark of the upper $500s to upper $800s.

Preparation for the procedure is simple. You should refrain from taking anything that could cause bleeding, such as aspirin, a few days before the procedure. Dr. Niamtu often recommends that patients who bruise easily take homeopathic Arnica montana to help lessen bruising.

Any pain during the injections can be controlled, he says, with topical anesthetic cream and a mini-block of injected lidocaine. Dr. Niamtu also applies ice before, during and after the procedure to lessen pain and swelling.

“One of the hot, new trends in fillers is to manufacture fillers that have local anesthetic built in,” he says. ”I prefer my technique for pain control, however. The problem with using local anesthetic in a filler is that it doesn’t take effect until you’ve punctured the patient numerous times.”

Nicole had her lips injected during her lunch break and opted only to have topical anesthesia and not the mini-block. “Dr. Niamtu injected the filler and although I felt it, it wasn’t as bad as I thought it was going to be. I was swollen after, but within an hour, it went down to normal size,” she says.

In Dr. Niamtu’s experience, about 95 percent of patients can go back to work the day of the procedure or the next day. Some, however, get more significant swelling or bruising and might want to make sure they have the weekend to recover.

When patients first look in the mirror after having the injections, Dr. Niamtu cautions, they will look over-corrected. That’s just a result of temporary swelling. “I also explain upfront that I want to see patients in two weeks because they may require a touchup,” he says.

As for the results, Dr. Niamtu says that, especially for those patients who have multiple deficiencies affecting the looks of their lips, improvement is a more realistic goal than perfection.