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Lip augmentation encompasses a broad range of procedures from simple injections to the surgical
implantation of permanent implants. Temporary injected fillers used for lip augmentation include
a wide variety of natural and synthetic compounds (see section on dermal fillers) such as bovine
(cow) collagen, human (foreskin) collagen (Cosmoplast), human (cadaver) collagen (Cymetra),
hyaluronic acid (Restylane), and fat. Permanent fillers for lip augmentation include silicone
and polymethylacrylate (Artecoll). Implants are a more permanent method of lip augmentation and
require surgery. Most of the implants are made of expanded polytetrafluoroethylene (ePTFE) and
can be removed if needed. Fillers and implants will be discussed separately.
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Lip augmentation using fillers is an elective procedure and is used to add volume to the lips.
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The filler is injected into the lip and can be painful so anesthesia and pain medications
are often used.
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The lip augmentation procedure can last from five to thirty minutes, depending on the
number of areas being treated.
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After the lip augmentation procedure, you may experience some pain and swelling. This usually lasts a few days and in rare cases, the swelling and redness can persist for up to two weeks.
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Your lips will be bigger after the procedure because of the swelling and the filler.
You will see the results of the filler alone in a few days after the swelling has subsided.
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You can most likely return to your normal activities in a few days after the swelling subsides.
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The temporary fillers in the lip last 3-6 months at best.
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Each filler has its own risk. In general, the main risk of animal-derived collagen fillers is an
allergic reaction and even people who have tested negative to the pre-allergy test required before
treatment sometimes have allergic reactions. In most cases however, the human-derived collagen
fillers appear to be well tolerated. There are theoretical risks of transmission of disease from
donor tissues although an extensive screening of the tissues is performed. The newer, synthetic,
injected fillers such as Restylane, Perlane and Hylaform reportedly have minimal side effects
however some patients have reported prolonged swelling and inflammation along with nodules at the
injection sites with Perlane. The permanent fillers (Artecoll and silicone) carry several risks,
including necrosis, granuloma (a hard, bumpy scar), severe inflammation, extrusion and infection.
You and your physician need to discuss the risks and benefits of the different options if you
choose to have lip augmentation with fillers.
Lip Implantation
There are many kinds of lip implants available today including Advanta, AlloDerm, Dermis grafts,
Fascia Grafts, Gore-Tex, SoftForm, Tendon Grafts, and UltraSoft. Gore-Tex, SoftForm, UltraSoft and
Advanta are made of a foam-like material called expanded polytetrafluoroethylene (ePTFE).
Advanta is porous, allowing your own tissue to grow within the implant. Alloderm is an acellular
collagen material made from a human donor. The material is purified, freeze dried, than
re-hydrated prior to use. The AlloDerm is placed into the lips and integrates into the
surrounding tissue as the body grows and heals around the graft. Long term studies are in progress
to evaluate how long Alloderm implants last.
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Lip augmentation is an elective procedure used to add more permanent volume and definition to
the lips
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You are first injected with a local anesthetic, similar to those you might receive at a dentist’s
office, for pain. After numbness takes effect, incisions are made at each corner of the mouth
(4 total) and the implant is inserted into the lip through the incisions. The implant is trimmed,
the incision sites are sutured, and the wounds are dressed. Your physician may use absorbing or
non-absorbing suture material and there is usually minimal bleeding.
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You will experience some swelling and post-operative pain for which your physician can provide
pain medication and you may experience numbness as well. It takes about one week for the swelling
to subside and there may be pain with pressure for up to three weeks. You may also have difficulty
eating and drinking at first. Bruising is usually minimal. You will have your sutures removed in
about 5 to 10 days after the procedure.
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Most of the implants are considered permanent.
Alloderm is relatively new and its duration is still being evaluated.
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Infection is a common but treatable risk. Other complications of the removable implants
(Gore-Tex, SoftForm, UltraSoft and Advanta) are less common but include migration, extrusion,
decreased mobility, and irritation from a poor fitting implant. The hollow implants
(UltraSoft) allow your own tissues to grow into them which decrease the risk of infection,
rejection, and mobility however they cannot be removed if there is a complication.
Cost is variable but usually runs about $1,000 per implant. All implants carry the risk of
permanent discoloration, scarring, and deformity. If you decide on implants, you and your
physician will need to discuss the risks and benefits in detail.
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Cosmetic/Plastic Surgery
