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Ask Dr. Rivkin questions on all non-surgical cosmetic procedures, laser treatments, and injection fillers, including Botox, Juvederm, Restylane, Radiesss, Sculptra, IPL, Fraxel, Thermage, Mesotherapy, Non-surgical nose job, chin/cheek augmentation, and many other procedures.
Lip enhancement is an art. If done correctly, it is one of the more difficult of the non surgical procedures because the shape of the lip is individual and complex. A good lip augmentation has to have the following qualities:
1. The lower lip should be a little bigger than the upper lip and can roll out a bit in a pout.
2. The upper lip should have the shape of the cupid's bow area in the middle preserved. The lip should not go straight across - it looks fake that way.
3. The upper lip should have a smooth and well defined transition from the red of the lip to the skin. It should not have a big ridge - that looks fake too.
4. Both lips should be symmetric from one side to the other and they should be smooth. There's nothing that looks more fake than bumpy lips.
My emphasis in lip augmentation is always on a natural, subtle look. The patient's friends should not immediately notice that she has had her lips augmented. They should just notice that she looks great but they should not be able to put their finger on why.
The difference between a good and bad job with lip enhancement is a matter of a millimiter or less. This is why I really do not think that imprecise techniques like fat injection, surgery or insertion of solid implants like Alloderm or GoreTex are any good.
I use Juvederm exclusively these days - I find that it is less likely to have bumps than Restylane and it seems to last a bit longer (5 to 7 months). Any of the hyaluronic acid fillers do a good job - Restylane, Perlane, or Juvederm - as long as the doctor or nurse injector is very experienced doing lips with that filler.
Another major point with lip augmentation is that it should never hurt. I still have people coming to me who recall their previous lip injections with horror because the injector used topical numbing creams. Lips should always be numbed with a dental block. They are some of the most sensitive tissue in the body and sticking a needle in them hurts like hell. Fortunately, septocaine and other dental injectable numbing preparations do a great job at making the experience completely painless.
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