The Skinny on Fuller Lips: Lip Lift

Lip AugmentationAlthough lip augmentation or filling is quite common these days, and can lend very beautiful results, there are times when a surgical procedure such as a lip lift can be more ideal.

As we age, the upper lip can lengthen quite significantly. This can be caused from collagen loss in the skin as well as loss of bony volume that provides support for the soft tissue. Lip lengthening over time can lead to a disharmonious relationship between the upper and lower lips. In many cases, because it is an often overlooked issue, inexperienced injectors can misdiagnose the problem as loss of volume in the lip and treat with fillers alone. Although this may help with the overall look of the lower third of the face, it is unlikely to really re-establish a more balanced look.

While a surgical option may sound drastic, a well performed lip lift is quite easy to recover from and can make a significant improvement. The procedure can be done under local anesthetic alone, or with sedation to make it more comfortable, and is generally complete within an hour. A small, curved incision is made just under the nose and a portion of skin removed – the incision does not extend into the mouth, so eating and drinking after surgery is not a problem. Absorbable sutures are placed to bring the tissues together and a few sutures on or just under the skin to obtain as thin a scar as possible. After a week or so, the majority of swelling and bruising resolves and the lip takes up a more balanced portion of the lower third of the face.

The biggest downside to this procedure is the fact that a scar must be made since skin is being removed. In most cases, however, the scar heals exceptionally well and is hidden nicely in the curves and shadows under the nose. If the scar is persistently red or raised, minor procedures can be done to minimize the scar even further to obtain the best possible result.

Although lip lifting is not as popular or easy as fillers, in some cases the patient’s anatomy calls for this to be done to help achieve a more youthful proportion between the upper and lower lips. If the area between the bottom of your nose and the top of your lip appears to be increasing with time, this may be an option for you. As always, make sure you are consulting with a surgeon well-versed in all your available options to allow you to make as educated a decision as possible. Our physicians at the Emory Aesthetic Center can help guide your lip augmentation decision process to achieve the best result for you.

About Dr. Sethna

Anita Sethna, MDAnita Sethna, MD, understands that facial plastic and reconstructive surgery demand a marriage of science and artistry, and she enjoys using precision, skill, and vision to make her patients’ dreams reality. Dr. Sethna’s meticulous attention to detail and her passion for maintaining a natural look ensure optimum results for her patients. A dedicated teacher, Dr. Sethna is devoted to assisting residents in facial trauma or reconstructive cases at Grady Hospital. She relishes the opportunity to educate residents and medical students in all aspects of patient care. Dr. Sethna has a strong interest in several areas of facial plastic surgery research and has presented at national meetings on the importance of resident and fellow education in rhinoplasty techniques and adjunctive measures to decrease discomfort during cosmetic procedures.

Chemical Peels – What Are They and How do They Work?

Chemical PeelThere are three components related to the aging of the face – loss of volume, descent of the tissues and changes in the skin. As we age the skin loses elasticity resulting in the loss of fullness and that youthful glow. In addition, over time the activities of facial muscles such as smiling, frowning, and puckering of the lips lead to those lines we refer to as smile/frown lines and crow’s feet. Eventually these lines become deeper and are etched in the skin. The process is only accelerated by sun exposure and smoking.

However, there are nonsurgical options to help slow down and reverse the aging process. Retinols, such as Retin A and Renova (derivatives of vitamin A) have a proven role in slowing the process, but there are also skin resurfacing treatments available, such as chemical peels and lasers that are also effective in reversing sun damage and, to a certain extent, the changes associated with aging skin.

Lasers and peels basically function in similar fashion. Both remove the top layer of skin and stimulate collagen deposition or tightening in the deeper layers. The laser relies on heat energy, while chemical peels rely on acid to achieve similar effects. The skin which regenerates appears more youthful with diminished lines and a glow. With lasers the amount of heat can be regulated, while with chemical peels, the concentration of the topical agent is adjusted to regulate the depth of penetration and effectiveness.

There are currently three categories of chemical peels – glycolic acids (fruit acid peels), trichloracetic acid (TCA) and croton oil peels. The glycolic acids are the mildest and the croton oil is the strongest. The concentrations of all are adjusted to suit the individual patient’s skin condition. The milder glycolic acid and more dilute TCA peels are often referred to as “lunch time “peels. There is little down time and the redness resulting from the peel is short lived. These lighter peels are best for individuals with slight skin changes, require no anesthesia and are commonly performed in our Emory Aesthetic Center Spa. These lighter peels may be applied to all skin types and colors.

For stronger peels, the concentration of the TCA and croton oil are adjusted according to the changes in the skin and the location. Higher concentrations are applied to areas with deeper lines and lower concentrations for the thinner skin around the eyes. These deeper peels require anesthesia as there is discomfort associated with them. Typically sedation and local or topical anesthesia is required. Peels may be performed as an isolated procedure or in combination with surgical procedures such as facelifts and eyelid lifts.

For best results we advise that our patients prepare their skin by applying retinoids and “skin bleach” creams to the face for up to three weeks before the peel. The deeper peels which can take up to an hour are usually performed as outpatient in a procedure room or, in some cases, the operating room. There is immediate swelling and some red coloration of the peel areas. Recovery varies based on the type of peel used, the concentration applied and skin type. It may take as little as five days to two weeks or more.

Peels are not a substitute for surgical procedures but are often applied in conjunction with surgery to enhance the result and improve skin texture. The Emory Aesthetic Center, and our cosmetic surgeons, have extensive experience with peels and can customize a plan that best fits your individual need.

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