LIP AUGMENTATION
Lip augmentation is possible with the use of a number of different materials. There are significant advantages and disadvantages to the use of many of these, both autologous (those taken from one's own body) or non-autologous, (those coming from someplace else) which are in common use.
Non-autologous materials include Zyderm collagen, AlloDerm, a collagen matrix, and synthetic materials such as GoreTex. The advantage to these is that no donor site is necessary, and the materials are readily available. The disadvantages, in general, are that they are less well-accepted. Often, they are absorbed quickly, and they suffer from the disadvantage of a larger probability of postoperative infection and increased complication rate. They are frequently expensive but are certainly convenient for use.
Most patients choose injectble fillers to augment the shape and fullness of the upper and lower lips. Injectible filler augentation of the lips is done under local anesthesia with an expected return to one's normal daily activities as early as the next day. Because the injectable material can be placed in either large or very tiny amounts depending on the patient's wishes this gives much more flexibility in refining the result than with any of the other techniques. The limitation of injectible fillers is that they are temporary. The results will last between 6 months and a year.
If patients wish to have a longer lasting result than that provided with injectable fillers, we prefer autologous materials.
Autologous materials are the body's own tissue that are transferred as grafts. They include injectable fat or dermal fat grafts. Injectable fat grafts are easily harvested with suction treatment and used as an enhancing material. They last for variable periods of time. There are many donor sites and, certainly, it is relatively easy to enhance the lips at the time of another procedure, such as a suction lipectomy. The limitation to fat injections of liposculpture of the lips lies in its reliability. A significant percentage of the patients lose part if not all of the enhancement effect on the lips.
Perhaps the most long-lasting and best-tolerated material for lip augmentation, however, are dermal fat grafts, which are placed in a tunnel, created in the upper lip. They provide a long-lasting correction and enhancement and frequently have secondary benefit in ameliorating small circumoral lip wrinkle lines. This has become our favorite material for the patient who does not wish to use injectable fillers. The donor site, however, does leave a scar, which is usually well hidden in a previous surgical scar, or at the time of another surgery, the material can be harvested without any additional scarring.
|
|
|
