Lip service

Knowledge is as important as any filler in perfecting your pucker, says dermatologist John Troccoli.

Your lips, your lips, your lips, your lips are juicy,” croons jazz bluesman Olu Dara, voicing a perennial lover’s homage.

Consumers today lay out about $1.4 billion annually on makeup for a pretty pout. Now, there are increasing options for more lasting lip looks. 

Over the past 15 years, we’ve seen a cascade of procedures that offer a wide range of lip enhancements, either to augment what people were born with or to address changes brought about by aging.

John Troccoli, M.D.

Over time, our bodies lose the key ingredients that keep our skin smooth and supple — and maintain the “plump” in our pucker. As we age, we start to see a decrease in collagen and hyaluronic acid (HA), resulting in skin sagging and wrinkling. In terms of our lips, we see increased lines around our mouths, as well as a thinning of the lips themselves.

We’ve come a long way from the 1980s, when collagen was first approved as a dermal filler. Now, patients can choose from 15-minute filler injections to much more involved surgical implants.

Lip enhancement injections typically bring back what was lost by replenishing collagen or HA, with fillers injected around the mouth or directly into the lips. The growing number of dermal fillers offers safe, minimally invasive ways to add lip volume and reduce mouth wrinkles.

There were more than 2.7 million dermal filler procedures performed last year, reports the American Society of Plastic Surgeons, an explosion in demand that has made these injections second only to botox in popularity. This is in part due to the increased menu of choices to customize a treatment that will work for an individual’s unique needs. 

In addition to dermal fillers, patients may opt for more extensive lip enhancement, such as implants. Like the injectable options, implants have evolved, offering patients safer “biocompatible” ingredients.

To help patients navigate the range of choices, I offer the following tips:

1. Choose your doctor carefully: These are not cookie-cutter procedures. In addition to numerous options, there are continuing advances. Our mouths are complicated and each person’s facial characteristics are unique. To make the most of what’s available and receive a customized approach, it’s imperative to find a skilled, up-to-date doctor. Check credentials and review the doctor’s portfolio of work. 

2. Be clear about your desired outcome: Your doctor will customize an approach based on what you want addressed. Do you want to minimize wrinkles around your mouth — for example, laugh lines or vertical lip lines? Do you want to address lost volume in your lips? Do you want to plump the lips you were born with? It’s important to articulate clearly your desires so that your doctor can identify the best options.

3. Consider a minimally invasive start: HA injections offer a wide range of formulations, providing different levels of correction, from minor touch-ups to deeper interventions. The effects are not permanent, and, in the rare instance that the patient is not satisfied they can be reversed. For these reasons, people may want to consider starting with an HA procedure. 

4. Understand the process and outcome: Make sure you have a very clear understanding of all aspects of the procedure and recovery, including any risks, especially for more invasive augmentation involving implants. You also want to understand how long the effects can last. While filler injections are not permanent, implants’ effects can be long-lasting.

5. Discuss combining procedures: We’re seeing advantages to using a variety of approaches. For example, botox and fillers together can accentuate each procedure’s results. 

Establishing an ongoing relationship with your doctor can help you take advantage of the ongoing advances in lip enhancement.

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