When Bad Lips Happen to Good People

One of the hallmarks of unfortunate plastic surgery in many celebrity photos is the overdone lip augmentation. The lips in these photos generally appear overstuffed, like two tubes, or two sausages lying side by side.
The real reason that these results are bad is that the idea of creating a beautiful normal lip has gone out the window! Real lips have many subtle features in their shapes – and beautiful lips maintain these features. Unskilled practitioners just “pump in” fillers without regard for the details of the anatomy. Skilled practitioners shape and enhance the underlying forms.
For example, the upper lip and lower lip are not the same size. Usually, the lower lip is about twice the height of the upper lip. It’s important to maintain this 2:1 ratio when enhancing lips. If the lips are made to be the same size, this will make the upper lip appear excessively large, which is not desirable.
Secondly, lips have subsections or segments to them. The upper lip has three segments, the lower lip has two. It’s important to recognize these segments and maintain their individual shapes when performing lip enhancement with fillers. For example, since the lower lip should have two symmetric halves, with a slight depression in between – the plan for the filler treatment should be designed this way too.
The central portion of the upper lip and the adjoining skin is particularly unique, with features known as “cupid’s bow” and the “philtral columns”. A well done lip augmentation preserves and enhances these normal contours, rather than obliterating them through excessive filling. Plastic surgeons have a unique understanding of the anatomy of the lip, as the surgical repairs for children with congenital cleft lip problems also require the restoration of these same anatomic features with careful attention to subtle anatomic details.
In addition to enhancing the outline of the lips, adding volume to the lips is also helpful to restore a loss of lip fullness that happens with aging, or to enhance the look of lips that were naturally thin. Once again, respect for the segmental lip anatomy is key to getting a good result. So is restraint.
Excessively sized “pillow lips” will not look attractive, no matter how you do them. Sometimes patients get carried away with their desires for lip fullness… and the results may look peculiar. In these cases, a responsible physician will have to tell the patient, “No – that won’t look good.”
The bottom line:
1. Careful communication about the desired result with your practitioner is essential.
2. Start small / be conservative at first, using a more subtle approach.
3. Avoid long-lasting or permanent fillers, such as silicone, radiesse or artefill, in the lip. If there is an unsatisfactory result, you could be stuck with it. The options for correcting lumpy looking permanent fillers are very limited.
4. Look at lots of before and after photos when evaluating the previous results of your practitioner. Your injection specialist should have a light touch and an artistic eye. If you see some of the problems we’ve discussed here, go elesewhere!
Happy Father’s Day!