Dr. Andrew Barnett MD Cosmetic Plastic Surgeon

Lip Augmentation

Well formed lips are a sign of youth. Lips which are thin, wrinkled, and disappearing into the mouth represent age. In the course of total facial rejuvenation, or in the younger patient who simply wants fuller lusher lips, the procedure to augment the lips is wonderful!

-Andrew Barnett, MD

Lip augmentation is designed to provide a more youthful and attractive smile. A new method, using a natural collagen sheet called AlloDerm, is a promising technique for long term lip enhancement.

Who is a candidate for lip augmentation?

Lip augmentation is used by two groups of patients. One group has always had thin lips and would like to have a fuller smile. The second group would like to change the unattractive signs of aging seen around the mouth. This is often characterized by a thinning of the lips, a rolling in of the lips towards the teeth, and wrinkling. Many patients fall into both categories.

How is lip augmentation performed?

There are many different techniques designed for lip augmentation. All methods bring additional material into the lips to increase their size. This can be done with your own tissues, or with materials from outside your own body, both synthetic and natural. Examples of your own tissue include local flaps, fat injections and dermis grafts. Materials outside your body include synthetic material like gortex and silicone, and processed natural materials such as injectable collagen. The newest technique involves the use of AlloDerm, a natural collagen sheet.

Which method works best?

All methods work to varying degrees, but the side affects and lack of long term result from many of the techniques have frustrated plastic surgeons. Tissues from your own body tend to "melt away" quite rapidly, and there is always some discomfort and scarring from the place the tissues are taken from. Artificial materials like silicone and gortex are considered permanent, but they are frequently associated with rejection, erosion through the skin, and infection. Soft Form, a tubular gortex material, is commonly used (see below). Injectable collagen is an established technique, but the results are temporary and must be frequently repeated to maintain the augmentation. The newest method, AlloDerm lip augmentation, seems to combine the best of all methods while minimizing risks. It does not require a donor site, needs only a small incision for insertion, and is not associated with rejection. While it should not be considered a permanent correction, early results are promising with regard to its longevity in the body.

Exactly what is AlloDerm?

AlloDerm is an acellular collagen matrix made from human skin. The AlloDerm is produced by LifeCell Corporation by taking human skin and treating it to remove all cellular components, than treating it again to inactivate any bacteria or viruses which might have existed. The material is freeze dried, than re-hydrated prior to use. The AlloDerm is placed into the lips and than integrates into the surrounding tissue as your blood vessels and cells grow into it's meshwork.

How long does it last?

AlloDerm is relatively new, so the longevity of the material in the body is unknown. Previous experience using AlloDerm in burn surgery points to a long term result. While the material has been used in the lips since 1995 and studies indicate that it produces a persistent augmentation with excellent stability, AlloDerm shoud not be considered permanent.

Why should AlloDerm last longer than transplanting your ovnl tissues to your lips?

This is an excellent question. Your own tissues "melt away" as only a very small amount of the tissues survive. AlloDerm is made of the non-living natural components of skin, mostly collagen, in an open mesh. This open mesh stimulates your own body to produce blood vessels and other living tissues which grow into the mesh. It's actually your own tissues which produce the long term result!

How is the procedure performed?

Local anesthesia is first used to numb the area. A number of small incisions are then made on the inside of the lips, and the AlloDerm is threaded into place. Sutures close the incisions and temporarily hold the AlloDerm in position.

What size will my lips be after augmentation?

The amount of AlloDerm placed will determine the final size. The procedure can be repeated and additional material added. Both the upper and lower lips can be augmented.

How long is the recovery time?

While each patient recovers at their own rate, the lips are generally swollen for a few days to a few weeks. Bruising may be present during the early period. Some numbness is expected early on, but pain is usually quite minimal. During the recovery period you may use lipstick and resume most normal activities within a day or two.

Are there risks to augmentation with AlloDerm?

While experience with AlloDerm has been quite positive with a very low complication rate, risks do exist. Infection, scarring, irregularities, numbness, swelling, and the ability to feel the AlloDerm are a few of these. Malposition and rapid loss of correction can also occur. At your consultation, you will have a comprehensive discussion with Dr. Barnett about the entire procedure, including the risks and potential complications.

Are there other uses for AlloDerm?

Absolutely! AlloDerm is useful in reducing the deep fold that runs between your nose and the corner of your mouth, called the nasolabial fold, as well as reducing scars and other skin depressions.

What is Soft Form?

Soft Form is a tubular ePTFE ("gortex"), a synthetic material. It has been used in the body for decades, particularly to replace large blood vessels and in orthopedic surgery. Recently introduced for soft tissue augmentation, it provides a very long lasting result. The problem is, it remains quite stiff, and one can always feel it in the lips, producing a somewhat artificial feel. It is helpful in defining the edges of the lip, and if appropriate, we will discuss it at your consultation.

Is lip augmentation right for me?

That's a decision only you can make. At your consultation, discuss your questions and concerns with Dr. Barnett. The doctor will discuss AlloDerm as well as the other alternatives. Together you will be able to reach the decision that's right for you. When you come in for your consultation, bring magazine photographs of models whose lips you find attractive. While Dr. Barnett can in no way guarantee that your lips will look like the model's, the photographs will provide the doctor with guidance to discuss and plan your augmentation.

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“I am a registered nurse… so after a lot of research and speaking to other physicians and fellow nurses… my decision was made. He is an artist and I believe the best in his field. Now my favorite thing to do is shop for bras. Thanks Dr. B, you are truly the best.”

-AN, RN, Napa, CA

“As a physician, I know about physician hype and marketing, the go to surgeon nonsense… Having lived and worked in the Bay area for many years, when it was my time I asked colleagues who performs consistently excellent facial work. Your name came up repeatedly… While I was impressed with your professionalism, it is the artistic, balanced, natural result that reminds me everyday that I made the right choice putting my face in your hands. Thank you.”

-LC, MD, Palm Springs, CA

“When I tell people that I have two adult children, they look at me and say, “You must have been a child bride.” Well I love the look on their faces when I tell them I’m 63. Sometimes I say “You know, Dr. Barnett is my secret weapon”, but most of the time I just say, “Oh, I guess I’m lucky. Good genes…” If they only knew! You are wonderful.”

-JG, San Francisco, CA

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Copyright 2014. All rights reserved. Andrew Barnett, M.D.