WOMAN'S WAY - Jully 2011

by James E. White, M.D., F.A.C.S.

esthetic surgery of the lips has evolved as the field of cosmetic surgery has evolved, as the study aesthetic finesse. Luscious full lips speak of youth and vitality. The lips thin as people age, and the wet line moves lower in reference to the dentition. In addition, the oral commissures begin to downturn. These thin, flat, and poorly defined lips impart a sense of age. Specific procedures address each of these labial-aging signs. Some of these procedures include augmentation to help restore full, well-defined, and proportional lips that impart a sense of beauty and youth. The lips are the most malleable and animate of all facial features. Many consider them to be the most pleasing feature of the lower third of the face. Many of the techniques used on other areas of the face may not work on the lips because of their 3-dimensional animate nature. With this in mind, many methods are used to augment the lips and to change their animate shape, repose shape, or both. The surgeon must always be aware of how static changes to the

lip change the animate aesthetics and function of the lip. Patients occasionally refer to this as kissability. Initial attempts at beautifying the lips probably started with Cleopatra, who colored her lips red. Later, silicone was used to augment the soft tissue of the body and face, including the lips. Other materials were then developed that could be used for lip augmentation. Some of these materials include collagen, facial fillers, fat, and acellular human matrix, just to name a few. Many new injectable materials used to augment the lips have become available, and many more are to be approved by the US Food and Drug Administration (FDA). Temporary injectable materials are the most common method of lip augmentation and reshaping. The problem with temporary injectable fillers is the fact that they are temporary. The newest advanced lip augmentation procedures involve the placement of a solid silicon implant similar to silicon implants used in breast augmentation procedures. The solid silicon implant can be placed into the upper and lower lips through 3mm incisions in the corner of the mouth. These incision sites heal rapidly and are barely visible to inspection after placement. The silicon implants come in several different sizes for permanent lip enhancement. The old silicon injections, like the ones completed on Ms. Priscilla Presley, caused lip deformity with invasive growth into the lip tissues. Injectable silicon is difficult to remove without major surgical excision. Silicon

Kissability

beauty & fashion

implants, however, can be easily removed if the lip augmentation look is no longer desired. The silicon implants have a soft natural feel. All lip procedures may be performed in an office surgical suite with local anesthetic (field block, nerve block) and this is, in fact, an ideal way to work on the lips. With general anesthesia, the lips become flaccid and adynamic. The ability for the patient to move the lips during surgery is a great advantage during the sculpture phase. Again, well defined, full lips speak of youth and vitality. Take care to review before and after photographs of patients treated by your cosmetic surgeon. Make sure that your ideal of aesthetic sense is the same as your surgeon. Beware of lip overfill; big pink slugs and platypus lips do not fit into the category of kissability. n Dr. James E. White is double board certified in General Surgery by the American Board of Surgery and the venous disease American Board of Phlebology. He is a Fellow of the prestigious American College of Surgeons, a Diplomat of the American Board of Phlebology, and a Fellow of the American Academy of Cosmetic Surgery. Recently voted 2010 Best of the Best in Cosmetic Surgery, his office, Advanced Surgical Concepts, 7446 Shallowford Road, Suite 205 in Hamilton Office Park, offers a variety of cosmetic procedures including laser skin resurfacing, facial fillers, minimal invasive cosmetic surgery, Thermage and Botox. He may be contacted at 423-648-4011.

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