Lip enhancement continues to be very popular ever since the late 80's when silicone was all the rage.  We now can rejuvenate and enhance the lips with hyaluronic acid (HA)-based fillers.  HA is a natural substance in the dermis of our skin that is lost with age.

The photos show an ideal youthful lip in my cute 23 year old medical assistant.  Note the plumpness of her vermilion lip skin, the peaks of her upper lip cupids bow, and in the side view the short distance from under the nose to the top border of her lip (short philtrum).  Also note, that the upper lip is not even sized with the lower lip and is a tad smaller, yet pretty.  Look at lips of models in magazines to see more examples like this.

With age, the lips will lose their plumpness, looked thinned and wrinkly.  Also with age, our philtrum will lengthen.   All this can be corrected or improved with filler in and around the lips.

Filler Rules

When we fill our lips we want to remember what a natural, youthful lip looks like and respect that.  A lot of people think about lip enhancement with fillers but are afraid that the outcome will be unnatural.  Lip enhancement has improved in technique and materials significantly since the 80's.  When you go to your doctor to have your lips done, you can request these simple lip filling goals that I have explained above.  To be clear, I will list my filler KISS rules below:

 Keep or enhance the cupid's bow

 Insist that your doctor only fill enough to smooth some fine lines and simulate that youthful lip

Shorten the philtrum

Soften the look by having the upper lip smaller than the lower.  (See link below to see what happens when this is not done).

Lip Filler Mishaps

It's not to hard to find pictures on the internet of lips gone wrong.  Check and see which rules are violated.  Usually, the upper lip is overinflated, sometimes looking like a duck bill from the side or too horizontal like a monkey lip, and missing the normal anatomy.  A common mistake I have seen done even by dermatologists is to overfill the vertical lip lines at the patient's request.  This also gives a duck bill pretty easily.

As a rule, I would avoid using filler to improve vertical lip lines, except very sparingly with a very thin filler like Belotero, and instead see a cosmetic skin specialist who offers laser resurfacing for lip wrinkles (as I do at my practice.)  Laser resurfacing is a more definitive approach to treating stubborn lip wrinkles, and with today's technology heals naturally without any discoloration.

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