Cosmetic lip enhancement is both desired and feared. Men and women commonly wish to maintain and enhance their lips but remain concerned about over treatment with resultant asymmetry, imbalance and the dreaded trout-pout or ducky lips. The key to great looking lips is a thorough pre-assessment of the whole face, gradual treatments to subtly enhance the lip, and ensuring that the surrounding tissue framing the lip is not neglected.
What do we look for in a perfect lip? Volume? Roundness? Structure and definition? Width? Symmetry? Historically it has been desirable to achieve a volume ratio of 1: 1.6 between the top and bottom lip, and a lip width in proportion to the lower face width. Paintings, sculptures and images throughout the years have commonly displayed this “golden ratio” and it seems that this ratio appears between various landmarks across the face. However, failure to thoroughly assess every individual persons face and tailor treatments accordingly, can lead to a formulaic approach and may not actually complement the rest of the face.
We all chronologically age; but intrinsic factors such as skull bone loss, changing dentition and diminishing fat pads can contribute to a prematurely ageing lip. Extrinsic factors such as smoking, excessive sun exposure and repetitive lip pursing, also accelerate skin ageing. As a result, the lip tends to thin, tuck inwards, lose their lip border definition and begin to look lined and dehydrated. We start to see lines develop around the mouth- so called smoker’s lines- and the corners of the mouth start to turn down. We can also lose the prominence of the philtral columns which run from the Cupid’s bow to the nostril. Rejuvenating the lip can create a more youthful appearance and complement the rest of the face.
Lip enhancement might involve treating the surrounding skin with chemical peels or micro-doses of muscle relaxant injections to relax deep smoker’s lines. More typically, non-permanent dermal fillers would be used to address the lip border, the lip body, surrounding lip lines, the corners of the mouth and the philtral columns. The amount of dermal filler used would depend on the degree of pre-existing volume loss and on the desired outcome agreed between the patient and the injector. Subtle enhancement is the key; and it is often desirable to treat the mouth area in stages to achieve the best outcome. The lip and surrounding area can be numbed with anaesthetic to make the procedure more comfortable. Lip swelling and an occasional bruise can occur, both of which settle after a few days.
There is no “one size fits all” approach with cosmetic treatments. Taking the time to establish patient’s concerns with their appearance and formulating an approach that both addresses their worries and enhances their appearance is paramount and a valuable skill of the cosmetic injector.
