Preliminary Report: Lip Augmentation in Conjunction With Facelift: Preliminary Experience With A New Permanent Implant
Primary facial rejuvenation surgery has often neglected the perioral area, instead using injectable fillers1 and secondary minor surgeries to address lip fullness. The fillers are temporary, expensive, and require fluid or tissue in-growth for their effect. Autologous fat has been used as an injectable filler with reasonable but temporary results that are marred by noticeable imperfections. Ersek et al2 showed good results in facial rejuvenation treatment (including lip augmentation) from layered fat injections with eight months of follow-up. Temporalis and superficial musculoaponeurotic system (SMAS) grafts3,4 have been used with some success, but these grafts do not produce long-term results. None of these treatments show a permanent benefit for the senescent lip.
Numerous minor advances in lip augmentation techniques have been made, but they fall short of full correction of the aging lip. Aiache5 described lip augmentation using a running W-plasty incision inside the mouth and vertical advancement of the flaps. The junction of the moist and dry vermilion is easily identified and avoided. His technique achieved a natural appearance without noticeable scars. The amount of augmentation, however, was limited and lip curl restoration was minimal.