Dr. Melanie Palm is a nationally recognized dermatologist and cosmetic surgeon specializing in natural and balanced lip enhancement. Her offices are located in Solana Beach, CA just north of San Diego. Dr. Palm lectures and teaches nationally on proper lip filler techniques and serves as an advisory board member and clinical researcher for Allergan, Merz, and Galderma, the makers of lip fillers such as Juvederm, Restylane, Volbella, and Belotero. She offers many effective treatment options for creating beautiful lips.
Beautiful Lips: Creating Natural, Believable, and Rejuvenated Pouts
Lip augmentation – we prefer the terms lip rejuvenation or lip enhancement – and are a frequent request of patients. However, many individuals express valid concerns about the outcomes of lip enhancement. Well done lips should appear as though they have never been touched by a syringe and needle. They appear natural and proportional. Lips should enhance the other characteristic features of the face, rather than detract or distract from them. Well done lip augmentation should not appear ducky or sausage like. Instead, it should appear beautiful, and as though a procedure was never performed.
Lip anatomy is extremely important when approaching procedures around and in the lip. An experienced injector understands the anatomy of the lip and how best to enhance the results from lip injections while balancing safety during the procedure.
Beautiful outcomes from lip procedures typically address several concerns. The area around the mouth should be well supported, a beautiful lip border should be preserved, lip volume should be enhanced, maintained, or balanced, and lip lines should be quieted and smoothed.
Areas considered during lip enhancement include the following:
- Support of skin around the mouth
- Lip lines
- Vermillion border or white roll (the border of the lips)
- Cupid’s bow: the gullwing appearance to the upper lip
- Philtral columns: two vertical columns above upper lip
- Lip tubercles: the 5 mounds of subtle volume to lips – 3 pillows in upper lip, 2 pillows in lower lip
- Oral commissures: the corners of the mouth should be neutral or slightly upturned depending on the patient
- Lip proportions: this depends on the ethnicity of the patient, but generally speaking the upper lip has more projection on profile than the lower lip. Also, the lower lip in most patients should be larger than the upper lip. The majority of lip volume should reside in the middle one-half to two-thirds of the lip, not at the sides or corners.
- Symmetry: This is an extremely important factor of lip augmentation. Symmetry is always desired in lip enhancement.
Lip Enhancement Treatment Options
Sophisticated lip enhancement should build confidence for the patient, and the outcome should not appear obvious or over-injected. Beautiful lips can be created by a skilled and artistic injector who is mindful of proper lip proportions, symmetry, and anatomy.
Applied to Lips
Following below are options for treatment in lip enhancement by area of lip concern::
- Lip Augmentation & Increasing Lip Volume
- Injectable fillers: various hyaluronic acid fillers are suitable for increasing the overall volume and shape of the lip. These fillers typically last 6-12 months and require periodic retreatment. Juvederm and Restylane were the first fillers used and approved for the lip. For subtle lip volume enhancement, Volbella is a newer hyaluronic acid filler from the Juvederm family that provides mild lip enhancement and decreased swelling following treatment.
- Smoothing of Lip Lines & Lines Around the Mouth including smile lines
- Injectable fillers: very fine lipstick lines around the mouth, the lip border (vermillion border), and lip wrinkles on the actual lip can be smoothed by lighter formulation hyaluronic acid fillers. Some, such as Restylane Silk and Volbella, act as almost a lip gloss, smoothing the pink part of the lip. Belotero, Restylane Silk, Volbella, and Vollure are all excellent choices for treating etched in lines. Small nuances between products will predicate the injectable filler chosen to rejuvenation the mouth area.
- Relaxation of the mouth muscle: small amounts of Botox or Dysport can relax the orbicularis oris muscle, the O-shaped muscle that allows our lips to purse. Very small aliquots of these injectables can be used strategically around the mouth to soften small lip lines and cause a pseudo-eversion of the lip, increasing the visual size of the red portion of the lips temporarily.
- Skin smoothing and resurfacing around the mouth: For moderate to severe lines around the mouth, laser treatment may be used alone or in conjunction with injectable fillers.
- Minimal downtime, lighter treatment: If downtime is a concern, mild lines around the mouth can be treated with ResurFX, an infrared laser that has minimal downtime. Makeup can be worn the next day. A series of treatments is recommended.
- Laser resurfacing, heavier treatment: CO2 laser skin resurfacing has approximately 1 week of downtime, but has a much greater ability to improve wrinkles around the mouth and tighten skin.
- Support around the Mouth
- Injectable fillers: downturned corners of the mouth, marionette lines, and lengthening of the upper lip occur around the mouth as we age. For addressing deeper folds, more robust fillers such as Radiesse, Restylane Lyft, Juvederm Ultra Plus and Restylane Defyne may be used. To address mild volume loss around the mouth, lighter hyaluronic acid fillers may be used, often with a blunt-tipped cannula technique that minimizes the chance of bruising.
A combination approach is sometimes ideal for creating a natural and rejuvenative approach to lip enhancement. Non-invasive and minimally invasive techniques are often combined with injectable fillers at Art of Skin MD to achieve the aesthetic goals of our patients in regards to lip augmentation.
If you are looking for a lip enhancement expert in the San Diego area for gorgeous kissable lips, call Dr. Melanie Palm at 858.792.SKIN (7546) to schedule your appointment.