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Lip augmentation or enhancement is a procedure offered by many cosmetic practitioners. For a permanent procedure to improve the shape and size of your lips you may consider lip implants. The commonest implants used in the U.K. are made out of a synthetic material called ePTFE (expanded polytetrafluoroethylene). Brands of this product that may be used include SoftForm®, Gore-tex® and UltraSoft® with more recent product launches including FulFil™ and Permalip™. Local anaesthetic injections into the lip are required to numb the area. The implant is then usually threaded through cuts at either end of each lip. Afterwards you may feel numb in the lips for several days, most people can expect to return to work either the same day or two or three days afterwards. Private prices for lip implants may range from £1,000 to £3,000 depending on the type of implant material used.
Permalip™ is an implant made of very soft, solid silicone which is tapered at each end to match the natural shape of the lips and is designed exclusively for lip enhancement.
Both women and men with thin lips sometimes seek ways to make them larger and fuller. As we age our lips seem as though they "deflate" or even thin out. The upper lip, in particular, is more prone to these signs of ageing such as "dropping" or thinning.
Lip augmentation or enhancement is a procedure offered by many cosmetic practitioners. The materials and methods which are used to plump out the lips can include dermal fillers, fat transfer from other parts of the body, lip implants using natural or man-made products and surgery which can re-shape the lips.
In this section we will describe the use of strips of different types of implant material for people who choose to undergo a more permanent procedure to improve the shape and size of their lips.
Although this procedure is considerably less common than the use of dermal fillers (which also include some more permanent options), there were just over 8,000 lip implant procedures performed in 2013 in the U.S., according to the American Society for Aesthetic Plastic Surgery (ASAPS), which represents an increase of 2.3% on the 2012 figures. More recent data is not available.
There are no similar statistics available for the U.K. as yet, but we do know that lip implants are becoming increasingly popular in this country too.
If you are considering having a lip implant the following information will give you a basic understanding of the procedure. It can't answer all your questions, since a lot depends on the individual patient and the practitioner. Please ask a practitioner about anything you don't understand.
Lip Implant Types
The commonest implants used in the U.K. are made out of a synthetic material called ePTFE (expanded polytetrafluoroethylene). It is a white "rubbery" material - the same thing used in Gore-Tex™ boots and rain jackets - but of course it is completely sterile and manufactured only for medical implants in this form.
ePTFE was first used as an implant material in humans in the 1970s as a replacement for small sections of veins.
Since then it is estimated that more than 3 million people have had ePTFE implants. Their use includes grafts from one vein to another, hernia repair and reinforcement of the stomach wall.
Development of this material into different shapes has allowed it to be used as a facial implant for the chin and cheeks, to fill out lines and wrinkles in the face, and lip enhancement. For details on the use of implants in other areas of the face, please go to our facial implants section.
As ePTFE never shrinks and is not absorbed by your body, this type of lip implant is permanent in terms of its effect, but it can be reversed if the implant is removed later.
Brands of this product that may be used by a clinician include SoftForm®, Gore-tex® and UltraSoft® and your practitioner may call them by these names.
Other more recent product launches include FulFil™ and Permalip™.
Another different approach used by some doctors involves the use of human tissue. Some surgeons will use small strips of your own tissue (cut from areas such as the groin) and, after careful preparation, implant these strips into your lips. This is known as an autograft and has the benefits of being your own natural material which will not be rejected by your body.
In practice this procedure is now little used owing to the fact that you will have scars at the site from where the tissue has been taken, and this tissue is difficult to prepare in order to achieve a successful graft.
Alloderm® is another alternative. This uses donated human skin that has been especially prepared by removing the outer layer of the skin and freeze drying the layer underneath. Using someone else’s tissue rather than your own is known as an allograft.
Careful screening of the material for viruses is undertaken, and the skin is specially prepared so that there is little chance of your body reacting to it or rejecting it. A skin test is not required before the insertion of this implant. Over time, this biological implant regrows into the patient's own natural soft tissue. The result, although more natural than synthetic implants, is not permanent and lasts for 6 months to a year.
To view other types of implant material that may also used for lip augmentation, please go to the dermal filler section.
During your first discussion with a practitioner, you should explain what you expect from the treatment and how you would like to look afterwards. He or she should tell you exactly what the treatment will involve, and discuss the advantages and disadvantages of this and other treatments to enhance the lips, as well as tell you how long it will take for you to recover from it.
You will need to be provided with information on and discuss the advantages and disadvantages of the different types of implant material available. If you choose a synthetic implant you would normally require a skin test before surgery to make sure that you are not allergic to the material.
A medical history should be taken by the practitioner to make sure that there are no reasons why you shouldn’t have lip implants. Once this is established, you would normally be asked to sign a consent form which means that you have understood the potential benefits and risks associated with a lip implant.
Photographs may also be taken by the practitioner for use as a “before and after” comparison at a later date.
Local anaesthetic injections into the lip are all that is usually required to numb the area enough so that you feel no pain during the procedure. You may also be given a mild sedative to make you feel drowsy.
The surgery is not at all complex nor does it take a substantial amount of time to perform – usually only around 30 minutes depending on the type of implant used.
The surgeon, after making the necessary 4 tiny cuts at each corner of the mouth, "threads" the strip of implant material through each lip and cuts the implant to the size of the patient’s lips. The incision areas are then stitched with a thin, either dissolving or non-dissolving, thread material.
No repeat procedure is required for synthetic implants as their effect is permanent, but if you choose to use a non-permanent implant material, you will need to return occasionally to have another implant inserted.
Depending on the procedure and the extent of the bruising and swelling, you can expect to return to work either the same day or two to three days afterwards.
Side Effects and Risks
There will be only the smallest amount of blood and no actual pain during the lip implant procedure.
There will be pain afterwards, especially if you put any pressure around your lips, or you may feel numb in the lips for several days. The area around the mouth will also swell up. You should expect to be very "full lipped" after the operation. You may have some difficulty drinking or eating without spilling and you may notice a difference in your smile and how you speak - especially during the healing stage when lip implants can feel very stiff and immobile. This takes some time to get used to.
It takes about a week for most of the swelling to go down, although it will be sensitive to light to medium pressure for about 3 weeks. Usually there is little actual bruising following this procedure, but occasionally your surgeon may recommend arnica to help reduce any bruising that you may experience.
Following the operation, tiny scars at the point at which the implants went in and at the end of the implant are visible. These scars usually become unnoticeable over time and can be camouflaged with make-up.
There are not too many risks or side effects associated with lip implantation, but there are enough to be concerned about. Infection can occur, and in these cases, the implant may be removed, which is not always a straightforward procedure.
There may be some movement of the implant or development of scar tissue around the implant. If this happens, the lips can look deformed or the tissue in the lip area can become very hard.
It is very important that you follow the advice of your practitioner carefully after an implant treatment to help to make the procedure successful and reduce the risk of complications or side effects.
Post-treatment advice may include:
Lip implants should be avoided in areas where the skin is swollen or where infections are present – e.g. active acne, or cold sores. This will reduce the risk of infection after the treatment.
Other people who may not be suitable candidates are those who have been taking isotretinoin in the last 12 months, those who have had any problems with healing or scarring in the past, and people who have a high level of tooth plaque or dental abscesses.
Who Can Do It
Only fully trained and qualified surgeons or doctors should perform a lip implant operation.
For more information about practitioner training, qualifications and relevant medical organisations please view the information contained within the Legislation section of the Consulting Room.
It is highly unlikely that anyone considering a lip implant operation would be able to access this free of charge on the National Health Service.
However we would always recommend that you visit your General Practitioner before embarking upon a cosmetic procedure involving surgery.
As well as their advice and guidance they may also be able to refer you to a local NHS Hospital for a consultation.
The NHS has set out the following guidelines on how to get cosmetic surgery through the NHS:
"To qualify for surgery on the NHS you must meet specific criteria as set out by your local health authority. The NHS will not pay for surgery for cosmetic reasons alone. Reconstructive and cosmetic surgery to correct, or improve, congenital abnormalities and injuries will usually be carried out free of charge.
NHS reconstructive surgery is performed by plastic surgeons who have had extensive training and belong to the British Association of Plastic Reconstructive and Aesthetic Surgeons. Surgeons who carry out cosmetic surgery through the NHS also belong to the British Association of Aesthetic Plastic Surgeons.
To receive cosmetic surgery from the NHS, you will normally need a referral from your GP. You will have a consultation with a plastic surgeon and an assessment by a psychiatrist, or psychologist. It will then be decided whether there is enough social, psychological, or physical benefit to be gained to justify surgery."
Private prices for lip implants may range from £1,000 to £3,000 depending upon the surgeon and type of implant material used.
It is important to understand that the appearance of your lips also depends on the structure of your teeth underneath the lips. For instance a malocclusion (failure of the upper and lower teeth to meet properly when the jaws are closed) can make the upper lip look less full. Furthermore, tooth bonding and veneers can alter the surface of the teeth. They can push the lips outward, which gives the lips a fuller appearance. Before considering lip enhancement, you may need to look at your teeth and even consult a mouth surgeon to discuss your options.
Also, before considering a lip implant, it is probably wise to find a practitioner who is experienced in the use of temporary dermal fillers. They can give you a temporary treatment to see if you like the effect.
Lip enhancement with most fillers is temporary. However, some newer fillers claim to be permanent which can be difficult to reverse if there are problems.
If you would like to avoid having to return for repeat injections every 6 months or so, then a permanent synthetic lip implant (which is still reversible) may be the ideal solution.
There are also additional surgical procedures that may be suggested by your surgeon, which might be more appropriate than either dermal fillers or lip implants for you. These include:
Before and After Pictures
Results vary enormously depending upon both the patient and the skill of the individual surgeon, so outcomes for cosmetic surgery procedures will always be more variable than those for less invasive non-surgical treatments.
For a gallery of before and after photographs using the Permalip™ product, please visit the Surgisil website.
Before and after photographs are real patients, your results may differ.