1016 Fifth Avenue, New York, NY 101 Old Short Hills Road, West Orange, NJ

New York: 212-535-5500 West Orange: 973-731-2000

Aesthetic Plastic Surgery & Mesotherapy - A. Peter Salas, MD, FACS, FACM

Lip Surgery/ Enlargement

Before Image After Image

"Lovely lips are a very important facial feature, and those who have abnormally thin or thick lips may wish to have them revised. The means are available to bring about this change. Reshaping may involve a surgical procedure or may be accomplished with injection therapy, depending on the desired results.

For overly large lips, excess tissue is removed surgically through carefully placed incisions in the inside of the lips. Excess mucous membrane as well as deeper glandular and soft tissue is removed to debulk the lips. The incision is closed with a fine absorbable suture that does not require removal. Do not expect an immediate change, as the operative swelling will obscure the results for several weeks, but patients can expect a significant improvement in time. Since the incisions are inside, scarring is minimal in the usual case.

For the long upper lip, a lip lift operation is available that is carried out by making an incision hidden at the base of the nose. Excess skin and subcutaneous tissue is remove raising the lip by as much as one third of an inch. The result can be very flattering for the properly selected patient.Two types of lip lift surgery are available. One involves and incision made in the lip itself and requires removal of a strip of skin above the lip. This procedure can result in unattractive scars, and we do not recommend it at our center, except in unusual cases, or in older patients who are not as likely to form thick scars.

The second procedure -- the one we prefer, involves and incision made at the base of the nose right at the junction of the nose and the upper lip. Skin is removed beneath the nose resulting in elevation of the lip. The incision is closed with very fine absorbable suture. The scar is inconspicuous after healing. Early redness can be covered with make up. For the first few weeks, there is an exaggerated look due to the swelling, but that usually settles quickly. Complications are uncommon with this operation but could include infection, wound separation or unsatisfactory scarring. We have not seen these complications in our experience. When done by itself, the surgery is easily carried out under local anesthesia.

For lips that are too thin, fat injections can be considered. Small amounts are harvested from other parts of the body and injected into the upper and lower lips. Although much of the fat is eventually lost, some of the effect may be permanent. The results vary from individual to individual.

Recently, the FDA approved the use of injectable silicone for certain cases of retinal detachment. This approval has paved the way for the renewal of microdroplet silicone injection therapy as an off label use of an approved device. This allows patients and their physicians to use their discretion in the use of the device for a purpose not intended by the manufacturer. Tiny amounts are injected on a monthly basis until the desired results are obtained. Usually four to eight treatments are required. It is not really the silicone that leads to the enlargement. What happens is this. Each microdroplet of silicone that is injected stimulates the development of collagen that surrounds the silicone droplet. Much as a grain of sand in an oyster leads to the formation of a pearl, the silicone induced collagen production is what leads to the filling or enlargement. For this reason, it is essential to wait several weeks between each injection session since it is hard to predict the exact amount of collagen formation that will take place. A full treatment program can take from six to twelve months.

What Our Patients are Saying...

"Dr. Salas and his staff were kind, gentle and caring while maintaining a high level of professionalism. My procedure went exactly as planned and I could not be happier with the results."