Lip augmentation is actually a pretty complex topic for what seems like a simple goal. The reason is that most patients would love to have a permanent augmentation to the lips but often it would be either a major undertaking, or involve enough steps that in the end a filler would be simply a much easier way to go.
For temporary lip augmentation, only one category of filler material is safe, which is a clear gel filler called hyaluronic acid. The brand names in this category are Restylane, Perlane and Juvederm (there are some other minor players, but those are all of the major ones). They last about 4-6 months for the most part in the lips. There is a bit (a 3-5 on a scale of 1-10) of discomfort with injection, but they seem to be tolerated fine in the office. Bruising happens in about 40-50% of patients and lasts about 3-5 days. This costs $600 per syringe and usually the job can be done with 1 syringe alone. For the first visit to the office, we offer a 20% discount to new filler patients.
For permanent lip augmentation, none of the artificial permanent fillers (i.e. silicone or Artefill) or the permanent lip implants (a silicone tube or a saline-filled tube) are a good idea in any way. The permanent fillers can harden over time and become a huge problem for the patient. Lip implants can often be felt and they actually protrude through the skin over time so many of them have been removed from the market over the years.
Filling the lips with one’s one tissues is really the only viable permanent option. This is done with fat grafting. The challenge here is that fat grafts tend to reabsorb in the face and therefore the patient and doctor have to decide if they want to do multiple smaller grafting procedures or one huge grafting procedure. Each has significant disadvantages – multiple procedures are expensive since fat grafting has to be done in a sterile operating room setting, and a single large session of grafting results in grossly overfilled lips that look nothing short of ridiculous for several weeks to a few months until they settle down. Each grafting session costs about $4,000 (this includes getting a bit of fat through liposuction, the surgeon’s fee and also the fees for the anesthesiologist and the operating room) so you can imagine that this gets expensive very quickly. Multiple grafting sessions do cost extra fees, so it can get really expensive to get the job done.
For lip fillers revisions are usually not necessary. If there are minor irregularities, they can almost always be massaged out. If the patient wishes to have more volume and we have already used the full syringe, then an additional fee for another syringe would apply. If, for some reason, the patient simply doesn’t like the augmentation from fillers then there is actually a material called ‘hyaluronidase’ that can be used to dissolve it. I haven’t ever had to do this with any of my injections to the lips but it’s nice to know there is a tool available for us for correction if we need it.