Lip augmentation with hyaluronic acid or inserts

The lips are a feature of the face that plays an important role towards its aesthetic appeal. They command a central position in the arrangement of the face, and as such tend to attract the attention of any beholder.

For this reason, many people pay particular attention to the aesthetic appeal of their lips.

It is very important for lips to have the right size and shape. Lips that are too small or too large form an unpleasant image. Lip augmentation must be performed very carefully, avoiding overcorrected lips.

In addition to size, shape is very important, and must appear completely natural. The distribution of volume must be distributed proportionally to each part of the lip, following its natural parameters.

Lip augmentation has been considerably discredited recently, due to the extremist construction of overlarge lips which some patients have undertaken. One should be aware that the correct results of the operation should not be confused with these extremities. Usually, overlarge lips are due to the implantation of large quantities of materials, or the use of bad quality materials. Therefore, the patient must be particularly careful when selecting the surgeon who will be performing the operation and verifying the quality of the materials they intend to employ.


There are several methods of augmentation, divided into the following categories:


Several types of injectable materials are available for use in lip augmentation. These are divided into two larger categories, permanent and absorbable materials.


To begin with, at least, it is a good idea to use absorbable materials, so that in the event that the result is not desirable, it can be sure it is reversible.

Hyaluronic acid is the most commonly used filler material. It is a transparent gel which is inserted into the lip and provides the desired volume and shape. It is a completely safe material that has been tested through millions of application throughout the world, over a long period of time. Results tend to last approximately six to nine months, but in most cases, after a few repetitions, the can last much longer.

Thanks to technological developments, hyaluronic acids specifically designed for application to the lips are available for use. The implantation can be performed in stages, while the results will become immediately apparent. Therefore, patients undertaking this method run no risk of receiving an overlarge augmentation. This is because the method allows for the insertion of small quantities of hyaluronic acid, and an evaluation of the result, which is then followed by yet another insertion of a small quantity and another evaluation, and so on, until the desired aesthetic result is achieved.

There is a solution even in the event that a patient feels that too much material has been inserted. The plastic surgeon can use hyaluronidase, an injectable substance which, after its insertion, removes the hyaluronic acid in under 24 hours. Therefore, the lip returns to its former appearance shortly.

These factors guarantee a natural-looking result for the lips. Thus any anxiety a patient may feel, if they wish to augment their lips but are terrified of an unnatural-looking result, can be dealt with.

In practice, the procedure usually followed by a plastic surgeon is to perform a small injection of hyaluronic acid every week, until the desired result is achieved. Hyaluronic acid does not provoke reactions from the organism and is completely safe.


Permalip is a solid, soft silicone implant, which is placed into the lip through a small incision. This technique is completely safe, as it is common knowledge that silicone implants do not provoke a reaction from the organism and, at the same time, can be easily removed if the patient wishes them to. In any case, silicone is employed quite widely in medicine, having various applications in several specialized areas. This is so because silicone has been proved to be a neutral material in relation to the organism. It is not at all related to injectable silicone, which has in the past caused multiple, difficult to solve problems.


Permalip has the following advantages:

•    It is a soft material and has a similar texture as the lip, and as such is not discernible.

•    It does not elicit a reaction from the organism and is completely safe.

•    It can easily be removed whenever the patient wishes.

•    Its results are permanent; it can last forever.



The disadvantages are:

•    One must decide beforehand on the size of the lips; this cannot be determined through a stage-by-stage procedure, as with injectable materials.

•    The lip will usually present some swelling for 5-7 days.

The permalip procedure of augmenting the lips is performed under local anaesthesia and lasts approximately 15 minutes. Two small incisions are made at the corners of the lip, wherein the implant is inserted. These incisions do not leave scars. Once the edema has cleared away, the patients will feel the implant as part of their own body, rather than as a foreign presence in their lip.

A Video presenting the Lip Augmentation procedure with implants is available to the video page. Click here to see the video.


This term is used to refer to tissues taken from the patient’s own body, which can be utilized in augmentation. The most frequently used of these is fat.

Fat is removed from a part of the body by a very small liposuction, processed, and then implanted in the lip. Other tissues that may be used instead are the fascia or the dermis.

This method is completely safe, as the tissues come from the patient’s own body and as such will not provoke negative reactions from the organisms. A part of the deposited tissues will be absorbed by the organism, while the rest will remain permanently. If a patient so wishes, the procedure can be repeated as many times as desired.


(gull wing lip lift and bull horn lip lift)

These procedures entail the removal of a small strip of skin from the upper lip (gull wing lip lift); the lip is then stitched back together, causing it to turn outwards. The incision can be made at the boundary between lip and skin, or at the point where the skin of the upper lip and nose meet (bullhorn lip lift). These incisions will leave some small scarring, but this is usually indiscernible and therefore does not cause an aesthetic issue.

These methods do not increase the volume of the lip, but merely turn the lip outwards to make it appear larger.

The recovery time is usually about two weeks; this is approximately the amount of time needed for the incision to heal. The results, of course, are permanent.


Choosing the correct method is a matter that each patient will have to deal with after a thorough discussion with the plastic surgeon. The type of augmentation that best fits each patient may be different, according with their particular needs and their attitude towards lip aesthetics.

It is most important, however, for the doctor to make the correct choice. We are all familiar with those particularly unappealing cases wherein the lips have been augmented to the point of appearing overlarge and unnatural. These are not merely aesthetically unappealing; they provide an example that should be avoided. One should be aware that these cases are usually the result of the patient not having being treated by a plastic surgeon, and in some cases not having being treated by a doctor at all.

Lip augmentation is a procedure which, if performed correctly, can yield very appealing results. A successful plastic surgery treatment on the lips will, ideally, appear natural to the point of being indiscernible, and no one should be able to discern that any type of procedure has been done on the lips in question.