Lip Sculpting
October 16th, 2009
I find that a significant part of doing cosmetic surgery is sculpture. Whether I am removing (liposuction), adding (breast enlargement) or rearranging (face lift), the quality of the result and achieving a natural appearance is the direct result of sculpture. Lip enlargement using injectable materials is no different. I first start out with mental image of what normal lips look like. The lips are then sculpted with the injections to look like normal lips. Just this past week, I did three lip injections to minimize wrinkles and give the face a more youthful appearance. All of my patients have a nice improvement in their appearance, no hint of the “sausage lips” look, that seems to be popular in Hollywood.
I have noticed that many injectionists must think lips look like sausages! Jimmy Dean fills cylindrical tubes with meat to create this shape. I do not find this look to be attractive. Nobody’s lips look like sausages except the ones which have been injected! Lips have a subtle curve know as a “Cupid’s Bow.” This complex curve is created by the mirror image of the upper lip meeting the lower lip. The Cupid’s Bow shape is most apparent along the upper lip where the red lip meets the flesh-colored skin also known as the vermillion border.
Lips injected with fat, collagen or hyaluronic acid will look like sausages if they are injected evenly along their length. It is a simple matter of physics. To maintain a normal appearance, they must be injected differentially, maintaining relative fullness of the central upper lip compared to the lateral upper lip. The lower lip should be the mirror image of the upper lip. The lower lip should be fuller lateral to a central relative thinness. You might think of the lips like gears which mesh. Full on top meshes with thin on the bottom and thin on top meshes with full on the bottom.
Three other things to remember. First, the lower lip is almost always fuller than the upper. Julia Robert’s lips are an exception to this rule. In other words, they are not normal. Seeking this appearance will give you unnatural looking lips. Second, lips naturally taper toward the corners of the mouth. Injections here distort this natural shape. Finally, lip enlargement can be accomplished with about 2 ml or cc. This equates to two syringes of most products. Injecting more than 2 ml, increases the risk of getting an unatural appearance (or sausage lips) and more importantly, the risk of terrible scarring from skin necrosis or skin death.
In other words, there is more to creating a naturally pouty lip than most people might appreciate.
Too Much of a Good Thing – Two to Tango
October 2nd, 2009
Patients choose whether to have cosmetic surgery or not. It is purely an elective and usually non-essential surgery. Some patients end up having so many cosmetic surgery operations that their physical appearance becomes distorted, as I have discussed in prior blogs. Obviously the responsibility of having multiple cosmetic surgery procedures rests with the patient. However, without a surgeon or injectionist doing each treatment, excessive surgery would never occur. It takes two to tango, except of course when patients do surgery or injections on themselves.
I often see patients during consultations that have had multiple surgeries. Most often they have had their surgical procedures over a number of years and performed for specific physical sensitivities. Most results are natural in appearance and they are generally accepting of results, which may not always be perfect. In my opinion, these individuals are not obsessed with cosmetic surgery and I will consider them as patients.
There happen to be a few patients that present having had multiple surgeries on a single body part in quick succession, done by different surgeons. Some have so much scarring; it is impossible to make any further corrections. I advise these patients not to have more surgery. My professional ethics do not allow me to accept them as patients. Sadly this is not acceptable to everyone and unfortunately they will continue to seek out other physicians either locally or in other cities, until they find a surgeon to do what they want. Rest assured, you can most always find a surgeon to operate on you. Understand that surgeons make their living by operating, so when a surgeon recommends not having surgery, there must be a very good reason because they are losing income. Nonetheless it is difficult to disappoint a patient and turn them away. Fortunately, here in Minneapolis, most of my patients have reasonable expectations and seem to be conservative in their desire for unnecessary or repetitive cosmetic surgeries.
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