Recently, the American Society of Plastic Surgeons (ASPA) has announced that the procedures of medicine and cosmetic surgery for the lips have increased by 48% in the last 15 years. We offer a brief overview of the different possibilities for approaching this topic.
The biggest requirements concern the desire for volumetric increase. In this context, the use of fillers is by far the most widespread procedure. Fillers are biocompatible injectable substances that can be differentiated between resorbable and permanent. The most widespread filler is hyaluronic acid. An alternative for the increase in volume is lipofilling, i.e. filling through autologous fat. This is a small outpatient surgical procedure that involves the suction of a modest amount of adipose tissue to be then injected into the lips. It is also possible to use lip prosthesis, i.e. soft silicone bars that are inserted into the lip through a minimal incision with the aid of a cannula.
Many requests concern the desire to reduce the vertical wrinkles of the upper lip, which are also known as “bar code” lines due to their parallel and vertical course. The most widespread technique involves the use of hyaluronic acid to fill the lines individually when they are very evident or to harden the vermilion border, that is the demarcation between lip and skin. Laser assisted laser procedures such as fractional CO2 or Erbium are also highly effective. These determine a more or less deep abrasion of the epidermis followed by a homogeneous and compact regeneration. Similar but older mechanisms, in which regeneration is obtained following a trauma, include chemical peels, microdermabrasion – using a dermoabrasor – or needling – using needles.
The need to raise or rotate the lip is satisfied by the labial lifting procedures in which the lip is raised through a mini incision under the nose or a more evident incision directly at the lip margin, as was done in some old techniques. To rotate the lip, even if minimally, the V-Y plasty technique is performed inside the mucosa.
Last but not least is the request for the removal of permanent filler residues, which have been so widespread over the past few decades, and which are a harbinger of unpleasant complications.
Giovanni Iacopetta