Lip beauty

The beauty of the lips is an important element of facial beauty. Just like the appearance of the face, the appearance and expression of the lips reflects the personality and temperament of the person. Their contour, tone and firmness must be in proportion with the face to form a homogeneous whole.

Aesthetic lip treatment is designed to meet two very different requirements:

• The most important requirement comes from younger patients who are satisfied with the appearance of their lips but, as they get older, begin to be bothered by the loss of volume that leads to a collapse of the coloured part of the lip called the "red lip" and the upper edge of this coloured part called the "vermilion line" or "cupid bow". This subsidence is usually accompanied by the first vertical wrinkles appearing which can spontaneously worsen at different rates depending on the individual and their genetics.

These patients normally have two requests: to correct these defects and to stop them getting worse in order to preserve the look of their lips from their youth for as long as possible. This point is very important. They do not want enhanced lips but the return of the volume they had when younger and the ability to maintain this.

• The second requirement comes from patients whose lips naturally lack a curve and who wish to embellish the contours of their lips and harmonise them with the rest of their face.

This is not a matter of reproducing standards but of practising embellishment techniques, preserving a natural look and your ethnic and personal identity. The aim is to bring your lips into harmony with the rest of your face, as much by their volume as by their shape.

Aesthetic techniques may concern the upper lip, the lower lip or both.

Most cases can be treated by aesthetic treatments but some cases may require plastic lip surgery.

The considerable technological progress of recent years has provided us with fillers that are more and more effective and reliable and can be used in medical centres, in particular, with hyaluronic acids. Previously, these were absorbed in a few months and sometimes caused inflammatory reactions but they now give much more lasting results of over a year and often 2 years or more. Also, they are well tolerated by tissues.

The products used are important, but the injection technique is also essential. It requires a perfect knowledge of natural anatomy and is like sculpting the shape of a toned and natural lip by skilfully choosing the location and volume of the injection. An unnatural result does not necessarily result from an excess of injection volume but often from the wrong choice of area for the injection.

The two main uses:

• Preventive treatment of ageing lips by maintaining their volume, which limits the appearance of vertical wrinkles. This can be used when the first signs of a loss of lip tone are noticed, regardless of age. It is not a question of inflating the lips but of maintaining their original volume.

• Correcting existing defects such as insufficient volume, whether constitutional or due to ageing.

Each person arrives with a request for the correction of a particular defect that is particularly troublesome to them. The objective of the operation will be to correct this defect as a priority by assessing whether it may be appropriate to correct other associated defects to have a well-balanced, natural result that meets expectations.

So, depending on the insights gained during the first consultation, the treatment may concern the upper lip, the lower lip, or both, or possibly be combined with another treatment to improve facial harmony.

It is common to combine treatments aimed at maintaining a good volume and/or attenuating lip wrinkles, such as chemical or laser peels and dermabrasion.

During the first consultation, it is essential that you openly express what bothers you and what you would like to improve. Do not be afraid to ask any questions, including expressing your fears and expectations. Everyone has a different body shape, psychology and expectations. These are not the same and there is no standard to apply.

After you have explained your motivations, I will examine you and offer one or more solutions, taking into account your expectations, your anatomy, respecting your identity and the natural aspect of your appearance.

So you can visualise the desired result, in front of a mirror, I will manually reproduce the effect of the recommended treatments on your skin and show you photos of surgical results from cases similar to yours to help you understand the objective of the intervention.

It is essential that you and I have a good understanding when deciding to operate and to determine the technique to use from among those I can offer.

I will then give you all the information on the techniques proposed along with the information sheets from the Société Française de Chirurgie Plastique Reconstructrice et Esthétique (French Society of Plastic, Reconstructive and Cosmetic Surgery) as well as a detailed estimate of the costs for the options chosen. You will then be able to move your project forward and get ready for a second consultation when you will be able to ask any additional questions to help you make a decision and prepare for the operation.

No special examination is required.

No medication containing aspirin or anti-inflammatories may be taken up to 10 days before treatment.

If you have a local anaesthetic, it is recommended that you drink and eat lightly at your usual mealtimes before treatment.

The treatment is carried out in the medical clinic and you do not need to stay in hospital.

The treatment lasts about 30 minutes. Then, you can go home straight away.

Local anaesthetic is sufficient.

To maintain or increase volume, either fillers (hyaluronic acid) or lipofilling (injecting your own fatty tissue) can be used.

Hyaluronic acid can be used to boost volume and as a product for filling superficial fine lines in the thickness of the skin, while lipofilling is used to give volume inside the lip.

The products used are important, but the injection technique is also essential. It requires a perfect knowledge of natural anatomy and is like sculpting the shape of a toned and natural lip by skilfully choosing the location and volume of the injection. An unnatural result does not necessarily result from an excess of injection volume but often from the wrong choice of area for the injection.

Before the injections, I will go over the precise objectives with you as we agreed during the consultation. You can then always make recommendations or ask any questions. I will then draw the marks to guide the treatment on your skin.

Hyaluronic acid injections

This injection uses extremely fine needles, limiting the pain and allowing greater precision. Foam micro-cannulas are also used which are not sharp and avoid bruises on the treated area.

There are no scars because the micro-cannulas are introduced through needle puncture holes that leave no marks.

These are performed in the following 2 ways:

• At a deep subcutaneous level for volume injections,

• On the surface and in the skin’s thickness to fill wrinkles and smooth the outer skin.

Injections should be performed regularly in small, well distributed volumes to avoid product accumulation in the same area that could leave a palpable or visible lump after treatment. In addition, following the injections, I massage the treated area to ensure the product is well distributed.

Lipofilling (injecting your own fatty tissue)

Fatty tissue that is intended for reinjection is removed during local micro-liposuction, if necessary, (for treatment of the jowls or double chin), and/or on localised areas of body fat, often on the hip, where the fat is of excellent quality to support re-implantation. With lipofilling, a portion of the transplanted fatty tissue will be absorbed back and a portion will be revascularised as normal local fatty tissue. The percentage of the fatty tissue graft taken varies depending on each individual and is usually between 30% and 80% of the volume of fatty tissue injected. This means it is necessary to take a larger volume of fatty tissue to be able to overcorrect the area that needs be filled by at least 30% (a total overcorrection of 130%).

Reinjection is performed using a micro cannula (1.5 mm) in small strokes so the graft does not accumulate in a single place and is evenly distributed over the entire area that needs to be filled.

There are no scars because the micro-cannulas are introduced through needle puncture holes that leave no marks.

Usually, there are no marks or pain and you can resume your normal social life the same day.

You are more likely to be bothered by the effects of the local anaesthetic for an hour or two, causing numbness in the treated area.

In the days that follow, there may be slight swelling (oedema) in the treated area, due to reactive swelling caused by the presence of the product. This takes just a few days to disappear completely.

Bruises are very rare and it is always possible to mask them with make-up from the day of treatment.

Care

• No specific care is required.

• You will need to attend a follow-up visit 1 month after treatment.

Recommendations

• Exposure to the sun: if you do not have bruising or marks, exposure to the sun is possible immediately using a sunscreen with a maximum sun protection factor. If you do have bruising or marks, do not have direct exposure to the sun until they disappear completely.

• Make-up: you can use make-up on the same day of treatment with your usual products.

The aftermath is a little more troublesome than those of hyaluronic acid injections, but even for moderate pain, most of the time, there is no need to take pain killers.

There is usually swelling (oedema), which can be significant in the hours following treatment and sometimes bruising, depending on the individual. This will require a few days to disappear almost completely. However, you can conceal this the day after the treatment by using make-up designed for use after operations.

You will need to take 5 days off work and social activities.

Care

• No specific care is required.

• You will need to attend a follow-up visit 1 month after treatment.

Recommendations

• Exposure to the sun: no direct exposure before 1 month then exposure is possible using a sun protection cream with a maximum protection factor. If you have bruises or marks, no direct exposure to the sun until they disappear completely.

• Make-up: the bruises can be hidden with a cover-up cream the day after the operation and your usual make-up can be applied on top of this. The products used must be adapted and designed for post-operative use. They will be prescribed to you on a post-treatment prescription.

When it comes to the lips, it is important that the result is very natural and does not attract attention. The products used are important but the injection technique is also essential. It requires a perfect knowledge of natural anatomy and is like sculpting the shape of a toned and natural lip by skilfully choosing the location and volume of the injection. An unnatural result does not necessarily result from an excess of injection volume but often from the wrong choice of area for the injection.

Following treatment, you will see an improvement immediately even if results take about a week to stabilise for hyaluronic acid injections and several weeks for lipofilling.

The smoothing and toning effect of the lips is accompanied by an improvement in the appearance of the skin, thanks to the hydrating effect of hyaluronic acid. This attracts water, leading to hydration and an improvement in the quality of the skin. This skin improvement can also be seen after lipofilling because the fatty tissue transferred contains a good proportion of what we know as “stem cells”. These are capable of regenerating local tissues, improving volume, your complexion and the appearance of the skin.

The effects of hyaluronic acid injections remain visible long term, thanks to the good resistance of filling products used today. Their effects last more than a year and often 2 years or more. This means that injection sessions can be spaced further apart, which has the advantage of being far less restrictive and less costly.

The effects of lipofilling are very long term after the time it takes for part of the fatty tissue graft to be reabsorbed. The injected fatty tissue that takes hold is permanently in place, although it is subject to natural ageing.

The ageing process in some patients means that maintenance may be necessary through other aesthetic treatments, such as chemical or laser peels or dermabrasions.

Prevention also involves the traditional means of good tissue hydration, limiting exposure to the sun and tobacco and having a well-balanced diet and lifestyle.

Read the information from the French Society of Plastic, Reconstructive and Cosmetic Surgery.

The cost of the treatment will depend on the procedure carried out and the price of the products used.

If the reason for the operation is purely aesthetic, you do not have a right to reimbursement through Social Security. On the other hand, if this is for reconstructive purposes after an accident or an illness, you may be covered by Social Security and by your mutual insurance company.

A detailed estimate is given to you during the first consultation according to the options you have chosen. You then have a minimum legal period of 15 days to consider your options and move your project forward.

The first consultation costs €50. The follow-up consultations before and after the operation are free.