Cheek Implants Houston

Options for Lip Augmentation

Women's mouths are bigger and better than ever. And those perfectly plump, appealing lips aren't always God-given. Sometimes, they're the result of visiting a facial plastic surgeon's office for a little assistance in achieving a pouty mouth.

Noted Houston facial plastic surgeon Russell W. H. Kridel, M.D., F.A.C.S., explains, "Young lips have bulk, a marked ridge above them, projecting pouti­ ness, and there is a large portion of red lip as opposed to white lip. With age, the lips change, and become flatter and less defined, especially the top lip. The red portion diminishes, and vertical lines appear around the mouth, which can create havoc for lipstick because it tends to trail off into the cracks."

But doctors have ways to increase the poutiness and the projection of your lips, improve the curved shape of the upper lip and the cupid's-bow, and eliminate wrinkles around the mouth. "Injectables can solve all three problems," says Dr. Kridel.

By the way, if you decide you want fuller lips, take pictures of what you like when you go to see the doctor for a consultation. That way, you can make your goal clear.

(If you're having lip injections, you need to be off of aspirin or ibuprofen for a week to ten days before the treatment.)

Ways to have your lips made fuller and more defined and soften wrinkles around the mouth are:

Zyplast (bovine) collagen injections. You must have two skin tests a month apart to make sure you're not allergic, so you can't have collagen injec­tions on the spur of the moment. Multiple sticks can make your lips feel uncomfortable because they are tender, but numbing medication helps. You can numb up your lips before leaving home (if you pick up the prescription in advance), or go to the doctor's office an hour early to have your lips numbed. After the injections, your lips are iced, and they will look overdone for one day because your doctor

overinjects the collagen (because it contains saltwater). Zyplast makes your lips full, but your body absorbs it over a period of about three months. Advantages are that you can't feel collagen inside your lips, and the full-looking lips are aesthetically pleasing.

Many women prefer collagen injections for lip- plumping even though the effect is temporary because collagen injections are simpler than other options, such as AlloDerm sheeting. And if you like what you see, you can return to your doctor for more injections periodically.

• Cymetra (human) collagen injections. In studies, Cymetra has been shown to last longer than Zyplast collagen. One advantage is that Cymetra doesn't require a skin test so you can have it done immedi­ ately; you're going to your class reunion and that week, you decide to have your lips augmented. Because Cymetra is thicker than Zyplast, it requires a slightly larger needle, which makes the injections a bit more painful.
  
• CosmoPlast and CosmoDerm injections. These types of human collagen are processed differently than Cymetra, which has a unique processing that preserves the collagen so that it has a better chance of being incorporated and building up over time with multiple injections.
  
• Restylane injections. This kind of injection lasts longer than Zyplast. When approved by the FDA, it will be a good option, says Dr. Kridel. Restylane has no numbing medication in it, which makes it uncomfortable for the patient and may make a block necessary.
  
• Fat infections. Fat can be "harvested" from anoth­ er part of your body (abdomen or thigh) and rein­ jected in your lips. "We have to overinject it because not all of it lasts," says Dr. Kridel. For two weeks, your lips are swollen, and the length of time fat injections last varies from person to person. It can disappear quickly or last for years.
  
• Alloderm sheets. These sheets (the same material as Cymetra) can be rolled and implanted in lips with the patient under local anesthesia. Alloderm sheet­ ing is made of processed human skin (dermis) that can be grafted and implanted into patients. The dermis is the bottom layer of skin that pro­ vides support and strength to the epidermis (top layer) and elasticity to the skin. In gum surgery, burn surgery, and plastic and reconstructive surgery, Alloderm grafts have been used to repair tissue in the nose, mouth, forehead, cheeks, chin, ears, head, neck, feet, breasts, hips, and around the eyes.
  
  Says Dr. Kridel, "I like Alloderm. Your own tissue grows into it, and it becomes part of you. There's nothing foreign, nothing to cause an allergic reac­ tion and come out. It feels normal after a few months." He adds, "In about half of patients, some Alloderm lasts as long as two years and in some patients, five years."
  
  Drawbacks of having Alloderm sheets placed in your upper and lower lips are that you have to undergo a minor procedure in the doctor's office, your lips stay swollen for weeks afterward, and your smile is stiff for about four months. "Your lips feel very natural after the Alloderm softens up," adds Dr. Kridel.
  
• Advanta implants. This is a type of Gore-Tex (Teflon) material, with the upside that it is perma­ nent and the downside that the edge of it may show in certain facial expressions. Some patients can feel Advanta implants. Also, these can extrude or get infected and then must be removed.
  
  For fine lines around the mouth and downturned corners of the mouth, you can have Dr. Kridel inject Zyplast, Zyderm, or Restylane. He can also use Radiance or a tiny amount of Botox close to that area to relax the downturned look.
  
  Tissue-filler injections aren't a remedy for deep lines on the upper lip, explains Dr. Kridel, who rec­ommends a chemical peel or laser skin resurfacing for those lines. "Also, when you have laser skin resurfacing, it makes flatter lips look fuller in some patients because the laser treatment causes con­traction," notes Dr. Kridel.
  
  When the doctor injects your lips, he can accentuate your lip line, increase the bulk of your lips, or do both.

Other operations also improve lips. Lip advance­ment pulls the lip up and increases the height of the top lip. The downside is that the incision on the top lip may scar. There is also a subnasal lip lift, which requires an incision at the base of the nose. The doc­ tor takes out some of the white lip. This may leave a visible scar, and not everyone is a candidate for this operation.

Some doctors also do an operation on the inside of the mouth to advance tissue and create greater bulk in the lips, explains Dr. Kridel, who doesn't do this operation because the results are widely vari­ able.

To keep your lips looking full and healthy, Dr. Kridel advises:

• Don't smoke.
• Stay out of the sun.
• Keep your lips moist.

Russell W. H. Kridel, MD, FAGS Dr. Russell Kridel has a vast range of experience in facial plastic surgery that has made him a sought-after speaker at medical meetings and courses worldwide. Elected by his peers, Dr. Kridel was National President of the American Academy of Facial Plastic and Reconstructive Surgery from 2000-2001. He also serves on the Board of Directors and is an examiner for the American Board of Facial Plastic & Reconstructive Surgery. His office is located at 6655 Travis, Suite 900 in the heart of Houston's Medical Center. For more information call 713-526-5665 or visit www.todaysface.com.