GET FULL AND LUCIOUS LIPS WITH INJECTABLE FILLERS AND BOTOX
NOVEMBER 2008

There are dozens of things that can be done to improve the appearance of the lips. So here I am only going to explain the state of the art use of injectable fillers and of Botox.

1. First, I study your lips, looking at the anatomy and at the ideals of beauty. After all, you want shapely, sensuous lips, not just big or fat lips. For example, the lower lip should be a little fuller than the upper lip. Creating the curve of the upper lip (called the Cupid's bow) is very important. The attractive upper lip has three little bulges: one in the center (the pout), and one on each side. On the other hand, the lower lip should have only two little bulges, one on each side.

2. Second, you need to understand that creating full lips is really an art. To get a great result and avoid problems, technique is everything. I do have strong preferences for the best lip fillers which I use in my Manhattan Plastic Surgery office (see below), but how well the lip injections are done is actually more important than which filler is used.

3. Best filler for beautiful lips: I use Juvederm. It feels soft and natural and lasts 6 to 12 months. The down side of Juvederm is that you may have some bruising and swelling for a few days.

4. If you need to look good right away, Cosmoplast (human collagen) is a good choice. Cosmoplast also feels soft and natural and there is usually no bruising or swelling, but it lasts only three months.

5. For young lips, I selectively inject the filler into the vermilion (the red, moist part of the lips) according to the anatomical and artistic concepts described above.

6. For older lips: I treat older lips exactly the way I treat young lips, as I just described, plus several other things need to be corrected:

A) Up and down 'lipstick lines" mainly in the upper lip.

These fine lines are injected with filler and the "white line" (between the skin and the red lip) is treated. Also, I use a little Botox to relax the muscles that helps to create these vertical wrinkles.

B) Corners of the mouth go down.

I inject filler in both sides of the lower lip to create a "pillar of support" that holds up the corner of the mouth. Here also, a little Botox will relax the muscle that pulls the corners of the mouth down and so the corners come up.

C) "Marionette lines".

These are folds running from the corners of the mouth to the jaw line. I treat marionette lines with Juvederm.

7. Pain-free injections.

I always use dental anesthetic blocks which last about 20 minutes before placing fillers in the lips. This is a very important point. You are relaxed and pain-free, and I don't have to rush and can sculpt your lips very carefully.

George J. Beraka, M.D.