There are a few features of our faces that express such beauty and expression as our smiles.
We now have so many options both surgical and non surgical to create beautiful lips and a sexy smile. In general, we can reshape, rejuvenate and add volume. There are fillers, silicone implants, dissolving thread implants, lip lifts, lip reductions, peels, and then of course cosmetic dental care to improve the color shape and contour of your teeth and gums.
Best-known fillers that we use include Juvederm and Restylane but there are newer versions that are less dense and feel softer and more natural. These are all HA or hyaluronic acids, the building blocks of collagen. They generally will last four to six months. Thinner patients tend to metabolize the products faster.
The G prime of filler relates to the elasticity or softness; lower G prime fillers being more pliable and softer, better for lips. Higher G prime fillers like Voluma and Restylane Lift are better for structure lifting and filler in areas like the cheeks.
Another characteristic is how the molecules of the HA link together (cross linking). Again this will provide different characteristics including their G prime and how much water they absorb leading to more or less swelling after injection.
Currently we are using Volbella and Belotero. These products have lower G prime.
Volbella absorbs less water so there is less swelling and its crosslinking seems to allow this product to last longer, up to a year for many patients. We are also able to inject this product into the fine lip lines around the mouth.
Another helpful characteristic about these fillers is the ability to dissolve them in minutes if you are not happy with the shape or volume. Injectables also have the ability to fill areas of the lips where more volume is desires and do this in a more artistic manner than simply placing an implant. So, if you like Angelina Jolie’s lips, these have a fuller shape throughout, but if you like the Michelle Pfeiffer pout then you need more fillers on the sides.
Typical areas that are filled include: the fine lines or smoker’s lines of the upper lip; the cupids bow or central fullness; the columella or columns that are between the lips and nose; the lip line or white roll; the corners of the mouth or commissures; the marionette lines or folds between the corners of the lips and the chin.
Fat Grafting is another filler that can be used to add shape and volume. It uses our own natural fat that is injected with small specialized cannulas.
The next category of fillers includes silicone implants, which are shaped, and soft and add permanent natural looking fullness. Nova fill threads can be placed in the lips to add volume and then dissolve while generating your own collagen.
In addition, Botox, Dysport or similar muscle relaxers can be used to soften the smoker’s lines and allow the corners of the mouth to turn up from the downward “look of despair”. These products stop the harsh action of the muscles in these areas, allowing a softer younger appearance.
These muscle relaxers can also be used to elevate the corners of the mouth to reduce the “look of despair.”
Surgical treatments can improve texture and contours in a number of ways. Dermabrasion, chemical peels, and laser peels can remove sun damaged leathery skin, fine and deep lines to smooth the surface of the skin removing years of aging. These treatments are often combined with fillers and muscle relaxers. The results are dramatic.
Lip lifts are minor surgical procedures that actually shorten the distance between the nose and upper lip and allow more of your central upper teeth to show both at rest and when you smile. This has sometimes been called the bullhorn procedure because of the shape. The incision at the base of the nose, just within the nostrils, tucks the muscle and shortens the skin providing a youthful upper lip in less than an hour under local anaesthetic
Another method of lip lifting is an excision at the white line or top edge of the lip. This is useful for patients with significant lip lines and lipstick bleed. It will increase the red part of the lip. Filler can be added to make the lip fuller and rounder.
A third surgical treatment uses small incision inside the lip to advance the red part of the lips forward and out to add volume. Lastly a small excision can be performed at the corner of the mouth to raise this part of the lip.
Additional treatments to get your sexy smile include permanent tattooing and cosmetic dentistry to improve the appearance of your teeth and gums.
|Radiesse + lidocaine||554||143,100|
|Juvederm Ultra Plus XC||139||32,152|
|Juvederm Ultra XC||11||27,034|
|Juvederm Ultra Plus||75||17,699|
Table taken in part from data from Sundaram H, et al. Dermatol Surg 2012;11(8 suppl)S12-24.