FAQ cosmetic surgery of the lips

Q. My upper lip is very thin and I would like to ask for your advice about the most suitable techniques and the safest materials for lip augmentation.
A. The increase of the lip volume can be achieved through several medical and/or surgical procedures which consist in using injectable filling materials (fillers), solid implants (threads), tissue grafts or local flaps. The choice of the kind of procedure (medical or surgical) and of the material to be used depends upon the cosmetic result you want to achieve and on the tolerability of the products used.
The filling materials may be absorbable, semi-permanent or permanent.
Absorbable fillers, such as collagen and hyaluronic acid, have the advantage of being easily tolerated by the body but provide a temporary volume increase (from 4 to 12 months).
Semi-permanent fillers have the advantage of providing a more durable result (from 12 to 36 months) but, though in exceptional circumstances, may provoke foreign-body reactions (granulomas).
Permanent fillers have the advantage of providing a permanent result but, sometimes, they can induce a rejection reaction that is not easy to control and correct. In my opinion, however, it is always preferable to use absorbable fillers, because they allow the patient to decide whether to continue the treatment or to regain his/her natural state; also, they don’t have any collateral effect.

Q. Are there any cosmetic treatments or cosmetic surgery operations capable of assuring definitive and permanent lip augmentation?
A. To achieve a permanent increase of the lip volume, it is possible to fill them with permanent materials (fillers), or to implant threads made of non-absorbable material, to be inserted inside the lips (vermilion) or along the contour of the mouth, or it is possible to graft tissue or fat taken from a part of the body and then implanted into the lips (e.g. lipofilling) or, finally, to use local flaps, making incisions (W-, V- or Y-shaped) in the internal part of the mouth and transferring a flap of local tissue to the external part of the lips.

Q. I’m 60 and small and quite deep wrinkles have appeared around my lips. I would like to know what the best treatment for this problem is.
A. The wrinkles that appear vertically above and under the contour of the mouth (perioral wrinkles) are frequent among thin-skinned people and among those who often tense the orbicular muscle of the mouth (for example, the women who smoke). Instead in the male skin, which is much thicker, this defect hardly ever occurs. Perioral wrinkles can be improved, but not eliminated completely, by a combination of various treatments acting on all the factors that cause them to appear. More precisely, the skin should be treated with techniques smoothing its outer layer, such as dermabrasion, CO2 laser and intermediate (TCA) or deep peelings (phenol). The subcutaneous fat that has thinned out should be replaced through filling materials such as hyaluronic acid and, above all, collagen. Finally, the orbicular muscle of the mouth should be relaxed through little injections of botulinum toxin to prevent this muscle from contracting, which inhibits the appearance of worry lines.