Vermilion is the area or zone between the lip and the skin adjacent to it and it is covered with specialized stratified squamous epithelium, which is in continuity with the oral mucosa of the gingivolabial groove. A thin vermilion is a characteristic facial feature associated with many genetic alterations and conditions but also with the aging process.
Lip enhancement or augmentation is a great option for the treatment of thin lips and they have become quite popular in the last 20 years or so. Although with recent advances in science and technology, more and more subtle enhancements can be done giving a very natural appearance.
You may rely on various methods and products to enhance your lips and give them the plumper, ‘Kylie Jenner’ appearance. Each product needing extensive research and so on, which can be quite overwhelming. Also, the wide variety of options available on the market may make the decision-making process even harder. This is why we have reviewed some popular methods and products to help you decide which option is the best for you.
Figure 1 – Before and after opting for augmentative lip fillers. Notice how the exposure of the vermillion peak is increased.
1. Juvederm Ultra XC and Juvederm Volbella XC
Juvederm products augment lip using non-surgical lip fillers which give the lips plumper and fuller appearance. Lip fillers are a commonly used aesthetic intervention nowadays. In fact, it is one of the most popular non-surgical cosmetic procedures worldwide (1). Temporary lip fillers are the perfect option for those who do not want to commit to a permanent lip filler or implant treatment as they only last approximately six months.
Juvederm products work by adding volume through their active ingredient, hyaluronic acid. Hyaluronic acid is a natural component of the connective tissue, playing an important role in wound healing and tissue regeneration (2). A randomized clinical trial conducted by Geronemus and his team with the objective to test the safety of Juvederm products found them safe and effective for lip enhancement purposes (3).
Another benefit of lip fillers is that they are minimally invasive procedures that can be designed or customized specially according to everyone’s own personal preference.
2. Aquamid (Polyacrylamide hydrogel) Lip Fillers
Aquamid lip fillers are permanent lip fillers containing polyacrylamide hydrogel that will stay in the body indefinitely. It is a non-absorbable soft tissue filler widely used for lip and body enhancement with common sites of del injections including nasolabial folds, lips, glabella folds, and so on.
Aquamid fillers are made up of 2.5% polyacrylamide (PAAG) and 97.5% water, creating a perfectly homogeneous and optimally viscous gel that is mostly used as a lip filler (72%) (4).
A clinical trial published in the Plastic Reconstructive Surgery Journal by Von Buelow and Pallua was performed with the objective of testing the efficacy of Aquamid in the short run and the long run (5). They found that Aquamid fillers were not associated with any adverse soft tissue reaction, like many feared with these lip fillers.
Not just that, Aquamid injections are also known for stimulating collagen production in the lip, helping the lips become plumper.
All in all, Aquamid is a stable, nondegradable, and safe gel filler that has the potential to be a lifelong soft tissue filler. Also, due to the need for sterile conditions, Aquamid can only be injected by qualified individuals, reducing the risk of botched lip jobs (6).
3. Gore-Tex (e-PTFE) Lip Implants
Lip implants surgery is a permanent, invasive medical procedure that can be performed for the purpose of lip augmentation. In this procedure, your doctor or surgeon might insert one of the various implants available on the market to enhance your lip structure to give a fuller lip appearance.
Expanded polytetrafluoroethylene (ePTFE) implants have been widely used since their introduction in 1997 for lip augmentation procedures. They usually produce great results, but just like any other medical procedure, some patients may face certain side-effects (7).
ePTFE has faced scrutiny due to the side effects usually associated with the, however, a study published in Dermatology Surgery Journal found that not only do ePTFE implants produce a natural-looking lip appearance, but they also do so effectively and safely (8).
This is the perfect choice of treatment for those looking for permanently augmented, and natural-appearing lips.
4. Lip Augmentation with Autologen
Autologen or autologous collagen lip injections are fillers, the main ingredient of which is collagen derived from the patient’s skin directly. It is part of the natural connective tissue found in the body and is hence, a physiologic, safe, and effective material to be used in lip augmentation procedures (9).
Moreover, autologen lip injections do not pose any threat of an allergic reaction or rejection since the filler substance is derived from each patient’s own skin. Features like this make autologen an ideal option for lip augmentation in women (10).
However, they are temporary injections that will dissolve over time, and hence need to be retouched. But patients need not worry about their skin being used for collagen extraction at every appointment. In fact, the collagen derived from the skin of the patient can be cryo frozen for up to five years, allowing the patients to undergo treatment using their own collagen for a long period of time.
5. Lip Augmentation with Fat grafting
This is a permanent type of lip augmentation that involves autologous fat grafting and implanting to give the lips a natural-looking, plump, and fuller appearance. This method of lip augmentation is an invasive procedure for which the patient is required to go under anesthesia for the fat grafting process. The fat is grafted from the patient’s own body and then injected into the perioral areas to augment the lip shape (11). The injections are given two to three more times, which result in permanently augmented lips that do not need any further injections. (11)
According to a prospective cohort study published in the Oral Maxillofacial Surgery Journal, they evaluated the patients before and 12 months after the autologous fat injection and found autologous fat lip injections to be a safe and reliable method of lip augmentation (12).
- Greene, Ryan M. “Comparing the Use of Injectable Fillers for the Youthful Lip and the More Mature Lip.” Facial plastic surgery : FPS vol. 35,2 (2019): 134-139. doi:10.1055/s-0039-1681083
- DENTAL SUPPLEMENT et al. “Hyaluronic acid fillers in lip augmentation procedure: a clinical and histological study.” Journal of biological regulators and homeostatic agents vol. 33,6 Suppl. 2 (2019): 103-108.
- 3 Geronemus, Roy G et al. “Safety and Effectiveness of VYC-15L, a Hyaluronic Acid Filler for Lip and Perioral Enhancement: One-Year Results From a Randomized, Controlled Study.” Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] vol. 43,3 (2017): 396-404. doi:10.1097/DSS.0000000000001035
- de Cássia Novaes, Wilse, and Agnes Berg. “Experiences with a new nonbiodegradable hydrogel (Aquamid): a pilot study.” Aesthetic plastic surgery vol. 27,5 (2003): 376-80. doi:10.1007/s00266-003-2119-x
- von Buelow, Silvester, and Norbert Pallua. “Efficacy and safety of polyacrylamide hydrogel for facial soft-tissue augmentation in a 2-year follow-up: a prospective multicenter study for evaluation of safety and aesthetic results in 101 patients.” Plastic and reconstructive surgery vol. 118,3 Suppl (2006): 85S-91S. doi:10.1097/01.prs.0000234844.59251.3f
- Hanke, C William. “A new ePTFE soft tissue implant for natural-looking augmentation of lips and wrinkles.” Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] vol. 28,10 (2002): 901-8. doi:10.1046/j.1524-4725.2002.02065.x
- Cheng, Jacqueline T et al. “Collagen and injectable fillers.” Otolaryngologic clinics of North America vol. 35,1 (2002): 73-85, vi. doi:10.1016/s0030-6665(03)00095-1
- Fagien, S. “Facial soft-tissue augmentation with injectable autologous and allogeneic human tissue collagen matrix (autologen and dermalogen).” Plastic and reconstructive surgery vol. 105,1 (2000): 362-73; discussion 374-5. doi:10.1097/00006534-200001000-00057
- Gatti, J E. “Permanent lip augmentation with serial fat grafting.” Annals of plastic surgery vol. 42,4 (1999): 376-80. doi:10.1097/00000637-199904000-00005
- Tabrizi, Reza et al. “Dimensional Changes of the Upper Lip Using Dermis Fat Graft for Lip Augmentation.” Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons vol. 73,10 (2015): 2030-7. doi:10.1016/j.joms.2015.03.040