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Lip
Implants For Lip Augmentation
I consider lip implants to be those
which are implanted surgically, and not injected. If you are interested in
injectable micro-implants please see Permanent Injectable Fillers.
Lip implants can be derived from your own body, they can be derived from
cadavers, or they can be synthetic. Some are easily removed and
reversible, others which are made from biological (either your own or a cadaver)
are not as easily removed.
Autologous Lip Implants
These products are not "products" at all but rather tissue harvested from
your own body either for the purpose of lip augmentation alone, or during
another procedure such as a face lift or brow lift. There is no risk of
rejection with harvested tissue. There are secondary scars involved in the
harvesting process, however, usually they are very discrete.
Dermal Tissue:
Dermal tissue is often performed only in conjunction with other procedures
such as a face lift or tummy tuck, however a pre-existing scar can be
utilized. The tissue is deepithelialized (removing the
superficial layer of skin called the epidermis) with a scalpel and the dermal
tissue leftover is then cleaned and implanted into the lips using a standard
lip implants. The use of an autologous graft may have a certain
amount of resorption associated with it. The graft can easily be
integrated by your own tissues thus possibly causing firmness and palpability
detectable by manual pressure and visual abnormalities during speaking,
smiling, or singing animations. However, this commonly fades with time
or massage.
How it's implanted: One incision is made at the corner of each lip end.
You would need four incisions total for both the upper a lower lip augmentation.
The tissue is dissected to create a tunnel for the implant and the implant is
threaded through the lip. The incisions are then sutured.
Cost: Approximately $4000 for the procedure for both upper and lower,
including anesthesia
Fascia lata:
The fascia lata is the thick, fibrous covering than invests the muscles and
some organs. The fascia lata is the fascia which covers the lateral
thigh. The is almost unheard of today of using autologous fascia lata in
lip augmentation due to the risks and scarring to the secondary area, called
the donor site, but mostly because of other available options. There is
a manufactured product which uses particulated fascia lata from cadavers,
called Fascian.
However, it has fallen out of favor for lip augmentation due to the influx of
injectable filler options. The use of an autologous graft may have a certain
amount of resorption associated with it. The graft can easily be
integrated by your own tissues thus possibly causing firmness and palpability
detectable by manual pressure and visual abnormalities during speaking,
smiling, or singing animations. Graft extrusion is also possible.
How it's implanted: One incision is made at the corner of each lip end.
You would need four incisions total for both the upper a lower lip augmentation.
The tissue is dissected to create a tunnel for the implant and the implant is
threaded through the lip. The incisions are then sutured.
Cost: Approximately $4000 for the procedure for both upper and lower,
including anesthesia
Galea aponeurotica:
The Aponeurotica galea is fascia which
covers the top of the head. This procedure is often performed only in
conjunction with other procedures such as a face lift. The graft
can easily be integrated by your own tissues thus possibly causing firmness
and palpability detectable by manual pressure and visual abnormalities during
speaking, smiling, or singing animations. Graft extrusion is also
possible.
How it's implanted: One incision is made at the corner of each lip end.
You would need four incisions total for both the upper a lower lip augmentation.
The tissue is dissected to create a tunnel for the implant and the implant is
threaded through the lip. The incisions are then sutured.
Cost: Approximately $4000 for the procedure for both upper and lower,
including anesthesia
Palmaris longus
Tendon Muscle**: The Plamaris longus tendon / muscle is a superficial
muscle in the forearm that attaches to a tendon that helps flex the hand.
If you make a tight fist you should be able to see a very apparent tendon
above the wrist. This muscle is missing in 14 to 15% of the population.
Patients who do not have this muscle do not show less grip strength when
compared to patients who do have the muscle present. The palmaris longus
tendon, sometimes referred to as an accessory tendon, is sometimes used to
replace other, more function-related tendons when they are damaged. The
use of an autologous graft such as this muscle / tendon or both may have a
certain amount of resorption associated with it. The graft can easily be
integrated by your own tissues thus possibly causing firmness and palpability
detectable by manual pressure and visual abnormalities during speaking,
smiling, or singing animations. Graft extrusion is also possible.
Temporalis
Fascia: The fascia is the thick
covering than invests the muscles and some organs. The Temporalis fascia
is the fascia which covers the muscles of the temples on the side of the head.
This procedure is often performed only in conjunction with other procedures
such as a face lift or brow lift. he graft can easily be integrated by your
own tissues thus possibly causing firmness and palpability detectable by
manual pressure and visual abnormalities during speaking, smiling, or singing
animations. Graft extrusion is also possible.
How it's implanted: One incision is made at the corner of each lip end.
You would need four incisions total for both the upper a lower lip augmentation.
The tissue is dissected to create a tunnel for the implant and the implant is
threaded through the lip. The incisions are then sutured.
Cost: Approximately $4000 for the procedure for both upper and lower,
including anesthesia
Cadaveric Lip Implants
Tissue can also be harvested from cadavers for the purpose of treating burn
patients and as a side market, for cosmetic patients. The cadaveric tissue
comes from donors which are thoroughly screened, the tissue highly purified and
processed and then treated for implantation and draping for the human body.
However, it must be said that many donors and families of donors were not
aware that these tissues were ever going to be used for purely cosmetic reasons.
Alloderm:
Alloderm is made from the dermis of donor cadavers which have been thoroughly
screened and rendered free of pre-existing DNA thus it is readily accepted by
the body. The product is essentially reduced to a protein network
which acts as a scaffold for integration and seeding by your own cells.
The product allows for immediate augmentation and resorption varies. I
have spoken to patients who have had no existing augmentation left after 2
years, and others which report 60 to 70% augmentation. There may be
initial firmness and palpability detectable by manual pressure and visual
abnormalities during speaking, smiling, or singing animations. However,
this commonly fades with time or massage.
How it's implanted: One incision is made at the corner of each lip end.
You would need four incisions total for both the upper a lower lip augmentation.
The tissue is dissected to create a tunnel for the implant and the implant is
threaded through the lip. The incisions are then sutured.
Cost: Approximately $4000 for the procedure for both upper and lower,
including anesthesia
Synthetic Lip Implants
Having had an earlier version of lip
implants (GoreSAM, Gore-Tex) which were actually not intended for lip
augmentation, I must admit that I was turned off at the idea of implanting a
synthetic material in my lips. However,
that was many years ago and improvements have been made since then. When I
speak of synthetic lip implants I am referring to those which are implanted via
an incision and not injectable micro-implant types. If you are searching
for permanent injectable micro-sphere products, that section is coming up soon.
Lip implants are commonly made from a single piece of material varying in
softness and materials although some implants have a dual membrane system.
Common materials include ePTFE (expanded polytetrafluoroethylene), and soft solid
silicone or a combination of the two as in the VeraFil implant.
I feel that lip implants are limited
in the definition that they can provide when compared to the areas which can be
selectively treated with an injectable. I also feel that although softer
materials are being used some firmness may result as well as the inability to
whistle* or play some notes on the flute** is possible after implantation.
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Perma
Facial Implant™ (Permalip™,
UE): The Perma Facial Implant is a
very soft implant that far surpasses the firmer implants of yesteryear.
This arrival of this implant actually renewed my positive view of lip implants.
Although I haven't had it, in theory and from patient and doctor feedback, it
looks very promising. Perma Facial Implant can also be used to augment the
soft tissue of other areas of the face such as the nasolabials. Perma
Facial Implant does not trigger tissue ingrowth which may inhibit normal
movement or cause visible distortion during facial movement. Presently,
the implant is available in diameters of 3, 4 and 5mm with varying lengths of
55, 60 and 65mm. The implant is tapered at the ends thereby eliminating
the need for customization by the surgeon as with some other ePTFE implants.
Manufactured by: SurgiSil (Plano, Texas)
Made from: solid, soft silicone elastomer
How it's implanted: One incision is made at the corner of each lip end.
You would need four incisions total for both the upper a lower lip augmentation.
The tissue is dissected to create a tunnel for the implant and the implant is
then threaded through the lip. The incisions are then sutured.
Cost: Approximately $4000 for the procedure for both upper and lower,
including anesthesia.
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VeraFil™
Facial Implant (FulFil™
Implant, EU): This implant consists of a silicone balloon (which is
filled with saline after implantation), surrounded by an expanded
polytetrafluoroethylene (ePTFE) layer. The silicone balloon is only
attached at each end inside the ePFTE implant, allowing it to move freely up and
down between the two attachment points. The implant is available in three
sizes: small (4.5mm), medium (5.5mm) and large (6.5mm). There are nine
lengths available: 4cm to 5 cm capable of holding volumes of .25ml to .70ml.
Manufactured by: Evera Medical (Foster City, CA)
Made from: a "multilayer polymer membrane" implant made from a an inner
silicone balloon, surrounded by ePTFE.
How it's implanted: One incision is made at the corner of each lip end.
You would need four incisions total for both the upper a lower lip augmentation.
The tissue is dissected to create a tunnel for the implant and the implant is
threaded through the lip, sterile saline is then injected into the implant and
adjusted for volume. Once the saline is injected the implant self-seals.
The incisions are then sutured.
Cost: Approximately $4000 for the procedure for both upper and lower,
including anesthesia
Lip Augmentation with Advanta Lip Implants
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Advanta™:
Having compared all three side by side (Advanta, GoreSAM™
and SoftForm™), in my opinion the Advanta implant is
considerably softer than he aforementioned two. Advanta reminds me of a marshmallow and takes a bit to bounce
back once you apply pressure to it. The implant has a dual porosity
structure in that the inside layer is very soft, having pores which are 100
microns in size and the outside surface has pores which are 50 microns which
contributes to its smoother appearance. These pores allow for tissue
integration. The implant is available in round and oval shapes in 2.0 mm x
3.2 mm, 3.0 mm x 4.2 mm, 3.2 mm x 5.4 mm, 3.5 mm x 6.5 mm, 4.5 mm x 6.5 mm, and
5.0 mm x 7.0 mm, all in a 15 cm length.
Manufactured by:
Atrium Medical
Corporation
Made from: expanded polytetrafluoroethylene (ePTFE)
How it's implanted: One incision is made at the corner of each lip end.
You would need four incisions total for both the upper a lower lip augmentation.
The tissue is dissected to create a tunnel for the implant and the implant is
threaded through the lip. The incisions are then sutured.
Cost: Approximately $4000 for the procedure for both upper and lower,
including anesthesia
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Ultrasoft™: UltraSoft is the next generation
ePTFE which replaced their implant, SoftForm™. It is made from microporous ePTFE which
allows for tissue ingrowth.
Manufactured by: Tissue Technologies, Inc. (San Francisco, CA)
Made from: tubular, expanded polytetrafluoroethylene (ePTFE)
How it's implanted: One incision is made at the corner of each lip end.
You would need four incisions total for both the upper a lower lip augmentation.
The tissue is dissected to create a tunnel for the implant and the implant is
threaded through the lip. The incisions are then sutured.
Cost: Approximately $4000 for the procedure for both upper and lower,
including anesthesia
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GoreSAM™
(Gore-tex): This product is what I had in
1999. It is made from microporous ePTFE which allows for tissue ingrowth.
I personally found this implant to be firm and palpable both visually in some
animations and to the touch when my lip was pinched.
Manufactured by:
Gore Medical
Made from: tubular, expanded polytetrafluoroethylene (ePTFE)
How it's implanted: One incision is made at the corner of each lip end.
You would need four incisions total for both the upper a lower lip augmentation.
The tissue is dissected to create a tunnel for the implant and the implant is
threaded through the lip. The incisions are then sutured.
Cost: Approximately $4000 for the procedure for both upper and lower,
including anesthesia
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SoftForm™:
SoftForm was the original ePTFE implant produced by Tissue
Technologies, Inc. and was replaced by their sister product, UltraSoft (above).
Manufactured by: Tissue Technologies, Inc. (San Francisco, CA)
Made from: tubular, expanded polytetrafluoroethylene (ePTFE)
How it's implanted: One incision is made at the corner of each lip end.
You would need four incisions total for both the upper a lower lip augmentation.
The tissue is dissected to create a tunnel for the implant and the implant is
threaded through the lip. The incisions are then sutured.
Cost: Approximately $4000 for the procedure for both upper and lower,
including anesthesia
Sources
*I was no longer able to whistle after
and during the entire time I had my GoreSAM lip implants. Once removed, I
regained the ability to do so.
**Out of 44 patients, 1 patient (a flute player) in a study of Advanta lip
implant placement, experienced oral mobility issues which affected their
occupation or hobby. Advanta ePTFE Facial Implants in Cosmetic Facial Surgery
- Joseph Niamtu, III, DMD* [J Oral Maxillofac Surg, 2006, pg 544 paragraph 2]
**Division of Plastic and Reconstructive
Surgery, David Geffen School of Medicine at the University of Los California,
Los Angeles, ETATS-UNIS
2008, vol. 121, no3, pp. 1024-1032 [9 page(s) (article)] (25 ref.)
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