Q: I would like to have my Advanta lip implant removed – it has been in place for greater than 10 years. Do you have experience with this and how many have you removed? Any problems with lip asymmetry? Thank you.
A: The Advanta lip implant is composed of PTFE (Gore-Tex) and is a single tube in configuration. It is often confused with the original PTFE lip implants placed in the 1990s which were multiple strands in their geometry. That distinction is more than just in the name as Advanta is relatively easy to remove because it is a tube which can be easily extracted without much trauma. The stranded lip implants can be incredibly difficult to remove and very traumatic to do so. They are often best left alone.
It sounds like you are fairly certain that you have Advanta lip implants. Over the years, I occasionally have removed them without any great difficulty. As for resultant lip asymmetry I can not speak as to whether that will result or not. That depends on whether any lip asymmetrywas present to begin with and how the lip tissues contract and heal back down after the implant is removed. That outcome would be beyond the control of whomever removes the implant. In general, I would not think that is a common problem afterwards and have not seen it in those patients that I have removed. But whether that would be an issue for you afterwards can not be determined beforehand.
Dr. Barry Eppley
Q: My main questions are in regards to the permanent lip options available to me. I could send you my picture so you can get a better idea. I have tried a few injectables and am not really happy with results in terms of size and longevity. I understand there are also options for implants vs. v-y surgery. (most permanent?) What are the complications, risks and costs of these options. Also, do you use Alloderm or Gortex implants, or is it based on cases by case basis. What is the longevity of Allodem?
A: I choose which permanent lip enhancement option on a case to case basis. That could include lip advancement,lip lift, v-y advancement or Advanta lip implants. There are different reasons for using any of these based on the existing size and shape of one’s lip. Pictures would be of great help in determining what may be best for you. Alloderm has not proven to be a permanent lip implant material so it is no longer used.
If you have not had good success with injectable fillers, then the concept of putting in any permanent material will likewise be unsuccessful. Your lips are not big enough or have the right shape to merely be ‘inflated’. This would indicate that you need more vermilion exposure through some form of excisional procedure such as a lip advancement or possibly a tissue shifting approach with an internal V-Y advancement.
Dr. Barry Eppley