Q: Dr. Eppley, I am interested in permanent lip augmentation with Advanta. I have read about the split technique. What can you tell me about this procedure in terms of effectiveness and potential complications.
A: Advanta, in my experience, has been a good permanent method for lip augmentation. While it is an implant in the soft and moveable tissues of the lip, the material is a double porosity tubed construct that has the feel of a marshmellow. While most patient can feel the implant, I have not had a patient who has ever wanted it removed yet due to palpability. if removal should be desired or necessary, it is easy to slide out as it has a surrounding capsule without any real tissue ingrowth. Because of the capsular tunnel left behind, that could be filled with fat injections which would probably take well in an established capsular space. (backup plan or salvage procedure)
The key to placing Advanta for lip augmentation is two-fold. First the lip must be immediately stretched out after the implant is placed so that there is no bunching of it prior to the ends being trimmed and the small corner of the mouth incisions closed. Secondly, I find it a good idea to do a partial central implant split so that the potential risk of banding or tightness across the lip is reduced. But the entire implant should not be sectioned in the middle as that will cause it to widely separate in the middle and each piece migrate towards the corner of the mouth, losing any augmentative benefit in the central third of the lip.
Advanta lip augmentation is a fairly simple and effective procedure, particularly for those patients who are tired of repeat injectable filler treatments or do not want to run the risk of volume unpredictability with fat injections.
Dr. Barry Eppley