Q: Dr. Eppley, I had Permalip lip implants placed in the top and bottom lip. My smile is horrid. And can’t even open my mouth wide enough for the dentist. My lips are extremely tight. I still want larger lips but not tight distorted lips.
A: The most common complications from Permalip lip implants is that of implant asymmetry or an inability to achieve the lip size increase that one wants. I have not had the experience of these lip implants causing extreme lip tightness or significant interference with one’s smile. But based on your lip symptoms it is clear that these implants needs to be removed and should bone replaced by fat injections. You need to get rid of what is causing the tightness (the implants) and replace them with a material that can help relieve some of the tightness and still provide significant augmentation. While it is true that fat injections into the lips have variable amounts of take and unpredictable volume retention outcomes, they are the best solution for relieving lip scar contractures. The residual capsules from the lip implants do provide a more favorable site for fat placement and graft retention.
Dr. Barry Eppley
Q: Dr. Eppley, I have gotten lip injections using fillers for the past five years. While my lips are not really that small, I like the plump up that fillers give them. But after five years and over a dozen injection treatments, I am tired of the expense and the hassle (pain!) of the lip injections twice a year. I have read that there are permanent materials for lip augmentation. This is of interest to me now as I need to really explore how to end injections by a single operation if possible. What can you tell about permanant lip implants?
A: The concept of lip implants has been around for a long time. Despite their existence for over fifteen years in the plastic surgery world, they have never garnered much traction as an everyday procedure. Part of that is because of problems in implant design and materials and partly because of a general fear of having an ‘implant’ in the lip. I have used every developed permanent lip implant available and have seen many of their benefits and potential problems. I have had good success over the past ten years with the use of Advanta implants but for a variety of reasons they are not as available as they have been in the past. But the newest lip implant, called PermaLip, is the best design and material that I have seen to date. It is made from a very soft and flexible silicone elastomer. Based on how it feels, it could easily be called the ‘Gummy Bear Lip Implant’. It has well designed tapering edges, which is very important, and has sizes up to 5mms in thickness. Based on my experience, this is a good safe size for the soft tissue tolerance of the lip tissues. They are placed in the office under local anesthesia with some swelling and occasional bruising which is largely resolved in a week after the procedure. The real test of the success of any permanent lip implant is the ‘kissing test’ in which the patient has no concern that they or the recipient may be able to feel the implant…and Permalip passes that test!
Dr. Barry Eppley