Fillers are different than Botox and other neuromodulators. Where neuromodulators are injected into muscles to prevent the patient from creating a “wrinkle in motion,” fillers are injected under the skin or lips to plump out these areas. Fillers are injected under the nasolabial folds (laugh lines), other deep lines, tear trough deformities in the lower eyelid, and to plump out other areas such as the cheeks and chins.

Lip augmentation with fillers can plump up the lips and also create definition. As the lips age, vertical lines cross the vermillion border that can make lipstick “bleed” into the skin. Fillers can define the vermillion border and eliminate these lines.

How long the results will last depends on several factors. Each patient metabolizes fillers at a different rate. Juvederm and Restylane will last about a year. Hyaluronic acid helps promote collagen regeneration. Dr. Mueller has noticed that some patients, after returning a year later for a second lip treatment, do not require treatment in the third year due to collagen production.

There are many nuances to the lip augmentation procedure. A thorough understanding of lip anatomy, facial proportions, and knowledge of the filler materials is paramount. Many injectors take a weekend course and simply inject the lips without regard for proper form, vascular anatomy, and aesthetics. Many of their clients are left unhappy with their “overdone” or “unnatural” results. Dr. Mueller has been performing lip augmentation for over 20 years and has the knowledge and expertise to properly and aesthetically perform your lip enhancement.

Lip augmentation and fillers are a passion of Dr. Mueller’s. He takes great care to make sure that his patients are comfortable and that the procedure is painless. Many other practices have their patients “suck it up” and endure the pain of injections because they do not use topical and injectable anesthetics. Dr. Mueller uses numbing creams, topical anesthetic gels, and several small dental injections to totally numb the lips. This makes your lip procedure virtually painless.

Once the patient is completely numb, the filler is injected into the lips. The procedure takes about ten minutes. Ice is then immediately applied to the lips and should be used at home periodically for about 24 hours. Due to their vascularity, the lips swell almost immediately. This will be resolved in about 48 hours. You can return to work the next day if you wish. It is best to refrain from aspirin, Naprosyn, Aleve, Motrin, Ibuprofen, and other NSAIDs for two weeks before your procedure to help reduce swelling and bruising. As symmetry is important, you should return in two weeks to evaluate your result as occasional touch-ups are necessary.

As the face ages, the upper lip lengthens to completely cover the upper teeth and rolls inward. This inward roll decreases the prominence of the lip itself. In addition, this greatly contributes to little or no upper teeth showing when smiling. Although filler injections are used to define and plump the lip properly, a “sub-nasal lip lift” can be easily performed to raise the lower lip, give the upper teeth more show, roll the lip out to a more normal posture and help turn up the corners of the mouth.

• The lip lift procedure can be performed either with local anesthesia or IV anesthesia.
• The procedure takes about 30 – 60 minutes.
• The skin is marked below the nose and the skin, and occasionally muscle, is removed.
• The skin is closed with fine sutures and healing takes about 7 – 10 days and full healing takes about a month with the scar hidden and rarely noticeable.
• If the scar is visible after a month or two, it can be treated with a CO2 laser.

Typically, if a patient has a long upper lip, either from heredity or aging, and has little to no upper tooth show when smiling or speaking, you are a candidate for a lip lift procedure. The only caveat is that you must have at least 18 mm. of lip from the base of the nose to the edge of the upper lip. Having less than 18 mm. is a contraindication due to the creation of a very short upper lip should a lip lift be performed.

I had my filler done somewhere else and it was overdone. What do I do? Can I have it removed?

Yes, it is possible to reverse an over-correction of hyaluronic acid fillers like Juvederm, Restylane, and Prevell Silk. These products can be dissolved by using a product called hyaluronidase (Amphadase or Vitrase). The injection of these products dissolves the hyaluronic acid gels in a simple and effective procedure that takes about ten minutes. Results are seen in 1 – 2 days and there is no recovery. Dr. Mueller has treated many patients to reverse filler mistakes from other offices. Again, this is where experience, not a weekend course, shows. Dr. Mueller was able to reverse these mistakes and make happy patients of our unhappy ones.

Excessive fat injections or transplants have to be removed surgically with either local anesthesia or light sedation. Swelling and recovery lasts about 3 – 4 days.