Lip Augmentation

Lip lift procedure elevates the upper lip, which in turn creates a shorter distance between the nose and the [vermilion] border of the upper lip. Recently, leading Beverly Hills plastic surgeon Dr. Tarick Smiley has performed the surgery, which was posted on Snapchat.


The patient shown in the video did not like the expansive distance between her nose and upper lip, which prior to surgery was around 2 cm. For females, the ideal length is usually 1.1-1.3 cm, while for men it is slightly longer, about 1.3-1.5 cm.


lip lift procedure

Dr. Smiley says there are two ways to perform the upper lip lift: the first one involves placing incisions inside the mouth in order to “roll up” the upper lip, while the second technique entails the use of external incisions at the base of the nose to shorten the space between it and the lips.


Since the patient required extensive reduction the intra-oral (inside the mouth) technique would not suffice.


During surgery, Dr. Smiley created incisions at the base of the nose to remove a small strip of skin and tissue (measuring 0.4 cm). In the process, the upper lip has been elevated and so now the teeth are slightly visible in frontal view.


Elevating the upper lip has also increased the pink part or volume of the lips.


This incision pattern results in a hidden scar as it lies precisely at the natural skin fold of the nose.

After removing the excess skin and tissue, Dr. Smiley closed the wound in a way that the scar would settle precisely at the skin folds of the base of the nose to hide it from view.


Meanwhile, the surgery was performed under local anesthesia, which could pave way for shorter downtime.


After recovery from upper lip lift, patients may opt for lip filler (fat injection or dermal fillers) to further improve their volume and shape. It should be noted that lip augmentation, especially with over-zealous injection, tend to provide unnatural results (duck lip appearance) if there is too much space between the nose and the upper lip.


Dr. Smiley has explained the general rule of thumb to ensure natural results from lip fillers:


  • There should be a 1.0-1.6 ratio in terms of volume distribution and height between the upper lip and lower lip (phi or golden proportions).
  • The outermost corners of the mouth should have very little volume. Over-injection to this area results in unnatural lip contour.
  • The volume of the lips gradually increases as it goes towards the center.
  • To avoid the appearance duck lips, the philtrum (two columns right above the upper lip) is occasionally filled in.
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Selfies and social media are driving the popularity of lip augmentation, as people nowadays see their online photos regularly and might feel the pressure to always look good, says leading Beverly Hills plastic surgeon Dr. Tarick Smiley.


In 2015 alone, about 27,450 lip implant surgeries were performed in the US. On top of that, lip fillers accounted for a large percentage of the 9.2 million facial injection procedures, according to data released by the American Society of Plastic Surgeons.


lip augmentation

This patient receives lip augmentation via Restylane, an FDA-approved filler commonly used to correct facial volume loss.

Dr. Smiley says that the vast majority of patients today desire for a more natural look, which can be achieved when there is a profound understanding of what constitutes an ideal “pout,” which of course is determined by gender factors and the pre-existing facial features.


And despite varying views on the ideal lips, Dr. Smiley says that recent studies have shown that most people found attractive “pouts” had their the lower lip about two times bigger than the upper lip. Also, female lips that took up about 10 percent of the lower third of the face scored higher in terms of attractiveness.


While most lip augmentation patients are women, there has been a significant increase in the number of men seeking some type of lip enhancement procedure. This new trend has a ramification—i.e., surgeons should understand the subtle but key differences between attractive female lips and male lips.


For instance, lip augmentation involving men should not create a well-defined “Cupid’s bow” shape; however, a slightly prominent bottom lip sulcus (dip) is perceived to be attractive. Also, a one-to-one lip corners ratio is desired to prevent feminine-looking lips.


Another “beauty” parameter, according to a recent study conducted by German researchers, is that female lips have a lower ratio between the lower vermillion height (lower lip) and the chin-nose distance than attractive male lips. This means that attractive female faces have a bigger “pout” in relation to the lower third of their face compared to men.


While several studies have pointed out that lips play a crucial role in the perceived facial attractiveness, Dr. Smiley says that other features also have their influence, adding that the “attractive faces are greater than the sum of their parts.”

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Restylane for lip augmentation is a non-invasive way to improve the shape and fullness of the lips. In the hands of good injectors who have profound understanding of the beauty tenets and facial proportions, the technique can provide natural-looking results.


Dr. Tarick Smiley, one of the eminent Los Angeles plastic surgeons, has demonstrated how Restylane for lip augmentation can provide symmetric and natural-looking results, which were recently posted on his Snapchat.


restylane for lip augmentation

The gold-colored vibrating device tricks the brain into thinking that the sensation comes from vibration, as opposed to the prick of a needle.

Restylane, Dr. Smiley said, is formulated with hyaluronic acid, a naturally occurring substance that gives the skin its “youthful plumpness and glow.” Aside from enhancing the lips, this type of FDA-approved filler or “volumizer” also works in age-induced facial lines and hollowness of the face.


While Restylane is a biocompatible filler and thus the risk of rejection is almost zero, it comes with a caveat: The body breaks it down gradually and so results only last 4-6 months, although when used as a lip augmentation the effects may be slightly shorter because the lips are always moving.


Less mobile areas such as the nasolabial folds or laugh lines tend to break down Restylane slower and so the results can last up to six months.


Because Dr. Smiley’s utmost priority was to create natural-looking results from Restylane, he first injected the lips border to improve their contour before giving them additional volume.


To further ensure natural results and avoid the “dreaded duck lips,” he made sure that the lower lip would appear bigger than the upper lip. One of the most common traps is making their size the same, or worse, the upper lip appears hugely disproportionate, a “look” which does not occur naturally.


Dr. Smiley said that respecting the pre-existing contours of the lips is the key to achieve natural results.


During lip augmentation, Dr. Smiley also used a vibrating device he placed adjacent to the injection site to “trick the brain so it would not feel the prick of the needle and instead focus on the vibration,” thus ultimately reducing patient discomfort.


His technique is backed by science. According to a recent study, the use of vibration device during lip augmentation provides analgesic effects, with 92 percent of patients saying they experienced significantly less pain with the addition of vibration.

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While some people spend thousands of dollars to look like their celebrity idol or to preserve their youthful appearance through plastic surgery, one man has decided to undergo the knife so that he would resemble the most popular comic book character—Superman.

For the past 19 years, dressmaker Herbert Chavez, who lives in Calamba City, Philippines, has received a series of plastic surgery that involved pec and abdominal implants, rhinoplasty or nose job, lip liposuction, skin whitening, and jaw realignment in an effort to transform himself into a real life comic book hero.


In total, Chavez spent P300,000 or about $7,000 worth of plastic surgery, which is already a fortune in a country where the average monthly salary of a worker is around $280.

The 35-year-old Superman fan said his fascination with the fictional superhero started at the age of five after watching him on TV wearing his iconic costume with an “S” logo.

To further emulate his superhero idol, Chavez said he often walks on the streets near his home dressed in a Superman costume, including the iconic red cape and perfectly coiffed hair, while teaching children about good morals of the comic book character.

In the first few years of his “journey,” Chavez spent his own money to finance his transformation.  But one plastic surgeon has offered him to work for free as part of an ex-deal and that is to promote his surgical talents to potential customers.

Despite countless of surgeries and “maintenance” in the form of hydrogel to give him the cleft chin and skin lightening, he said more procedures are under way to make him taller and create a more muscular “derriere” and abdomen.  However, he still considers the possibility that someday he will grow old and may not be able to tolerate more surgeries.

Meanwhile, many board-certified plastic surgeons in the US do not work on patients who have unhealthy or unrealistic expectations with cosmetic procedures—such as aspiring to look like someone else—because of safety and ethical reasons.

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Liposuction surgery is not designed to solve obesity because it only removes the superficial fat underneath the skin and not the deeper visceral fat.  To regain a stable and normal weight, a healthy lifestyle—i.e., regular exercise and balanced diet—is the only effective and “sustainable” treatment.

Body contouring expert Dr. Tarick Smaili said a good liposuction candidate is near her ideal weight or at least within 30 percent of her recommended body weight to achieve the most desirable result possible.  Equally important is the patient’s health and goals, the renowned surgeon added.


Meanwhile, it is not uncommon for previously obese individuals to undergo liposuction, which is usually a part of their total body lift to address the deformity caused by redundant skin, loose and weakened tissue, and exercise-resistant fat.

For massive weight loss or MWL patients, it is important to wait until their weight has been stable for at least six months, or ideally a year, before they undergo liposuction and other surgeries that aim to provide them a near normal appearance.  The right timing will help them achieve the most desirable result, minimize the risk of complication and avoid the need to have major revisions in the future.

Aside from a stable and healthy weight, MWL patients must be healthy and have no healing problems.  Even with a normal body mass index, some of them are advised to postpone any cosmetic surgery particularly those who suffer from temporary nutritional deficiency caused by a sudden decrease in their food intake.

Compared with people who have a stable weight throughout their lives, MWL patients tend to have a more fibrous fat that is difficult to remove.  For this reason, their liposuction may take longer and their doctor might charge more because of the additional complexity.

While the total number of fat cell remains constant throughout a person’s life even with moderate changes in weight (it just expands and shrinks), previously obese individuals tend to have more fats; this is particularly true if they have been fat since childhood.

Because there is a maximum size to which fat cell can expand, the body of morbidly obese individuals is forced to create more fats.  And even with a significant weight loss, the number of fat cells remains constant and they just shrink to a smaller size.

Since MWL patients maintain a high number of fat cells, their liposuction has to remove the same amount of fat as if they are still obese.

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Queen of controversy Lady Gaga has been recently rumored of having plastic surgery after she Twitted a photo of herself with extremely swollen lips, which some people speculated as a work of dermal fillers like Restylane and Juvederm.

The 26-year-old singer-songwriter posed a photo of her while lying back on a pillow with her eyes shut. While she looked quite sultry, people were quick to notice her “bee-stung lips” that appeared way out of proportion.
The photo included a Tweet saying “Night night. Love, Mademoiselle Melbourne.”

While Lady Gaga has not yet commented on her rumored plastic surgery, the star has previously said she did not have any work done on her face or body.

In April 2010, the pop singer said in an interview that celebrities who opted for plastic surgery were somewhat promoting “insecurities.” However, it seems like her opinion in cosmetic procedures changes from time to time.

In a separate interview, the star said she may consider plastic surgery after giving birth to babies, although she still remains adamant that she did not undergo nose job or rhinoplasty.

“I haven’t had any [plastic surgery] yet…I was born this way, but maybe after I pop out a few Gaga babies, I’ll be not born this way anymore,” she was quoted saying.

A few years ago, rumors of the pop star’s nose job surfaced on the Internet. While she denied them, not everyone is convinced especially when some celebrity plastic surgeons said she probably had some work done on her face.

One plastic surgeon has cited a 2007 photo of the singer showing that she had a very large “Italian” nose that overpowered the rest of her features, and compared it to her most recent pictures showing a smaller nasal profile.

Aside from nose job, the star has also been rumored of having a chin implant, a procedure that often complements rhinoplasty.

However, cosmetic surgeons all agree that Lady Gaga’s nose job looks great because her doctor only used a conservative approach which successfully balanced her nose with the rest of her face without making it too small.

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