The surgery is performed under local anesthesia. A small amount of fat
is harvested by liposuction from the abdomen, hips, or thighs, and concentrated
under sterile conditions. Nerve block, much as in dental surgery, is accomplished
to render the lips insensitive. A small incision is made at the corner
of the mouth, and a blunt cannula is inserted through the length of the
upper lip. One to two milliliters of fat are injected slowly along the
lip margin using a ratcheted transfer syringe. The cannula is then directed
to the lower lip where the procedure is repeated. A single absorbable suture
closes the wound. No splints or bandages are required. Initially the lips
will be somewhat larger than desired, but swelling will subside over the
next several days.
After six to twelve weeks, an assessment as to
the need for additional augmentation is made. Some of the transferred fat
is always reabsorbed. This is slightly variable from patient to patient.
Approximately 50% of patients are satisfied with the single augmentation,
30% require two augmentations, and 20% require three. This variability
in the amount of fat retained to viable tissue in the lips is the major
drawback, and negative aspect of lip augmentation. On the other hand, it
allows us to produce a large lip as a trial with the assurance that at
least a portion of the original transfer will be reabsorbed. This allows
for tailoring of lip size based on actual experience as opposed to theoretical
ideal.
Preoperative and postoperative photos in the frontal
and lateral views are shown (Patient I, Figure I and 2, Patient II, Figure
1 and 2).
