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How To Avoid ‘Monkey Lips’

Posted: 12:01 a.m. Sunday, Apr. 14, 2019

By Anita Mandal, M.D.
Question: I have thin lips, lipstick bleed and lip wrinkles. I know I need filler but have seen so many overdone lips. Some people even have a “monkey look” to their lower face. How can I assure that I will look natural from filler treatment to my lips?

Answer: Rejuvenation treatments of the lip area can be quite complex, making it especially important to seek a specialist if you want a natural looking result. Placing injections in and around the lips is mostly a technical exercise that can be learned by non-physicians as well as non- plastic surgeons. The key to a natural result lies in combining technical expertise with a thorough understanding of aging lip anatomy and a strong artistic eye.

Typically with lip rejuvenation, there are three main elements to evaluate. These include the upper and lower vermilion borders of the lip, the extent of lip wrinkles and the loss of lip volume.

With extensive lip wrinkles, it is important to avoid attempting to completely fill the lines 100 percent as this may give an overfilled appearance to the skin above and below the lips, resulting in an unnatural look. Equally important is choice of injectable filler. Fillers like Restylane Silk are formulated for use in very fine lines whereas other fillers may result in an unnatural appearance.

When visible lip lines are worse with facial expression, including smiling and speaking, you may have overactive lip muscles contributing to the formation of lip lines. In such cases, micro-botox injections combined with filler can give effective results. Failure to use micro-botox for overactive muscles can result in the filler going away quickly.

Poor lip definition is typically due to flattening of the lip vermilion, also known as the lip border. In patients who have thin lips due to volume loss as well as poor lip definition, a common mistake is to only fill the lip vermilion. Failure to also place filler in the lip itself, in such instances, can result in an imbalanced and unnatural lip.

Patients with lipstick bleed often have both lip wrinkles and flattening of the lip vermilion border with age. Addressing this concern effectively involves placement of filler along the vermilion border as well as into the lip lines themselves.

Seeking a Board Certified Facial Plastic Surgeon who understands the detailed anatomy behind lip rejuvenation and is experienced in creating natural looking lips is key. Having treatments by someone who simply does a lot of lip injections may not be sufficient. A natural looking result often lies in the details of evaluation and treatment by a true specialist and not just a technician. Of course, one must have realistic expectations as medicine and surgery are not an exact science and results can vary from one patient to another.


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