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Preventing ‘Duck’ and ‘Sausage’ Lips

Posted: 11:53 a.m. Friday, June 19, 2015

By Anita Mandal, M.D.
Question: I had my lip borders filled with Restylane by a doctor but they look “ducky.” A second doctor advised filling the lips themselves. How will additional filler look more natural when less made me look “ducky?”

Answer: Sadly, with the high number of people that I see with unnatural, overfilled lips, “duck” and “sausage” lips seem to have become socially acceptable. Many patients and doctors, alike, are so focused on filling the lips themselves that they often disregard the impact that lip aging and the surrounding tissues have on natural lip restoration.

The good news is that you don’t have to settle for an unnatural, overfilled lip. A skilled facial plastic surgeon can assess the aging tissues of the lower face and their relationship to the lips to give a balanced, natural lip.

A proper approach to the vermilion border is important. Raising this lip edge with filler can soften lip wrinkles and restore youthful lip definition. However, aged lips differ from the lips you had when young and the tissues surrounding your lips also change with age. For instance, someone with very thin lips may not benefit from lip border filling alone as a “ duck” or “monkey” appearance can develop, unless filler is also placed within the lip substance.

Lip volume threshold must also be evaluated. Your upper and lower lips have a natural upper volume limit. Placing more filler than the lip volume can handle causes the lip to expand disproportionately, leading to an overfilled, unnatural look. Changes in lip anatomy with age can further reduce this volume threshold. Balanced lip rejuvenation should account for the lip’s volume threshold as well as the impact that aging has on this threshold.

Droopy mouth corners or deep smile lines must be assessed. When these concerns exist, lip rejuvenation alone, can actually make the face appear more aged or unnatural. Temporary fillers or a long-term filler, like Bellafil, can be corrective.

Attention to the natural aesthetic shape of the lip is important. An aesthetically proportioned lip is normally fuller in the center and tapers towards the lip corners. Many surgeons tend to fill the lip uniformly from side to side rather than mimic its natural youthful appearance. Uniform lip filling can give a “sausage” appearance to the lips.

A receding chin can offset the results of lip rejuvenation. Restoring lip fullness when a receding chin coexists may give the illusion of a receding lower face and/or over-protruding lips, unless the chin is also balanced. Temporary fillers or a long-term filler like Bellafil can be effective.

It is a misconception to think you should only seek a surgeon for surgery. Facial Plastic Surgeons have expertise in both non-surgical and surgical facial aesthetic treatments. Each time you have a non-surgical procedure by a less qualified doctor, you increase the risk of complications and poorer results. When it comes to your face, why would you consider less than a Board Certified Facial Plastic Surgeon? Go to www.abfprs.org to verify that your doctor is board certified in Facial Plastic Surgery.

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