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Skin Care Guide Canada


Lip Augmentation ("Cheiloplasty")

Author: Dr. Bryce J Cowan BSc MSc MD PhD FRCSC
Reconstructive & Cosmetic Plastic Surgeon, The Skin Care Centre, Vancouver, BC

Lip augmentation is a commonly requested cosmetic procedure. Many women now desire the full lip look, also called the "Paris look" which is common in Hollywood. Although all lips have an area of natural fullness, the look that is considered attractive has a very specific shape. An attractive lip is generally defined as a centrally full lip with slightly less volume toward the lateral edge of the mouth. Attention is paid to these details when restoring the lips.


Lip augmentation is performed as an outpatient procedure under regional anesthesia in office based treatment rooms or surgical facilities.

CONTRAINDICATIONS (some may be relative)

  1. Allergy or sensitivity to product or carrier molecules in proposed filler (pre-testing may be required in select cases)
  2. Areas of inflammatory or infectious skin conditions (i.e. active acne or cold sores)
  3. Women who are pregnant or breastfeeding
  4. Association with laser treatment, chemical peels or dermabrasion
  5. Unrealistic expectations


Prior to any surgical procedure, it is important to take appropriate preparations to increase safety, and maximize the benefits of the procedure. First, patients should not take anti-inflammatory drugs such as Aspirin®, Motrin®, Ibuprophen, or Advil®, due to their effects on the body's blood clotting, for at least two weeks prior to surgery. Tylenol ES®, is a painkiller that can be used for those who suffer from chronic pain. Any use of herbal supplements or other alternative medicine should be discussed with your surgeon. Finally, alcohol should be avoided for at least a week prior to the surgery date.

Additionally, any medical condition or medications that are used must be disclosed to your surgeon prior to the procedure. Conditions such as high blood pressure are important considerations in a procedure like face-lifts where bleeding and hematomas are a real risk.

The patient is required to make various choices with regard to the augmentation mediums. Precise lip location, quantity of augmentation that is desired, and the type of implant, are all very important considerations. These components of the clinical decision should be discussed with your surgeon prior to operation so that the advantages and disadvantages of each choice can be discussed in detail.

Autologous Fillers

Biologic Fillers

Synthetic Fillers

  • Fat
  • SMAS and FatDermis
  • Dermal fat grafts
  • Autologen® (collagen from patient's own skin)
  • Restylane®
  • Perlane®
  • Juvederm®
  • CosmoDerm®
  • CosmoPlast®
  • Cymetra®
  • Artecoll®
  • Artefill®
  • Gore S.A.M® (subcutaneous augmentation material)
  • Radiance®

* All products listed above have been used for lip augmentation and may not be the filler medium of choice in all cases.

Fat grafting of the lip ("lipo-sculpturing" or "structural fat grafting") is one of the best methods of maintaining a permanent full and soft lip. It is also widely used as it is well tolerated.


Lip augmentation or rejuvenation with Restylane®, Juvederm®, or other temporary soft tissue filler is performed by a smooth threading injection below the muscle of the lip to camouflage the filler. Superficial filling below the smooth outer surface of the lip may result in discoloration. Typically Restylane volumes of 0.5 to 1.0 cc per lip provide excellent results. Often, the addition of a larger molecule and more permanent fillers along the lip margin (like Perlane®) allows for greater definition of the lips white roll. This provides better visual effect in more comprehensive lip rejuvenation.

Structural fat grafting of the lip requires harvesting of fat from another site (usually the belly, thighs, or "love-handles"). In this procedure, the harvest site and treatment sites are anesthetized using a combination of local anesthetics and nerve blocks. Fat is removed from the donor site using a specialized harvesting cannula attached to a suction syringe. The fat is processed by simple centrifugation prior to re-injection with fine cannulas. Approximately 1.0 cc of fat is use to rejuvenate the white roll above the lip and 1.5 to 3 cc of fat is often used to fill the body of the upper lip. Nearly twice that volume is often used on the body of the lower lip.

Traditional, injection techniques placed fat cells within the lip muscle to provide the augmentation required. Today, the technique is refined, and the fat between the muscles is placed between the lip and the red lip vermillion. This placement location provides a beautiful roll of the red lip and unparalleled volume that looks and feels normal in repose and with facial animation. The change is also permanent, and does not require a repeat procedure.


Care must be taken to avoid facial expressions as much as possible in the days immediately following procedure. Post-operative swelling and discomfort are considered normal for 3 to 5 days following treatment. Oral antihistamines such as Claratin, and ice packs can reduce this to a manageable level.

For two weeks following injections you should only have very brief exposures of the treated areas to sunlight or excessive heat. You should also avoid handling or massaging the treated area. Make up and standard skin care is resumed the day after treatment.


The use of temporary fillers for lip augmentation can be very desirable as there is little to no down time. Final lip shape and volume should be seen at 3-5 days post treatment assuming there is little residual bruising.

Swelling and bruising are expected after the injection of fat. Your surgeon will often overfill ("overcorrect") the lips when structural fat grafting as your body absorbs some of the fat with the rest remaining to provide a long lasting result. The typical convalescence following lip augmentation is 2-3 weeks.

Most patients require only over-the-counter medications or are comfortable without pain medication within days of the procedure. Bruising and swelling of the lips and around the mouth can occur with these procedures and swelling can slightly more marked within 3-4 days after the augmentation. Remember that this is a normal part of recovery and disappears within weeks.


Any cosmetic procedure carries risks. Although these risks are uncommon, it is important that they are discussed between the patient and physician. Some potential risks are listed in the table below. For a more detailed discussion on expected results, recovery, and specific complications, please see your individual physician or surgeon.


Early Post-operative

Late Post-operative

  • Drug (anesthetic) reactions
  • Bleeding
  • Hypersensitivity reactions
  • Itching
  • Bleeding
  • Hematoma (blood collection)
  • Infection
  • Sterile abscess
  • Numbness
  • Fat necrosis (volume loss)
  • Rejection (Extrusion/Exposure/Infection)
  • Small irregularities
  • Asymmetry (between sides)
  • Implant volume loss
  • Persistent sensory change
  • Granulomas
  • Skin colour change (irreversible)


Patient satisfaction with this procedure is extremely high.

The rejuvenation or augmentation provided by Restylane®, Juvederm® and similar temporary fillers typically lasts between 4-8 months. After repeat treatments, patients can see a more sustained correction lasting closer to 8 to 12 months.


Lip augmentation surgery is considered to be elective, and is not covered under the Canadian Medical Services Plan. The final cost of the procedure is at the discretion of the physician or performing surgeon, and is partially determined by the medium that is used for the filling.


This website does not cover all medical knowledge related to lip augmentation nor does it deal with all possible risks and complications of treatments to the lips. Although it is designed to provide the patient with greater depth of information in some areas, it is not intended to substitute for the in depth discussion between patient and clinician that must occur prior to any cosmetic procedure.