An interest in lip augmentation by the public began in the late 1970s and early 1980s.
Surgical techniques were attempted that produced significant scarring but did not give favorable or lasting results.
A new injectable filler at that time, collagen, had been approved by the FDA due to the investigative reporting and experience of pioneer, Dr. Edward Terino.
Although, alterations in the lip could be made with injectable collagen that would produce attractive results and for the first time afford surgeons with the ability to create requested shape changes, its lasting quality was only in the range of 2-4 weeks maximally.
A technique was used by Dr. Terino at that time which involved obtaining skin with underlying fat attached taken from an inconspicuous area of the patient’s body, often in the area of a cesarean section scar. The surface epidermis layer was removed to use the remaining dermis with fat attached as a volume implantable graft in the upper and lower lips. This procedure could easily be performed under local anesthesia.
At first it appeared to be almost miraculous because the transplant tissue appeared to be lasting so long (6 months plus). However, after further time passed, 1 year following surgery, there was a serious shrinkage and sometimes there was resulting scar tissle which created unpleasant or even troublesome symptoms to the patient.
A number of implantable materials followed that were placed into lips. These included Gortex and AlloDerm.
Gortex, a synthetic material, could be placed in a threadlike form or in pieces that resembled cardboard.
It was difficult to create a decent shape with this material and it was always too palpable. Also there were significant infections or extrusions of the threads so that removal of the material had to be done. This was difficult.
AlloDerm, a tissue derivative from human skin approved by the FDA and used significantly in serious third degree burns to replace skin that was totally destroyed, was another popular way to augment lips.
Dr. Terino felt that the AlloFerm was the best alternative and therefore he used this in over 700 patients in a 3- or 4-year time period. This also was performed under local anesthesia where different size pieces could be placed and shaped. This appeared to be a very satisfactory answer to lip augmentation and patients were quite satisfied with it as was Dr. Terino.
However, once again, 1-2 years later, the Allo Derm volume would shrink in size and Dr. Terino and his patients would be disappointed.
Ultimately, the new hyaluronic acid (HA) fillers became a choice that patients and plastic surgeons started to rely on. Partially, this was because it did not require an operative procedure only an injection. Partially, it was also accepted because it was a lesser expense than a surgical procedure.
But in the long run, the HA filler also dissipates over time that could be anywhere from 2 months to 6 months requiring repeated injections.
Also, to obtain a natural appearance requires significant artistic talent on the part of the injector. Many if not most, HA filler augmentations of lips result in peculiar artificial lip protrusion that is popularly known among the public as a duckbill look that is highly unattractive.
It became obvious that permanent implants may offer the best solution for this highly desired change in the volume of lips.
In the late 1980s and before the AlloDerm and HA Filler revolution, Dr. Terino saw the obvious advantage to silicone lip implants. He already had mastered the art form and the technology for custom anatomic shape cheek, jaw, and chin implants that could provide beautiful and permanent results for shaping the human face.
Therefore, he decided to use silicone implants in lips. His chapter “Lip Augmentation” in his pioneering textbook “The Art of Alloplastic Facial Contouring” discusses his experience with silicone lip implants.
After abandoning his own technique in implants to use the latest lip augmentation techniques with injectable fillers, Dr. Terino has returned to using them again for those people in which they are appropriate.
There is no way that an implant which produces volume can be introduced into the tissues of the face without there being the possibility of it being manually felt and palpable. This is absolutely true as well with silicone lip implants.
However, the degree to which it is palpable is not great and must be accepted as a consequence or side effect of being able to possess larger, more attractive looking lips.
Other disadvantages include the possibility of an infection which is a standard possible result of any operation or injury to the human body. Also occasionally they may appear slightly unsymmetrical. An advantage, however, is the fact that it is quite easy under local anesthesia to remove silicone implants in the case of 1) infection, 2) undesirable asymmetry or shape, and 3) undesirable feelings by the patient perhaps from social sexual contact during kidding.
Dr. Terino found that the satisfaction of his patients with silicone lip implants was high.
Therefore, at the present time, he if offering his pioneering procedure once again to any patients who feel that they would prefer not to have continuous permanent injections until or unless a more desirable and more perfect alternative is invented.
Call the office for a consultation regarding this exciting procedure. Dr. Terino continues to perform aesthetic filler lip augmentation as well and has one of the busiest practices in this particular specialty.
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