Plastic Surgery 101

Fillers can restore plumpness of lips and their definition

Q. It's my mother’s birthday and I would like to give her lips. Her lips have been shrinking for years and she keeps marking them with lip liner and now they're looking ridiculous. What can I tell her that would make her feel better about having lips? She doesn't want to look like a duck!

A. Let her know that lip injections don't always have to be exaggerated. I have many patients who, with age, have lost their normal volume and now have wrinkly lips with minimal to no definition. Lip injections, when done properly, enhance a woman's appearance.

Lip injections are most commonly done with hyaluronic acid such as Juvéderm and Restylane. Some people choose a more-permanent filler, such as fat. Fillers that should never go into the lips are silicone and biopolymer, which can create hard lips that continue to grow irregularly with time.

When I approach lip injections, I remember a statement that one of my mentors told me, “The lips are sisters, not twins.” Therefore, lip injections are done to make the lips look as symmetric as possible but some asymmetry may persist. The procedure is very simple: Local anesthetic cream is placed on the lips and set for 10 minutes, then the lips are injected in small increments so that when the patient feels that their lips are appropriate, the injection can stop. I will generally under-inject the first time so that when the patient comes back she will want more.

Choose a physician who is a board-certified facial plastic surgeon, plastic surgeon or dermatologist. These three types of physicians will generally be the most secure for the use of lip injections for your mom. Make sure you ask to see before and after pictures so that you can see what your physician feels is an aesthetically pleasing lip shape.

Dr. Carlos Wolf is a partner in Miami Plastic Surgery and is board certified. Email your questions to him at