Q: My upper lip is substantially smaller than my lower lip. I have had several consultations and the recommendations have ranged from injectable fillers, to implants, to a lip lift. I am confused by these conflicting recommendations.
A: As you have discovered, there are a variety of lip enhancement procedures. In the end, they all have the same objective – making the pink vermilion of the lips more pronounced (increased vertical height and fullness). These procedures range from minimally invasive (non-surgical) to surgical. As a general rule, most patients should always start with injectable fillers, because this treatment is the simplest and is completely reversible. An injectable filler can tell you whether the existing size of your vermilion can be adequately inflated to achieve the look you want. If it does, then you can ponder whether fat injections or implants may be a better long-term solution. If expanding the existing vermilion is inadequate or produces an undesired look (duck lips), then the location of the vermilion needs to be removed. This is where vermilion advancements and lip lifts have a role to change the vermilion-skin junction and the amount of lip skin.
Q: I am a 34-year-old woman who has had two children. I am done having children and want to address the damage done to my breasts by pregnancy and breast-feeding. I want breast implants, but I don’t want a breast lift. I don’t want the scars from the lift, but I would be ok with small hidden scars. Is that reasonable?
A: Unfortunately, there is a significant difference between what you need for a good breast result and what you want. You are not alone in this position, as many women need a breast lift but don’t want the scars. Too much sagging makes it difficult to get a good result using breast implants alone. In fact, implants without a lift is going to make your breasts look worse, not better. They will create a mound above the current level of your hanging breast tissue and will merely end up placing your nipple on the bottom half of the implants. It will just be trading into a different type of breast deformity. If you are not ready to accept scars as of yet, you can always have breast implants first and see if the results are acceptable. But ultimately, a breast lift is in your future if you want to make a significant breast appearance improvement.