First, we should begin with what method Dr. Lam does not use for lip enhancement. He does not believe in placing any kind of solid implant in lips like Advanta, Softform, Ultrasoftform, or Gore-Tex into the lips. These solid lip implants have numerous problems. First, they appear artificial since the entire lip is ballooned out at the same size. Dr. Lam likes to shape a lip so that it does not look like a sausage. Second, these lip implants simply feel unnatural when you kiss someone or eat food or lick your lips since they are very hard. Even if the lip implant feels soft in your hands, they invariably become hard over time and can also shrink, shift, and risk infection. For all of these reasons, Dr. Lam no longer performs surgically inserted solid lip implants as mentioned above for the lips. Dr. Lam prefers to use injectable fillers as the mainstay of therapy to enhance one’s lips. He prefers two types of fillers: hyaluronic acid based fillers (Restylane, Juvéderm Ultra) for an immediate but temporary solution and silicone microdroplets for a delayed but permanent solution. Hyaluronic acid fillers are a wonderful solution to augmenting lips but they have three major drawbacks. First, they are temporary and can have variable longevity (from 2 months to a year or more) in an individual. Second, they can swell for 2 to 3 days after treatment. (However, Dr. Lam has some methods that he uses to reduce this period of swelling down to usually less than 2 days.) Third, they are still not completely soft when you feel your lips. These fillers however provide immediate benefit and can be used elsewhere around the mouth like for fine lines, downturned lips, smile lines, etc. Silicone lip enhancement provides permanent enhancement for one’s lips and usually has a shorter period of swelling (typically only the night of the procedure) compared with hyaluronic acid based fillers. However, if bruising arises, bruising in the lips cannot be treated with a laser and may linger even for up to 10 days to 2 weeks. If you avoid aspirin, aspirin-related products, vitamin E pills, and herbal medications a week prior to your injection, you may be able to minimize or entirely avoid any bruising. You do not see an immediate improvement with silicone lip enhancement. In order to achieve a smooth result, you must undergo several treatment sessions with silicone spaced out a minimum of one-month intervals. Typically, you will be underwhelmed with only one treatment of silicone and will most likely require between 2 to 3 sessions over 2 to 3 months to achieve your desired result. If your budget or time does not permit, you can delay your subsequent treatments even further than a month but you cannot have any session shorter than 4 weeks from the previous one for your safety. Silicone truly provides the most seamless and softest result for your lips, where you should not even be able to feel anything in your lips in almost all cases. However, you must be patient to achieve your desired effect.

Dr. Lam believes that silicone microdroplets are very safe if performed by the right physician. If you have seen lumpy bumpy lips from silicone or some other permanent injectable agent, Dr. Lam did not create those lips. Instead, he has corrected numerous individuals with that problem (see following question). Silicone must be undertaken with only microdroplets and in discreet amounts spaced over monthly intervals. Doing so permits the silicone to be held in perfect position permanently by virtue of the collagen that maintains the silicone from ever moving. Bad silicone injections are obvious for several reasons. The injector is not injecting restricted, medical-grade silicone but either industrial-grade (impure) silicone or injecting an overall quantity that is too much in droplets that are too large during a single session. Alternatively, the injector is not even using silicone at all but some other bioincompatible product. Dr. Lam has never observed these kinds of complications with his technique and has trained with a physician who has performed this kind of procedure for over 40 years without these kinds of problems. Silicone is currently FDA approved for use in the eyeball to manage retinal detachments. Accordingly, the use of silicone in the body is perfectly legal so long as the physician consents the prospective patient about the risks, benefits, and limitations of treatment. This type of therapy is known as an “off-label” treatment. Moreover, after two decades of controversy concerning silicone in breast implants, the FDA has finally approved their use again. The moratorium on silicone breast implants has been lifted after extensive and long-term clinical review by the Institute of Medicine and the Food and Drug Administration. However, whether you decide to have silicone lip enhancement is your personal choice. For a better understanding of the safety and use of silicone, please watch Dr. Lam’s video logs on the subject: Silicone Safety Video 1: Breast Implants and Collagen Vascular Disease, Silicone Safety Video 2: Silicone is Already In Your Body, Silicone Safety Video 3: Silicone Versus Fat as Permanent Fillers

Although it is unsafe to use both silicone and hyaluronic acid on the same day in the same facial area (e.g., the lips), you can have silicone placed over hyaluronic acid or vice versa if separated by a minimum time of one month. Some patients desire a subtle permanent lip enhancement and want something more dramatic for special events. In this circumstance, silicone provides a permanent enhancement of the lips that can be subtle and then hyaluronic acid can be used once or twice a year for a more luscious looking lip that may not always be desired. (Fore more information on silicone and hyaluronic acid, please refer to the Dermal Fillers FAQ section.)

Silicone is truly intended to improve contour, shape, and dimensionality of the lips. It is not an ideal filler for fine lines around the lips. As far as fillers are concerned, hyaluronic acid is preferred for this type of treatment. First and foremost, wrinkles around the mouth oftentimes develop due to a bad habit of pursing one’s lips, smoking, or using straws on a regular basis. Breaking a habit can be the first step in improving the situation. In addition, BOTOX can be used to help break the habit or recondition one’s behavior to refrain from further such activity. BOTOX is only safe around the lips in limited quantity and must be repeated twice as frequently as normal BOTOX for the areas around the upper face. Besides these treatments, the ideal method to correct deeper lines is Plasma or Pixel skin resurfacing, as discussed in the Skin Rejuvenation FAQs section.One more thing: if you are a woman who is used to looking at your fine lines at a distance of 2 inches from a magnifying mirror, then you may benefit from stepping 5 feet away and looking at a mirror without the aid of added illumination or magnification. That is in fact how the world sees you. In that case, these lines may not appear as bad as you think, at least to the casual observer in a normal social setting.

That is perhaps the biggest concern many people express when it comes to lip enhancement. Dr. Lam takes a lot of pride in the artistry of his design work and creates only natural appearing lips. As described in the principal lip section and in the video, lips must be designed with an artistic eye to the balance in size between the lips and also the natural shape and contour of beautiful lips. In fact, Dr. Lam is a world expert on fixing other people’s bad lip procedures and does so about every other day for people who fly in for him to do so. After a consultation with Dr. Lam, he can explain to you exactly how he would help enhance your lips based on your aesthetic desires in combination with his artistic eye.

A large percentage of the corrective work that Dr. Lam performs is aimed at individuals who only had their upper lip augmented. The upper lip is augmented in isolation due to patient request or physician desire to do so. However, Dr. Lam rarely performs isolated upper lip enhancement for two reasons. No matter how small the upper lip is, if the upper lip is enhanced in isolation, the result at times can still appear unnatural. Further, the pouty, lower lip that should naturally be fuller can provide the overall illusion that both lips are larger: see the before and after result in the principal lip section as an example. At times, with silicone, after establishing a harmonious balance between the lips, Dr. Lam may elect to enhance only the upper lip to accentuate the shape and size a bit more. However, with hyaluronic acid, Dr. Lam rarely performs only upper lip enhancement. In contrast, Dr. Lam may perform isolated lower lip enhancement to balance an overly aggressive upper lip enhancement done in isolation.

Dr. Lam is very sensitive to the size and shape of lips that you desire. If you express a conservative degree of enhancement, Dr. Lam can accommodate this request by being more conservative with any treatment. Using his before and after photographic gallery, Dr. Lam can discuss with you what changes would be expected with each treatment session in regard to silicone. Fortunately, the way that Dr. Lam performs his silicone enhancement, the changes are slow and graduated.

If you have absolutely paper thin red lips, then success with lip enhancement with injectable fillers can be a bit less than if you start out with slightly fuller lips. At times, you may require more than an injectable filler to achieve the ideal results, e.g., a subnasal lip lift, corner of the lip lift, or direct lip advancement. Only a careful evaluation with Dr. Lam will help establish realistic expectations of what is possible in your case.

As mentioned, Dr. Lam categorically does not put solid implants into lips anymore for the reasons enumerated before. In certain circumstances, he will consider a lip lift procedure performed with an incision along the bottom of the nose for a person who has an elongated white upper lip and a very thin red upper lip that hangs over the upper teeth. Alternatively, a downturned lip at the corners of the mouth can be improved with a corner of the lip lift procedure. A discussion with Dr. Lam will help establish whether you are a candidate for these types of procedures.

Absolutely not. If you have had an experience elsewhere in which you had mild, moderate or severe discomfort during lip enhancement, you simply will not with Dr. Lam. The dental block that he performs is excellent, and you will not feel any needles (even for the dental block), burning, or pain, period. Also, Dr. Lam does not use any “epinephrine” in his anesthetic mix so that you should not feel your heart race during the procedure. This special anesthetic that Dr. Lam uses also wears off between 30 minutes to an hour so it is very short acting. Since it is an office-based treatment done in a few minutes, you are free to drive home afterward.

Unfortunately, a large percentage of Dr. Lam’s patients come in for corrective lip work. Dr. Lam is known for his skill in correcting bad work. At times, he cannot correct a lip 100% but can reshape a lip that may take him several months to get to the outcome of which you and he are desirous. Only a consultation will help Dr. Lam decide what he can or cannot do to correct your previous work (see Lip Reduction FAQ for more information).