#AskID- Thinning lips with Prof Niki Ralph

Thinning lips
We asked Prof Niki Ralph:
“Lips get their shape in part from collagen. But as the body ages, the body produces less of this critical protein, and the lips start to lose their plumpness. One may also notice the “vertical lip lines” which appear more obvious on the upper and lower lip, as well as lines around the mouth.
Another factor which contributes to changes in the lips as we age is Ultraviolet light. One way to help preserve the fullness of your lips is to protect them early on in life from the sun, by wearing a lipstick or lip balm containing sunscreen. Some individuals, especially > 45years, fair skinned people may notice chronically dry/chapped lower lips. This may be a sign of early sun damage of the lip and if it doesn’t fully clear with the regular use of lip emollients you should have the area checked by your doctor.
Most treatments to create a plumpness of the lips are temporary. Not everyone is ready to consider semi-permanent Lip Fillers so there are some other treatments which may help to create a natural plumpness of the lips. These include regular use of a protective lip balm/emollient and daily use of a lipbalm/lipstick containing SPF to protect against UV damage.
PRP (Platelet rich plasma). This treatment targets a number of areas including:
• Improving vertical lines on both the upper lip and lower lip (called “Lipstick Lines”)
• Diminish the appearance of vertical lines around the mouth (called “Smokers Lines”)
• Improve skin texture on and around the mouth
• Redensify the skin on the lip area, in order to create a natural plump
It works by promoting collagen production and it kick-starts the skin’s regenerative capabilities.
Growth factors in the plasma increase collagen and elastin production, stem cell proliferation and vascular formation. This produces a plumping and tightening effect on the treated area. The skin is rejuvenated and rehydrated and wrinkles are reduced resulting in a healthy, regenerated glowing complexion that looks smoother and more youthful.
Lip Fillers are a series of injections containing hyaluronic acid, which may be used to improve the shape of the upper and lower lips. During a consultation one’s lips will be assessed by a doctor and photos will be taken. The lips will be assessed as well as overall facial symmetry/balance. The lips will have a local anaesthetic cream applied before the procedure and will then be cleaned before any injections take place. The injections such as Juvederm contain local anaesthetic Lidocaine, which is a numbing medication, therefore the lips will feel somewhat numb post procedure for a couple of hours and then will appear quite swollen especially after 48 hours and may remain this way for a few days before they settle to the size/shape they will remain for a period of up to 8 months. This is a semi-permanent solution therefore will require repeated treatments to maintain lip plumpness.
Lip implants are a more permanent and costly solution, however this is also a more invasive procedure.
A consultation would be required with one’s Plastic surgeon with regard to the appropriate size of the implant and photos would be taken. The lips are cleaned and numbed with local anaesthetic and then small incisions are made at the edges of the lips. A small tunnel is created in the lip and then the implant is placed in this tunnel. The implant is placed above the lip muscle, below the lip fat and it is sutured into place with a few small absorbable sutures. Post this procedure there will also be quite significant swelling usually by 48hours which will settle over a period of 5-7 days. The lips are very sensitive to being manipulated therefore there may also be bruising.
Other invasive methods of augmenting the lip include fat grafting and tissue grafting which is using one’s own skin to change the shape/plump the lips. This procedure should be performed by a Plastic surgeon. It results in permanent changes to the lip which may last up to 5 years. It is a costly and also invasive procedure as there are two areas on the body which require healing – the lips and the location the fat or tissue graft is taken from.