The Lips

The lips, by expressing emotions, become a very important element in human interaction. The lips and the mouth as a whole are one of the most important elements of attraction, and thanks to their exceptional expressiveness, they convey a major part of our feelings, from happiness through a smile to disgust.

Despite their apparently simple design, the lips are composed of several anatomical units that must harmonise to become beautiful, feminine and sensual.

The shape and volume of the lips are determined by the patient's morphology, and therefore their genetic code. For these reasons, we have our parents' lips. Depending on facial proportions, they can be considered harmonious and attractive.

Lip mobility is due to a multitude of subcutaneous muscles that animate them, raising, lowering, opening or closing them. The combination of these movements allows very fine expression of our emotions.

The second element responsible for lip shape is ageing.

With age, our lips lose their volume and definition, the skin of the white lip wrinkles and makeup such as lipstick begins to bleed.

This degradation of lip volume, shape and surface can be accelerated by tobacco, extreme temperatures, excessive sun exposure, an unhealthy lifestyle, poor nutrition, and significant weight changes.

The upper lip is composed of 2 parts: a cutaneous part called the white lip, and the mucosal part called the red lip.

They meet to form a small ridge called the vermilion border. This, along with a slight groove in the middle called the philtrum, gives the lip its definition; this is known as Cupid's Bow.

The lower lip also has a cutaneous white part and a mucosal red part.

The volume of the upper and lower lips is not standardised and must be assessed for each patient according to the harmony of their face.

The decrease in lip volume is part of the normal ageing process; our lips change shape as the once plump, well-defined and attractive lip becomes thin, the red part of the lips narrows, the white lip lengthens disproportionately, and smoker's lines appear on the upper lip. The corners of the mouth droop and our facial expression becomes sad.

This phenomenon is due to skin and muscle laxity of the face, our facial expressions and volume loss, particularly of the lips. We lose the shape of the smile.

The goal of treatment is not to create lips with a disproportionate volume or a shape unsuited to the face, but to achieve the most natural result possible, while simultaneously making the mouth much more sensual.

Unfortunately, some lip defects are very difficult to correct, for example superficial lines in the case of "smoker's lips".

Attempts to correct these defects by filling or rather overfilling the white part of the upper lip can result in a caricatural effect (the "trout pout") so often seen in the celebrity world.

It is absolutely essential to consult an experienced specialist to avoid worsening the pre-existing situation.

• Insufficient volume of the upper or lower red lip can benefit from volume augmentation with hyaluronic acid or with a graft of your own autologous fat: the advantage of lip augmentation with hyaluronic acid is the simplicity of injection in the medical office.
• Lipofilling with injection of your own autologous fat requires a surgical procedure.
• Insufficient lip definition or lack of allure can be effectively improved primarily through hyaluronic acid injection to change the shape or enhance the lip contour: here, hyaluronic acid is preferable to autologous fat injection as it is much more precise despite its temporary action.
• Effaced mouth corners with marionette lines can be partially corrected with botulinum toxin (Botox) injection, which changes the balance of muscle tension in this area, sometimes by injecting a small volume of hyaluronic acid to reduce the depth of marionette lines.
• Nevertheless, the most effective definitive treatment in this case remains the cervico-facial facelift which re-tightens the skin with the underlying muscles and lifts the sagging muscles.
• For the cutaneous white part of the upper lip that is too long and disproportionate, an upper lip lift can be considered, most frequently performed alongside the cervico-facial facelift.
• For vertical upper lip lines, very subtle filling (micro-injections of HA) can be effective, as can laser resurfacing or chemical peeling. These methods must be administered with the greatest caution to avoid worsening the situation with iatrogenic sequelae.

Special cases:

• Gummy smile caused by hyperactivity of the upper lip muscles can be effectively treated with a very targeted Botox injection.
• Lips filled with non-resorbable products (prohibited in France) are extremely difficult to treat and require extensive surgical experience to achieve a satisfactory result.
• Ethnically thick lips can be treated by excision of the labial mucosa with an invisible scar, as it is located on the inner surface of the lip.