It seems like everyone is talking about lips these days. Many women are turning to dermal fillers to achieve the lush lips of Angelina Jolie. Other women are looking to restore the pillowy appeal of youthful lips.
Lately, the tabloids are having field day featuring celebrities with overstuffed lips and "bad" plastic surgery in general. My patients have been asking me if there is any aesthetic formula used to create full lips that enhance rather than overtake the face.
The answer is yes. In most circumstances the width of the lower lip should be two-thirds wider than the upper lip. I keep this in mind when appraising all patients regardless of their age. There should be a pleasing upward curve to the lips, giving the impression of a smile rather than a scowl. I work with the natural architecture of the lip to accent the cupids bow.
Patients who are concerned about aging should keep in mind that as gravity takes over, the face and it features begin to sag. That is why we use fillers to lift in addition to filling in lines. As time goes by the vertical lines between the nose and the upper lip begin to flatten. I use fillers to rebuild these lines (the philtrum) for a more youthful appearance.
Bryan J. Michelow, MD., FACS
