Introduction

Those of you who read the last two parts on facial implants recognize that it is possible to improve the facial contour and develop a better self-image. It is also true that a person who has a pleasant appearance makes a better first impression on other people. In our society the concept of many people is that youth represents fitness, brightness and potentially high achievement. Therefore, many people wish to enhance their influence by appearing more youthful and better proportioned in their facial features.

I have discussed other procedures to restore the youthful looks of the face in other articles so I will now discuss only the technique of implantation of materials to enhance the lip and to correct the lines of the face.

Lip

Several methods have been used to enhance the lip. The first patient demonstrates the technique of unrolling the red part of the upper lip from inside out. This involves making a V-shaped cut in the red skin of the inside of the lip with the tip of the V pointing towards the upper teeth. This V-flap of skin is then loosened and pulled up. The space created by having this V-flap tissue advanced upwards is closed in a straight line below the tip of the V. The two arms of the V are then closed thus producing an incision shaped like a Y this is called a V-Y advancement flap. The diagram shows how it is done. The result of this surgery is permanent and does not involve using filler substances from somewhere else. It is shifting existing tissue to a neighboring place that needs it more.

Picture A

Picture B

The next patient shows a technique of putting a substance in the lips to enlarge them. Some of the materials that have been used are collagen, fat from the person, and various types of artificial materials. This patient chose to have Gortex because of the certainty of retaining the shape and size since Gortex will not get absorbed or shrink. Its disadvantage is that there is a feeling of something hard in the lip when you bite the lip or feel it between your fingers. The picture of Gortex used in lips is seen. The implant is pulled from one corner of the lip through a tunnel to the other corner of the lip. Gortex is available as a soft tube or as an elliptical sheet with multiple strands cut in it. Seldom does it get infected but if it should get infected it can be easily removed.

Picture C

Picture D

The next patient had an indentation of the right cheek of unknown cause. She had injection of fat taken from the abdomen three separate times about three months in between each injection. At a year after beginning treatment her indentation is completely corrected. In her case the fat injection had to be placed at several levels from very shallow under the skin to deeper in the fat and even in the muscle.

Picture E

Picture F

The reason fat was chosen for these two cases was because of the desire to have material that looks and feels exactly like the body's natural tissue. No doubt fat will partly dissolve but that which remains is real living fat cells which will remain long term in the place where they were put. It must be noted that the success of fat injection is very technically demanding and sometimes unpredictable from one patient to another.

Conclusion

It can be seen that cosmetic facial implants can impact people's lives very significantly because it is by the looks of the person's face that much interaction takes place between people. We are fortunate to live in a time when there are multiple techniques that are available to enhance the way we look and improve the quality of life we lead.