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Francis R. Palmer III, M.D. Powered by ZocDoc Doctor Directory
Francis R Palmer III MD FACS
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Lip Augmentation

Lip Augmentation – Lip Implants in Beverly Hills

If you’re looking to enhance the size and shape of your lips, you should first understand aesthetically what makes lips full, plump and naturally beautiful. Dr. Francis Palmer a world-renowned Beverly Hills Plastic & Cosmetic Surgeon, based in Los Angeles, is the developer of The Palmer Code. This revolutionary set of beauty principles identify, describe and quantify beauty of the face and body. Revealed in Dr Palmer’s new book “What’s Your Number… the Palmer Code”®, The Palmer Code represents trade secrets, he has used for over 2 decades, to make people more naturally attractive in a highly effective and consistent manner. The Palmer Code has been featured in People Magazine’s 50 Most Beautiful People and other major media outlets.

Before and After Pictures

Pre Lip Implant with Alloderm

Pre Lip Implant with Alloderm

Post Lip Implant with Alloderm

Post Lip Implant with Alloderm

Actual Patient Photos. Results may Vary.

The Palmer Code allows you to understand what beautiful lips should look like before you have lip augmentation or lip enhancement. According to The Palmer Code, the Lips are the 3rd most important facial feature accounting for 7% of overall facial beauty. When ideally shaped and proportioned the lips, not only have the ability to soften the entire lower face, but can even camouflage a less attractive nose or chin.

Men and women’s lips are aesthetically very similar. Both look best with full, plump lips giving a soft, sensual appearance to the mouth. This is perceived as soft and gentle-in stark contrast to the thin or asymmetric lips that exude a sense of being stern, mean or untrustworthy.

lipAccording, to The Palmer Code, ideal lips have a certain size and shape. On profile, the lips should have a gentle S-shaped curve between the lips and chin-with a 4mm depression existing between these two structures. The illustration in figure 1 shows this relationship. Although, the nose and chin typically set the strength of your profile, Lip Augmentation does have the ability to add balance to this area. Enhancing the size and shape of the lips may aesthetically improve the entire lower 1/3 of the face.

The arrow, in figure one, indicates the 4mm groove that should exist between the lips and chin on profile (mento-labial groove). Lip Augmentation can achieve a balanced, more aesthetic profile. Ideally shaped lips have other characteristics according to The Palmer Code, developed by Dr. Francis Palmer. These should be the cornerstone of any Lip Augmentation and Enhancement treatments or procedures. If these Aesthetic principles are violated, the lips may appear to large or out of balance with the entire face resulting in a less desirable outcome.

lipImaginary vertical lines drawn down from the inner colored portion of the eyes delineate the overall width of the lips. The ideal fullness, of the lips is achieved when the upper lip is approximately 75% (and not larger) as full as the lower lip. This assures an overall pout to the lips-no matter how plump or full they are. Should this aesthetic ratio be violated, the lips will look out of proportion and odd.

The lips typically loose volume with age giving the illusion of an increased space between the upper lip and nasal tip. This gives the lower face an aged and stern look that is not aesthetically pleasing. The sole purpose of Lip Augmentation, Lip Enhancement or Lip Enlargement treatments and procedures is to add volume and mass to the lips that otherwise appear to small and thin.

If you don’t have perfectly shaped lips, there are several methods of augmenting or plumping the lips to achieve a soft, naturally attractive appearance. These can be organized into two types of Lip Augmentation procedures, ones using injectable materials and those requiring a surgical procedure to enhance the size and shape of the Lips. Let’s look at each of these Lip Augmentation methods:

Lip Augmentation/Enhancement using Injectable Materials:

Lip Augmentation/Enhancement using Injectable Materials
Restylane®: Lips can be Augmented, Enhanced and Enlarged using this material that is injected along the borders of the lip (Vermillion Border is the edge of the lips where the red portion of the lip meets the skin). This material is hyaluronic acid (HA) derived from bacteria and as such does not require skin testing before treatment. Treating the lips for augmentation entails an office treatment where Restylane is injected along the borders of the lips for Augmentation. The effects last about 6 months after which time the injections need to be repeated to maintain the augmentation and enhancement.

Juvederm® Juvederm Ultra® : Similar to Restylane, Juvederm is a hyaluronic acid with silimilar placement and duration of effects.

Cymetra®: This is processed human tissue that is injected into the lips to create Augmentation of the lips. This is an injectable form of Alloderm. Dr. Francis Palmer believes that Alloderm in the sheet form offers longer lasting Lip Augmentation and Enhancement.

Artefil® or Artecol®: A permanent filler made of methylmethacralate (MMA) beads suspended in a carrier gel. Once injected, the carrier gel dissolves leaving the MMA beads permanently. The risk of any permanent filler is the formation of permanent lumps that require additional procedures to correct.

Silicone: Pure medical grade silicone is applied in micro-droplets into the lips. The silicone becomes surrounded by collagen and creates Augmentation and Enhancement of the lips. Some experts caution consumers on having silicone injected into their tissues. Be sure that the silicone is medical grade and that you understand the risks and benefits if you are considering this option for your Lip Augmentation or Enhancement. This permanent filler has been known to create inflammation, increased lip swelling and benign tumors as well as migrating outside the injections sites. For these reasons, Dr Palmer does not recommend silicone injections in the lips or face. Silicone can’t be dissolved or removed and over-sized distorted lips require lip reduction as a corrective measure. Dr Palmer believes that silicone injections can act up creating swelling and inflammation at any time, even years after being injected.

Bio Alcamid®: Is a three percent polyalkylimide mixture suspended in water. This material may be able to be removed but otherwise has the same risks and limitations of all permanent fillers, in Dr Palmer’s opinion, making them unsuitable for Lip Augmentation, facial shaping or contouring in his opinion.

Aquamid®: Aquamid is the trade name for a specific formulation of 97.5% water for injection and 2.5% cross-linked polyacrylamide. Reportedly this filler can’t be removed.

Sculptra® and Radiesse® are mentioned so that you are aware that they are available but these are not recommended for Lip Augmentation, Enhancement or Enlargement, in Dr Palmer’s opinion, as they are meant to be injected into the fatty tissue layer. The lips have no such fatty tissue layer which raises the risk of long-term lumps and bumps.

Fat Transfer (grafting): No matter how it’s processed, injected or modified fat becomes non-viable dead tissue once it’s removed from the body. Transferring the fat has issues of uneven absorption, scarring and hardening and as such is not a reliable method of Lip Augmentation, Facial Shaping or Contouring. In Dr Palmer’s opinion.

Lip Augmentation/Enhancement Surgery using lip Implants (Permanent and Semi-Permanent):

Lip Augmentation/Enhancement Surgery using lip Implants Alloderm®: Dr. Francis Palmer’s top choice for longer lasting Lip Augmentation is an Alloderm implant (sheets) Dr. Palmer has used Alloderm Lip Implants many times over the past 15 years and is the senior author of several scientific papers on using Alloderm for Lip Augmentation. Alloderm is processed dermis chemically treated to remove all the cellular elements leaving a collagen framework. The Alloderm (tissue framework) comes freeze dried and is reconstituted, at the time of the Lip Augmentation, using sterile saline (salt water).

In Dr. Francis Palmer’s opinion, it is the fact that this material is a framework and not living tissue that adds to its predictability and reliability versus tissue transfer (fat or fascia lata) procedures for Lip Augmentation. The Alloderm becomes soft and supple. Dr. Palmer folds the Alloderm and places a dissolvable suture to maintain the desired shape. A local anesthetic (like Novacaine) is injected into the lips. Small entry sites are placed in each corner of the lips and the red portion of the lip is gently elevated and lifted off of the underlying lip muscle.

The Alloderm is then placed across the lips. Alloderm, in Dr. Palmer’s opinion, is the premier Lip Augmentation material as it leaves the lips soft, supple and naturally augmented. This fibrous tissue framework is ideally suited for the thin tissues of the lips. When properly placed beneath the exposed red portion, Allodermr gives the lips a soft natural fullness. There is no change to the sensation or movement of the mouth and the Allodermr is generally undetectable within the lips. For these reasons it remains, in Dr. Palmer’s opinion, the premier material for natural looking lip enhancement.

Dr. Palmer has performed fat and other types of tissue transfers, for Lip Augmentation in the past and does not believe that they give the same results. Read some of the media comments on this procedure at the top of this page (click here).

The amount of Lip Augmentation is determined by the amount of Alloderm sheets used. For example, the upper lip may receive 50% of 1 sheet and the lower lip 75%, of another sheet. The maximum amount that Dr. Palmer has used to Augment the Lips is 1 full sheet for each lip however, if further Lip Enhancement is desired, additional Alloderm can be placed after 1 month to further Enhance or Enlarge the lips. The effects last for up to 7 years and may be repeated for further Lip Augmentation.

PermaLip by Surgisil: A soft, solid silicone implant that is placed within the lip muscle.

Verafil: A saline filled, gore-tex coated implant placed within the lip muscle.

Gore-tex®: This is a man made synthetic material that has been used as an implant to Augment the lips, nose and soft tissues of the face. Dr. Francis Palmer used gore-tex threads placed within the body of the Lip for Lip Augmentation for numerous years and performed many procedures. Dr. Francis Palmer believes that Alloderm gives a more natural, soft and reliable Augmentation to the Lips and no longer recommends gore-tex for Lip Enhancements.

Gore-tex comes as threads and implants that are solid or hollow (Softform) using a material called ePTFE. Dr. Francis Palmer is senior author of a scientific paper that compared Alloderm to gore-tex for Lip Augmentation using a retroactive clinical study and found Alloderm to have fewer side effects and complications after the Lip Augmentation Surgery.

Here is a brief explanation of how goretex works in lip augmentation. The lips are numbed using a Novacaine-like substance and the gore-tex may be introduced in several ways depending on the type of Lip Enhancement that is desired. Threads may be placed through the center of the lip muscle for Augmentation of the entire lip. Softform, which is a hollow tube of gore-tex, may be placed along the Vermillion border of the lip and comes with its own needle delivery system. Two or three pieces of Softform are typically used for each lip border (top or bottom lip). There is a solid gore-tex lip implant, but these may not be approved depending on the country in which you obtain your Lip Augmentation Surgery.

Dr. Palmer feels that several important factors came into play when using Gortex for Lip Augmentation. Gore-tex is a bit firm and there is an inherent limit to the amount of Lip Augmentation that can be obtained using this material before the lip becomes somewhat hard. Consider this. The lip is a tubular structure and the gore-tex is being placed within this tube to Enlarge the Lips. A tube within a tube so to speak. Commonsense tells us that there is a limit to the size of the inner tube, or the Lip Augmentation that can be performed without making the outer tube (lips) hard.

This is indeed what we expect when using gore-tex threads or solid implants within the center of the lips for lip augmentation. Even when using Softform along the border, of the lips, hardness may result if to large of a piece is being used. Some of you may ask “why is the gore-tex placed deep and not more superficial?” This is a good question. Gore-tex is to stiff of a material to be placed immediately below the lip mucosa above the muscle where it can appear white or even erode through to the surface. For these reasons, in Dr. Francis Palmer’s opinion, gore-tex should be placed deep within the lip tissues when performing lip augmentation or enhancement surgery.

Fascia Lata Transfer: Fascia is the tough outer covering of muscles that has been used for Lip Augmentation. This can be done as an office procedure where the muscle is injected with Novacain and a small strip of the fascia is removed. The fascia is then placed under the red portion of the lip to Augment, Enhance and Enlarge the size of the lips. As with fat transfer, it’s the predictability and reliability of the fascia that is in question. Experts may differ on their opinion of using fascia for your Lip Augmentation.

Dermal tissue transfer: This is another example of a type of tissue transfer to the lips to create Augmentation and Enhancement. In this case a segment of skin is removed and the dermal layer is isolated and removed. The dermal layer is then placed through the lip tissues to create the Lip Augmentation. As with all tissue transfers, predictability and reliability are the main concerns when using these materials for Lip Augmentation.

If you are interested in Lip Augmentation, Enhancement or Enlargement and are looking for semi-permanent solutions to thin lips, this will involve the placement of some type of reliable tissue into the lips. Dr. Palmer believes that Allodermr is the gold standard of all of these materials. Recovery time is minimal, if any, bruising, swelling or discomfort. The patient is advised to eat a soft diet and limit the use of their mouth for about 1 week. Ice, applied to the lips, will decrease any swelling that may occur.

Indications for Lip Augmentation/Enhancement/Enlargement Procedures and Surgery are:

- Thin Lips
- Asymmetry of the lips. One lip is smaller than the other beyond the ideal aesthetic limits.
- Small amount of red portion of the lip(s) visible
- Area(s) of the lips are not full and plump. In some instances, this may require a V to Y procedure where the red portion of the lip is advanced to eliminate indentations of the lip shape. Dr. Francis Palmer prefers to perform any V to Y procedure after the lips have been augmented to their ideal size as this often eliminates the need for the V to Y completely.

Men and women’s lips are aesthetically very similar. They look best with full plump lips that give a soft, sensual appearance to the mouth. This is perceived as soft and gentle-in stark contrast to thin or asymmetric lips that exude a sense of being stern, mean or untrustworthy. Lip Augmentation should be performed in a subtle and artistic manner. Beverly Hills Plastic and Cosmetic Surgeon, Francis R. Palmer III, M.D. has the aesthetic judgment necessary to create naturally attractive lips following The Palmer Code. Why don’t have the beautiful, full lips that you’ve always wanted?

Lip Augmentation Pictures and Photos…

The pictures and photos demonstrate the soft, supple natural Lip Augmentation/Enhancement that is achieved with Alloderm sheets. The lips are soft, supple and retain all their sensation. There is minimal discomfort and swelling when Dr. Palmer uses Alloderm for Lip Augmentation.