Augmentation of the lips is usually performed by the use of autologous material (fat, derma-fat graft or fascia from the temporal area). Filler material, such as hyaluronic acid, is often used. However, if there is no visible upper lip mucosa, augmentation using fillers is impossible. The first step is to mobilize mucosa from the inside of the upper lip and to move it to the front of the lip. This V-Y-plasty technique is usually sufficient for the augmentation of the lip. However, this mobilized mucosa (lip) can then be filled either with autologous material or with fillers. If you fill a non-visible lip with material, the mouth will look as if you have been punched.
V-Y plasty means more surgery and a longer post-operative period. Autologus material is normally used 2 – 3 times. Fillers are usually repeated every 3 – 5 months.
We never use permanent fillers on the lips, since this can create inflammation, poor circulation in the lips and pain.
Fat has aroused enormous interest in recent years. In most patients, 60 – 70 % of the fat survives and then becomes permanent. Nothing prevents you from putting in fat two or three times. To do so twice is very common. The advantage is that the patient can participate in deciding the final lip volume.
In a few individuals the fat disappears virtually completely. We then change to autologous graft, such as fascia from the temporal area or from the deeper parts of the skin, so-called dermis, sometimes removed from scar tissue. Fascia and dermis do not give such post-operative swelling as fat does, and more material becomes permanent. Sometimes we combine dermis with fat (so-called dermis-fat graft), which is also a very good alternative. The addition of more material is not a failure but rather a planned intervention.
All these operations and use of fillers are performed by experienced plastic surgeons (for example by Doctor Wieslander) at the Institute of Plastic Surgery, Western Harbour, Malmö, Sweden.
Treatments for cleft-lip patients can be found under the heading Rhinoplasty (nose surgery). In cleft-lip patients, there is frequently a lack of soft tissue in the lips. The reconstruction using autologous material as described here is an excellent technique by which to rebuild the lips.