Dermatologists use injectables to add volume to lips, soften signs of aging around mouth. Reading someone's lips isn't always easy, and trying to determine if someone has had a little work done on them is even harder -- thanks to the art and science of lip augmentation. Now, dermatologists are using injectable hyaluronic acid fillers to not only add volume to the lips, but also to reduce the fine lines and common signs of aging around the mouth, enhancing the natural smile.

Adding Fullness to the Lips

    While used off-label for years, in October 2011 one hyaluronic acid filler was approved by the U.S. Food and Drug Administration (FDA) for lip augmentation in patients 21 and older.
    Lip augmentation is a procedure in which hyaluronic acid is injected into the lips to enlarge them and is best suited for patients who want to subtly change the shape and appearance of their lips.
    Dermatologists recommend not overdoing the procedure, as results will look more natural if less filler is used. For that reason, Dr. Krauss notes that most dermatologists are conservative with the amount of filler used in the first injection. In some cases, a second injection may be needed for optimal results.
    Lip augmentation should be approached cautiously in patients who have a large space between the base of the nostrils and the red part of the lips, as fuller lips could create an unflattering appearance similar to a duck's bill.
    Dermatologists caution that patients need to be realistic with their expectations. For example, patients with very thin lips will not get dramatic improvement in the fullness of their lips from lip augmentation, as the lips need to be proportionate to other facial features.
    On average, results typically last six months or longer.

Improving Age-Related Changes to Lips and Mouth Area

    Originally approved by the FDA to treat moderate-to-severe facial wrinkles, hyaluronic acid has been used successfully for years to reduce the signs of aging around the mouth.
    Common signs of aging include a decrease in the structural components, or scaffolding, around the corners of the mouth. Exposure to the sun, smoking and time accelerate aging and result in drooping, a decrease in volume, and/or lip lines which extend onto the skin above and below the border of the lip.
    In addition to filling in depressed areas or lines around the mouth, hyaluronic acid fillers also stimulate collagen production.
    Lip augmentation is not recommended for those with severe sun damage or deep wrinkles, for results will not be as dramatic as in someone with more moderate signs of aging.
    On average, results typically last six months or longer.

Discuss Possible Side Effects With Your Dermatologist

    Lip augmentation can cause bruising, swelling and discomfort following the procedure. While bruising often can be covered with makeup, a pulsed-dye vascular laser can be used to fade bruising quickly. Swelling usually resolves within a few days, and dermatologists recommend sleeping with an extra pillow to keep the head elevated. Acetaminophen can be used for pain.
    In rare cases, severe swelling can occur that would require the use of an oral medication, such as prednisone.
    If a patient's skin is easily irritated and has a history of cold sores, the procedure may cause a flare up and require the use of anti-viral medications.
    Patients who are allergic to any hyaluronic acid products, those with a history of severe or multiple allergies, and those with bleeding disorders or who are on blood thinners or aspirin therapy are not appropriate candidates for lip augmentation.

This information was presented at American Academy of Dermatology's Summer Academy Meeting by Madeline C. Krauss, MD, FAAD, a board-certified dermatologist at Newton-Wellesley Hospital in Newton, Mass.