I get a lot of questions from friends and patients alike about the different ways to add “fullness” to the lips. It is fairly obvious that there are lots of celebrities and people walking in the grocery store who have had various fillers injected into their lips. One of the telltale signs is the “bicycle tire” appearance to the upper lip. This is the look that is most telling for people who have undergone lip augmentation, as it is not the “natural” result most people request. Adding volume doesn’t mean disrupting natural contours that are part of a normal, youthful appearing lip.
A natural-appearing upper lip has three noticeable prominences and two small indentations. The most notable prominence is the central tubercle – the portion right below the tip of the nose, which gives the upper lip its distinctive look and “pout.” Next to this, on either side, are two small indentations with two areas of fullness on the lateral or outer portions of the upper lip that taper off to almost nothing at the corners of the mouth. In attempts to make the upper lip fuller, a common mistake is to fill in natural areas of hollowing and give the lip a uniform “puffiness”. The gradual taper which is normally present towards the corners of the mouth is also commonly filled – this contributes to the characteristic bicycle tire appearance.
The lower lip is not straight either. There are areas of relative thinness – both in the middle and out near the corners of the mouth – which correspond to the areas of fullness in the upper lip. There are also two distinct areas of fullness in the lower lip which fit nicely into the small indentations of the upper lip, just off the midline of the mouth. Again, in attempts to make the lower lip appear more full, these small indentations are often filled in, which gives the lower lip an unnatural appearance. Injectable fillers should accent normal contours, not get rid of them.
These are things to keep in mind when you are considering undergoing lip augmentation. If done correctly, filler injections – such as Juvederm or Restylane – can produce very subtle and pleasing changes to the lips and drastically enhance the youthful appearance of the whole face.