Dr. Joseph M. Perlman Advanced Plastic Surgery Centre

With the busy holiday season upon us, many of my patients are looking for quick fixes. In previous posts, we talked about dermal fillers to plump up the facial lines as well as using Botox to smooth out the wrinkles on the upper face. My practice is one of the busiest in the city, particularly at this time of year, for injections of my favorite dermal filler, Juvederm. This is made of hyaluronic acid, one of the natural building blocks of the skin, along with collagen. Juvederm is a smooth filler that I like to use, especially for the nasolabial folds and the marionette lines in the corners of the mouth. It’s also great to help turn the corners of the mouth upward by adding volume to the lower cheek.

We see many patients in the office for lip enhancement. The majority of patients are interested in smoothing out the vertical upper lip lines as well as adding some volume to the lip because as one age, your lips thin out. Juvederm is a great filler for these areas also. I’ll often inject a small ribbon of Juvederm along the upper lip border, although some patients will need injections into the vertical lift lines themselves.

We are starting to see more patients who are interested in a more permanent enhancement of their lips. For these patients, we offer implants. The quality of implants has changed over the years. We had satisfactory results with Alloderm, which is a cadaver dermal graft, as well as Advanta, which is made up of a Gortex-like material. Lately, we have almost exclusively started using Permasil. This is a great lip implant. It is made from silicone and is shaped like a gummy bear worm. It comes in three different sizes, depending on how full the patient wants their lips to look. The insertion is quite easy through small incisions in the corners of the mouth and to date, we have not had any problems. Our patients have been 100% happy with the results. This is definitely the way to go for patients who like full lips, but don’t like to return yearly for injections.