Fillers aren’t always the answer.
Facial features evolve over time, and if you’re a woman of “a certain age” (like me) you may be less than thrilled with Father Time. I’ve never had much of a pout, nor have my teeth ever shown when I smiled, but my lips seem to be disappearing little by little year after year. As it turns out, the decrease in collagen and elastin production that affects your skin also does a number on your lips. Combine that with decreased hydration levels, and once-voluminous lips fall – well – flat.
Injectable dermal fillers may sound like the solution, but what if the space between your nose and your top lip seems to be longer and flatter than in years past? Philtrum shortening, lip lifts, and lip contouring can create a plumper pout and even restore the natural “V” in your Cupid’s bow.
Aging and the Space Above Your Lip
You know that vertical depression between your nose and upper lip? That’s your philtrum. And much like your other features, its appearance is predominantly genetic and subject to the natural aging process. Dr. Kevin Sadati, Board Certified Facial Plastic and Reconstructive Surgeon, explains that “loss of collagen and subdermal fat in the skin and fascia around the mouth are part of the aging process. As skin loses elasticity and begins to sag, it can cause the space between your nose and mouth to become more pronounced and noticeable, leading to a flaccid and elongated philtrum.” Lovely, right?
Dermal Fillers Won’t Fix It
We’re all quick to think that injectable fillers are the answer for all things lip. Alas, they’re not. According to Dr. Sadati, “Patients with moderate to severe skin laxity concerns would not typically benefit from fillers. For moderate or severe cases of elongated philtrum, fillers to the lip would cause a very unnatural look and bring more attention to the elongated philtrum.”
The Combination Approach
While most surgical candidates are in their 40s or 50s, Dr. Sadati says the surgery is an option for younger patients who exhibit early signs of elongation or who‘ve disliked the way this area of their face has looked from an early age. “Philtrum contouring can be done in conjunction with a lip lift,” which increases the visible pink tissue and makes the lips look fuller. “To achieve a more noticeable Cupid’s bow, the muscles of the philtrum are sutured in [such] a way that the vertical columns of tissue alongside the philtrum become more prominent, and the philtrum deepens.”
Patients can opt for IV sedation or local anesthesia (numbing the philtrum) if they prefer to be awake during the procedure, which will run you anywhere from $5,000 to $15,000 and takes about an hour with little to no pain. The surgeon removes excess skin and hides the dissolvable sutures beneath the creases of the nose and inside it as well. Recovery time is short, but your mileage may vary, so plan your procedure accordingly if a special occasion is on the horizon. Depending on your healing, patients look presentable in about three weeks or less.
What About Procedure Remorse?
Unlike hyaluronic acid-based lip fillers that the body metabolizes naturally over time, surgery is a done deal, and perioral rejuvenation requires a skilled hand. If you’ve suffered a negative result from a previous surgeon, Dr. Sadati says all is not lost. “There are supplemental treatments that can be done to soften a less than desirable outcome. [Injecting] Botox [into] the upper lip muscles will help to drop the philtrum and elongate it.”
As always, do your homework instead of looking for a quick fix. Consult with a board certified facial plastic surgeon and review his or her “before” and “after” gallery photos thoroughly. Reputable surgeons proudly share their results, and its good practice to consult with more than one expert to ensure they are qualified and can deliver the results you want.
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