Lips and Makers

How one local surgeon can make your lips bigger than life

Words: Paul Jenulis

Image: Provided courtesy of the good doctor

Lips. Those wonderful pinkish folds of flesh; the very tools that help us speak, whistle away our days or smoke away our lives; the soft frame around the mouth, responsible for the b, m, and p sounds, the essential equipment for drinking, spitting, sucking and kissing. Lips: companions of the tongue and teeth; the subtle but significant speech-making residents of the space below the nose. Lips are the LeBron James of the face. Plastic surgery is the game.

Lip augmentation surgeries have been steadily climbing in the Pacific Northwest. More and more people—mostly women are supersizing their lips in the belief that puffier is sexier. “Fuller lips are sexy!” says Seattle facial plastic surgeon Sam Naficy, M.D., a ten-year veteran in facial plastic surgery. Naficy performs nearly 1,000 surgeries a year; eight to ten percent of which are lip augmentations. In today’s world of the ever-increasing importance of appearance, full lips have become as essential as breasts used to be. “As far as number of people who come in and have injections on their lips, I’d say that by far surpasses the number of people who have breast implants.” Naficy, 37, says fuller lips can lead to happiness via increased confidence. “Men are attracted to certain aspects of a woman’s face,” he says. “One of them is their lips. Younger women come in because they want to be sexier. It’s about making people feel more confident and happy.”

How in the world could you live with lips like these? They're hideous! Now, with the miracles of science, you don't have to! (Yes, this is the before shot.)

The beautifully enhanced after lips

Naficy was voted one of Seattle magazine’s Top Facial Plastic Surgeons in 2003. Based in Kirkland, WA, he has provided lip service to mostly women, ranging in age from 18 to the late 50s. Rarely, he says, do men get their lips augmented. A native of the Northwest, he received his Bachelor of Science from the University of Washington as well his Doctorate of Medicine, graduating with highest honors—number one in his class of 175. After his residency in Michigan, Naficy returned to Seattle, specializing in facial cosmetic surgery. “I feel strongly that to do something well, you need to focus on it,” he contends. “If I were spending 90% of my time doing boob jobs and liposuction, then I wouldn’t be as good in doing noses, eyes, and lips.”

Lip augmentation is performed mostly to create fuller lips in younger women and to diminish wrinkles forming around the mouth in older ones. It’s simple: women generally under 35 do it for volume, sexiness and to be more attractive; women in their 40s and 50s do it more for wrinkles and to fill in their lipstick lines. “As we age, we all lose volume from our face,” Naficy explains. “As [women] get older, the skin becomes loose. They get kind of those lipstick lines. So for them, a lot of it is more for not showing their age.”

There are several different procedures for lip augmentation, most involving injection of solutions into the lips; the few still involving cutting of skin, Gore-Tex and AlloDerm are becoming less popular and less used. Collagen, the most popular product until recently, also happens to be the name of the protein naturally found in animal connective tissue. Once boiled, the protein collagen yields gelatin—also used in Skittles and Starburst—which is injected into the lip. The product Collagen, however, actually derives its substance from cows. “[Collagen is] pretty much falling out of favor,” Naficy remarks. “There are so many new things out there that it’s pretty much a thing of the past.” The decrease in popularity is not necessarily because Collagen comes from our bovine friends, though. “People are a little bit weary of having things injected into them that’s from another animal,” Naficy states, “[but] it’s not as much that it’s from another animal—but it’s just the fact that it’s really short lasting and there’s the risk of allergy. A lot of people can actually develop allergies to it because cow Collagen is different from human collagen.” Collagen is short in duration, lasting only two to three months, but is significantly cheaper ($300-600) than other products, including AlloDerm ($1,000-2,000), which is derived from human cadavers.

AlloDerm is potentially long-term but requires incisions along the corners of the mouth for implantation. It eventually loses approximately half its volume over time. “[It’s] sort of permanent but not really,” Naficy says. These aren’t the only two issues in AlloDerm’s lack of popularity, though. Apparently, humans have more issues with using products from their own species than from other animals. “AlloDerm basically comes from dead people. It comes from a tissue bank where they use human cadavers and they essentially take their skin and use the collagen from them to make this implant.” Although it’s more natural than Collagen, AlloDerm has remained less fashionable. “This is a human product,” Naficy emphasis. “Not everybody likes that.”

Fat injections, however, come from an individual’s own fat—usually taken from the abdomen—and cost and last about the same as AlloDerm. “[Fat] is very soft and very natural,” Naficy says. “[It’s] nice and soft and bouncy.” However, over time, fat injections disappear. They can also leave lumps or scars.

Generally, Naficy confides that those getting augmented lips try a short-term solution first before going permanent. However, there are advantages but risks associated with short-term procedures. Mainly, not all the short-term products have the same consistency as long-term ones. “If someone wants fuller lips, they generally try out something short-term, like Collagen. Just to see how they like it; how they like the feel of having fuller lips. A big difference, however, is that although volume will be similar when switching from a short-term to a permanent, the feel will be different.” Gore-Tex and silicone are permanent materials but have different consistencies compared to collagen, fat, and AlloDerm. Silicone is the cheaper of the two ($450-650) but has the potential risk of deep lumps, although recovery time is significantly less than that of Gore-Tex (a few hours compared to four to five days for Gore-Tex). And Gore-Tex ($1,000-2,000) occasionally can be felt or seen.

The obligatory before and after shots.

From an ugly duckling to raging beauty

“It’s an implant,” Naficy ruminates. “Some people that have had Gore-Tex lips, you kind of almost see this outline of this tubular structure. You might not notice it but I have seen enough that I can tell ‘that lady has Gore-Tex lips’ because I can see that tubular structure.” That tubular structure may have something to do with the material used: Gore-Tex is made of similar material of ski jackets, only “they’ve added more air to it so it’s a little fluffier.”

For the short-term, quick and easy, come-in-on-a-Friday-night-before-hitting-the-clubs kind of augmentation, Restylane is the deal. “It’s got a really nice, soft, watery consistency to it so it doesn’t cause any kind of lumpy-bumpiness. Restylane is a clear gel and lasts six to eight months. It is made of hyaluronic acid, which naturally occurs in everyone. “Every one of us has hyaluronic acid in our bodies,” Naficy explains. So there’s no need to test for allergies. “With Collagen, patients had to have test spots and had to wait four to five weeks to make sure they didn’t become allergic.” Restylane is a cheaper option ($450-650), lasts longer than other injectables, and requires only a brief recovery of a few hours. A person can literally come in on a Friday, get Restylane, and go out that night. “You could do it and you could go out that night and look great. Probably get twice as many dates as you would otherwise.” The downside is that Restylane is very new and relatively still unknown, becoming FDA approved in January.

Before you jump to get augmented, Naficy says consider all the options. He advises people to make sure their surgeon has experience with the procedure they are having and to look at before and after photos of previous clients who had the same surgery performed. Duration of procedures vary from person to person depending on the method. Those with current cold sores, certain diseases (diabetes, lupus, for instance), scarred lips, or blood clotting problems are not good candidates. Smokers may be required to stop smoking for a period before the procedure. Augmentation also generally decreases sensitivity to the lips during healing, but this eventually returns to normal. The non-surgical forms of lip augmentation also may have to be periodically repeated.

Recovery depends not only on the product and method chosen, but on the individual’s lifestyle, as well. For surgical augmentations, the recovery period can last up to two weeks. “A lot of people don’t really want to go through the recovery period of some of the longer things because they do involve more swelling, more bruising,” Naficy warns. “After a lot of these procedures, the lips can really swell for like three or four days. [People] can look like a duck.” Physically active people may not be able to exercise for a few days after injections and perhaps for a few weeks after surgical implants. There is also a risk of bleeding or even hardening of the implants, which may require removal. And there’s always the risk of nerve damage or infection. People should think about materials that come from animal or human sources because there is always a risk of disease transmission”, Naficy says. “With any lip implant or lip injection there is a risk of infection but this is very low.”

Although lip augmentation has many perks (“A lot of lip augmentations are subtle enough that you might not be able to tell”), cost of lip augmentation must be considered. “It is expensive,” Naficy admits. Longer-lasting augmentations are more expensive because they take more time and involve purchasing products that are more expensive. “A lot of [people]… need to be gainfully employed to be able to afford these luxuries. Even if you go to the discount plastic surgeon in Tacoma, it’s still going to cost you. [Sometimes] you just can’t justify spending six hundred dollars just for your lips.”

For more info on Sam Naficy, M.D., visit seattleface.com.