Question:
Is there a period of time after lip augmentation when the lips are swollen and doesn’t look like the final result? If so, how long does this last for?

Answer:
Anytime we do virtually any treatment to the face we are going to create some swelling whether that be from Botox, which the swelling may only last for an hour or so, to fillers where the swelling could last for at most a few days.  Fat transfer or more invasive approaches can obviously create swelling that could last for weeks but regarding your question of lip augmentation I would expect the lips to go back down to their normal state within a few days after the injections and slightly faster if you ice the lips immediately afterwards. 

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Question:
Are implants the only way to get permanent lip augmentation?

Answer:
Implants are certainly the most consistent way to get permanent lip augmentation, but implants do come with risks and, therefore, are not ideal for everyone.  Other ways to permanently enhance the lips would be through fat injections though frequently you will need two separate sessions to give an adequate amount of volume without creating lumpiness or irregularities.  Other ways to create permanent lip enhancement would include silicone injection though I would highly recommend that you avoid this treatment since it is not FDA approved for facial augmentation and should a complication arise it can be very difficult to rectify.  Overall, at the time of this blog I really like the hyaluronic acid fillers for lip augmentation since they can be highly customized to create the lip that we desire.  They are incredibly safe.  They are easily reversible if necessary and they will last six to nine months. 

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Question: If I have injectable fillers in my midface and cheek area, how long should I wait before I can safely have a midface lift?

Answer: You really do not have to wait to have a midface lift after having fillers placed in your midface, but obviously if you have gotten a nice result from your fillers, you might want to enjoy them and then get the midface lift once they have resorbed.  If the timing is good for a midface lift surgery and the fillers are unnecessary after the surgery then hopefully you have had hyaluronic acid fillers placed in your midface and your surgeon can simply place a small amount of hyaluronidase in the area a few days before surgery to literally make the filler completely disappear prior to the surgical procedure.  Ultimately, I feel this is a rather individualized and customized approach, and I would just discuss your concerns with your surgeon.

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Question: How do you avoid “pillow face” with injectable fillers?

Answer: The answer to that question is simply do not overuse the fillers and place them in an appropriate location. This, unfortunately, comes with experience and expertise as well as artistry and that is why I always recommend that patients seek out a very experienced injector to make sure that they get the result that they want since filler placed in too low of a location on the cheek can sometimes give patients an overly full appearance while that same amount of filler placed up higher in the cheek can frequently give people a more aesthetically pleasing result. With that said, there are patients who have very strong cheekbones and if the filler is placed too high then they actually look strange and if it is placed lower in the face, this balances out their full cheekbones and gives them a more youthful appearance. I know that sounds a bit confusing but, ultimately, there is a significant amount of artistry involved with facial fillers and that is really why a very experienced injector is necessary to give patients the appearance that they desire.

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Question: I am a lifetime smoker planning to get fat injections into my smile lines. Will my habitual smoking affect the longevity of my fat injections?

Answer: I have personally not seen any good studies at this stage showing any decreased viability of injected fat into smokers versus nonsmokers, so I am not sure I can scientifically answer that question but, for the most part, I do not feel that smile lines are very successfully treated with fat grafting at least not in the long term. I usually steer my patients toward an injectable filler material such as hyaluronic acid for a temporary, but very significant, improvement in these lines.

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