Dr. Sam Lam Plastic Surgery Forum

very interesting procedure. however, i have two major objections with this method (not to say that it is bad):
1. going into the nose WILL cause distortion at the nasal base. look carefully at all the noses in the before and after images. there is distortion, some less, some more, some way more than I would like to see. That makes sense because any weight on the nose from cutting to move the lip could or would pull it down. That is more risk than I am willing to take on a person. This is a technique that I would wait 2 to 3 years to see if it is still around. Like I started doing the surgiwire a year and a half ago to manage lines and folds. I stopped 3 months later. I got no results. My colleagues who combined it with fat grafting got disasters. There is a good saying in the field of cosmetic surgery, "Don't be the first one on the block doing something and don't be the last."
2. as you know, i do not believe in putting solid materials in the lower lip. i think natural tissues are better but i am too concerned that a solid piece of muscle will feel hard or create a lump that is very difficult to fix.
in all deference to the authors, those are my personal concerns. whether they hold merit or not, that may be another issue. but i have no plans incorporating this technique into my practice any time soon. i appreciate the article.
best,
sml

I recommend not doing one. For the most part, they can look fake because a bigger upper lip is one of the cardinal sins committed by plastic surgeons. a larger reason for that is that they are listening to what patients want. except for estella warren, adriana lima, and angelina jolie who probably have naturally large upper lips, most people have relatively small ones, especially when they smile. Google images of Nicole Kidman. You will see she has the illusion of a very full lip despite a tiny upper one. That is the look that I create. It is opposite of what most women want. But what they want is a mistake. You have to have a sense of artistry and balance. Another thing that I would like to point out, a woman came in 2 weeks ago and said, "When I smile, my upper lip goes away. Can you fix that?" THE ANSWER IS NO!!! That is what makes an upper lip look fake. It should disappear during a smile. If it doesn't, then you have a duck. The bottom lip is the one that should be augmented. I know I run counter to most people's wishes. However, if you come to see me, I have to exercise some degree of artistic control because I do not want you to walk around with ugly lips. I am very passionate about what I do. I like to minimize risk, maximize gain, and exercise artistic discretion in all facial work. I rarely give a patient carte blanche. That is not arrogance but really a fiduciary responsibility to do what is right and beautiful. Of course, if what you want won't hurt you, I will work with you to get what you want. Watch my vlog on making safe and effective plastic surgery decisions. Okay, this is getting too long. I'll get off my soapbox.
best,
sml