Lip Service : Plastic Surgery Is Making Mouths That Are Fashionably Full a Possibility for All

CALL IT THE year of the fat lip. Flip through any fashion magazine and note the predominance of voluptuous pouts. Cover girls, once famous for their thin-lipped, piano-key smiles, now color their bee-stung, Kim Basinger-like lips in shades that emphasize, not minimize, their size.

Now cosmetic surgeons are finding ways to augment thin lips to fashionable fullness. Doctors create dramatic mouths with collagen injections, which are often performed under local anesthesia, usually Xylocaine. The pain factor, some doctors say, is comparable to that of minor dental work. Or surgeons may use liposuction techniques to build up the lips with transplanted fat, which can be taken from any part of the body but typically comes from the thighs, buttocks or stomach. This operation can be done under general or local anesthesia. Such procedures may cost $500 to $1,500, but the fullness--even that created with body fat--will probably be temporary.

Dr. Lawrence Koplin, a Beverly Hills plastic surgeon, uses both the collagen-injection and the fat-transplant techniques, depending on the needs of the patient. Collagen injections, he says, rarely last more than three months. “For actresses who are reshaping their mouths for a particular role, collagen is perfect,” he says. “In a few months their lips are back to normal size.”

Collagen was the choice of actress Barbara Hershey when she opted for fuller lips to play the role of Hillary Whitney in the film “Beaches.” By the time the movie was released and her plumped lips were being described in magazines and newspapers across the country, Hershey’s body had absorbed the collagen, returning her mouth to its natural proportions.

For patients who want longer-lasting results, Koplin says, fat transplants are preferable to collagen injections. “From 20% to 50% of the injected fat cells survive and are not absorbed by the body, so you eventually have a 20% to 50% improvement,” he says. “If you want more fullness, the procedure can be repeated.”

However, Dr. Timothy Miller, professor of plastic surgery at UCLA School of Medicine, maintains that fat transplants do not last significantly longer than collagen injections. “I haven’t yet seen conclusive proof that fat transplants last longer than six months tops,” Miller says. But, he adds, “fat transplants do not seem to do any harm.”

Though lip augmentations are becoming very popular, many surgeons won’t perform them, citing unpredictability and temporary results. Dr. John Williams, a Los Angeles plastic surgeon, had performed several lip augmentations, but he recently stopped.

“It’s very difficult to control where the fat is going in the lips, so you can end up with irregularities of shape,” Williams says. He adds that, occasionally, a patient’s lips may feel too firm, or they can experience a temporary numbness. But, he says, the lips’ natural sensitivity is usually not diminished.

Koplin adds that for about two weeks after surgery, his patients “have to go into hiding; the lips are so full that they look a bit scary at first. After the excess is absorbed, the results are pleasing.”