Cheiloplasty

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A cheiloplasty (also: lip plasty ) is a plastic-surgical change or reconstruction of the lips . It is often performed as a cosmetic operation. A medical indication for lip plastic surgery as an intervention (cleft operation) to close lip defects ("harelip") is present, for example, in cleft lip and palate .

This article only deals with the aesthetic-surgical modification of the lips. A distinction is made between lip lifting, the upholstery, in which a filling material enlarges the lips, and the reduction of the lip. Most lip corrections can be done on an outpatient basis. They take half an hour to an hour. Most of the time, those treated are given a local anesthetic. General anesthesia is usually not necessary. After the treatment, the lips swell and temporarily pain, bruising may occur. Talking and chewing should be avoided if possible for two days. Feelings of numbness can persist for a longer period of time, especially during major surgery.

Lip lift

With a lip lift, the age-related lengthening of the lip line, the flattening of the lip contour, the drop in the smile lines and the formation of wrinkles are corrected. With a direct lip lift, the ideal contour is drawn and then the skin in between is removed. At the border between lip red and lip white, the underlying tissue is undermined by one to two millimeters and pulled up over the resulting gap. Then the edges of the skin are sutured in several layers to keep the scar as small as possible. In indirect lip lifts, a 3 to 6 mm wide piece of skin under the nose is removed and the edges of the wound sutured, which lifts the upper lip.

Padding

The second option is to plump up the lips. Various substances can be used for this: the body's own tissue, biological substances and plastics. What these methods have in common is that the padding material is introduced through small cuts in the red lip or with a syringe. However , no matter what type of treatment is used to plump the lips, there is always the risk of infection .

All biological fillers have in common that they are broken down by the body sooner or later. However, this has the advantage that these preparations do not have any long-term consequences.

Autologous fat padding

The advantage of autologous fat treatment is that it does without foreign material and thus does not trigger any foreign body reactions. However, the fat must first be obtained elsewhere. The fat obtained is injected into the lip tissue in many small tunnels with a diameter of 1 to 2 mm. Since the body absorbs up to 30% of the administered fat in the first few weeks after the operation, an overcorrection must be made during the operation. In any case, several paddings are necessary in order to achieve a long-term stable result. The failures often associated with outdated bolus injections, such as oil cysts, inflammation and calcifications, are no longer to be expected with the newer techniques.

Padding with collagen and hyaluronic acid

Similar to autologous fat, lip tissue can be filled with preparations based on collagen or hyaluronic acid . Hyaluronic acid can cause severe swelling after administration, which is why the injection should be a little below the red line of the lips. The padding with hyaluronic acid is currently the most commonly used method.

Plastic upholstery

An alternative to lip augmentation are plastics . For example, liquid silicone can be injected in the form of tiny droplets along the red line of the lips. About two to three sessions are necessary for this. Small hemorrhages are common; granulomas develop in around 2% of cases, but these can be removed surgically or with cortisone injections. The injection of polymethyl methacrylate beads enables permanent lip padding. Complications occur in the form of nodules in about 7% of patients, and very rarely permanent pain.

reduction

In the case of lip reduction, which is performed much less often, the lip that is perceived as too large, usually the lower lip, is narrowed by a mostly outpatient procedure. This involves making an incision on the inside of the lip. A spindle-shaped piece of mucous membrane with connective tissue is removed. In addition, wedge-shaped pieces of connective tissue can be removed to enhance the effect in the corner of the mouth. This type of lip reduction usually leaves no visible scars. Only in exceptional cases, such as with pathologically thickened lips, e.g. B. in Down syndrome , a wedge-shaped removal of part of the center of the lower lip in the midline, since a visible scar remains. As with other cheiloplasty procedures, massive swelling is to be expected.

Alternatives

There are alternatives to "real" cosmetic surgery. In addition to make-up techniques that make the lips appear fuller, there is also the option of optical enlargement with a tattoo . Applying this permanent make-up is painful. It fades after about 2 years and then needs to be renewed. The dyes can cause allergic reactions or skin inflammation , rarely granulomas .

Individual evidence

  1. ↑ Cheiloplastik In: Duden - The Foreign Dictionary , 9th Edition, Bibliographisches Institut & FA Brockhaus AG, Mannheim 2007 Online
  2. ↑ Cheiloplasty In: WAHRIG.digital - German Dictionary , Wissen Media Verlag GmbH, Gütersloh / Munich 2002-2005
  3. ↑ Christoph Weißer: lip plastic. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 857.
  4. ^ Johannes F. Hönig: Aesthetic surgery . Springer, Berlin 2013, ISBN 9783642577277 , pp. 106-108.
  5. ^ Johannes F. Hönig: Aesthetic surgery . Springer, Berlin 2013, ISBN 9783642577277 , p. 108.
  6. ↑ Murad Alam, Jeffrey S. Dover: Non-Surgical Skin Tightening and Lifting . Elsevier Health Sciences, 2008, ISBN 9781416059608 , pp. 99-100.
  7. ↑ GN Mannino, SR Lipner: Current concepts in lip augmentation. In: Cutis. Volume 98, Number 5, November 2016, pp. 325-329, PMID 28040807 (review).
  8. ↑ JE Fulton, S. Porumb, JC Caruso, PK Shitabata: Lip augmentation with liquid silicone. In: Dermatologic Surgery Volume 31, Number 11 Pt 2, November 2005, pp. 1577-1585, PMID 16416641 .
  9. ↑ A. Bagal, R. Dahiya, V. Tsai, PA Adamson: Clinical experience with polymethylmethacrylate microspheres (Artecoll) for soft-tissue augmentation: a retrospective review. In: Archives of facial plastic surgery. Volume 9, number 4, 2007 Jul-Aug, pp. 275-280, doi : 10.1001 / archfaci.9.4.275 , PMID 17638763 .
  10. ↑ Cosmetic Surgery, Ed. Angelika Taschen
  11. ↑ One should pay attention to this with permanent make-up , Die Welt from January 19, 2016