Pucker Up – A Pert Pout Without The Trout

Posted: Wednesday 16 June 2010 09:42am

First the good news …
A recent scientific study found that women will full, tender lips will look younger than their thinner-lipped peers, even if their faces are otherwise wrinkled, have sags, bags or dark circles.
David Gunn, a Unilever scientist, worked with researchers from seven universities to analyse 102 pairs of white Dutch female twins (aged 59-81) and 162 British white women (aged 45-75). Their conclusion: women with fuller lips seemed younger than their chronological age.

Now the bad news …
How your lips age is genetically pre-determined (although sun damage and counter-productive habits like smoking won’t help). You can look after your skin all you like, but if your DNA has pre-determined it, your lips will “deflate” as you get older, losing definition and fullness. The mouth corners may also droop and the lines between the nose and mouth and those from the mouth to the chin deepen, often causing the face to appear aged, well beyond its years.

Nowadays, of course, it’s not all bad news …

Creating a younger-looking mouth is simple, with an array of safe and effective options available for any age group and budget, be it enhancing lip volume, erasing smoker’s lines or correcting a downturned smile. Here are five options:

1. NON-SURGICAL LIP AUGMENTATION
Adding Volume: This is easily achieved with injectable dermal fillers. “The injection is done to the pulp of the lip,” says Sydney cosmetic surgeon, Dr Anoop Rastogi. “The top lip usually needs more enhancing than the bottom, but we may create a little roll over on the bottom lip by injecting the Vermillion Border, causing it to pout more.”

Defining the Vermilion Border: Fillers are injected to add definition to a softened lip border. This also helps to stop lipstick bleeding, which tends to occurs with the onset of smoker’s lines. “We add a filler to enhance the lip border and the Cupid’s bow,” says Dr Rastogi. “It can give a result that is the equivalent of using lip liner. At the same time we may add subtle volume.”

Highlighting Cupid’s bow: As we age the peak above the top lip becomes less defined and may take on a slackened appearance. Enhancing it with filler restores a youthful appearance. “We simply augment the peak and it immediately creates a younger looking appearance. Typically we team this with defining the Vermillion Border.”

Pain/Downtime: Local anaesthetic is administered in all three procedures, dulling any pain. Expect slight swelling for 24 hours

Cost: All procedures can be performed alone, although tend to be done at once, depending on the patient’s needs. The cost is upwards of between $600 and $800, depending on the administering practitioner and the amount of filler used.

Semi-permanent hydration: Plump lips are also usually moist lips, which look lush and tempting. Lips can be injected with micro-droplets of hyaluronic acid (eg. Restalyne Vital Light) , which attracts and retains moisture on a semi-permanent basis.

2. FILLING OUT LINES
Softening Naso-Labial Folds: These lines run from the corners of the nose to the corners of the mouth. With age, they tend to furrow due to the gravitational effect that causes the cheeks to drop towards the mouth. “We simply inject filler suited to the depth of the groove, into the lines to fill out furrows,” says Dr Rastogi.

Softening Marionette Lines: These are the grooves that run from the corners of the mouth down towards the chin. With age, they can deepen and give the face a sullen, down-turned appearance. “We treat these using a layered filler technique,” says Dr Rastogi. “We use sturdier filler deep within the furrow to correct the groove, then finer filler superficially to erase the appearance of the crease on the skin. In addition we can inject Botox to rebalance muscles so that the smile muscles are better able to lift the corner of the mouth and oppose gravity.”

Pain/Downtime: Local anaesthetic dulls pain.  With both procedures, there may be minimal redness and swelling, which subsides within 24 hours. Any bruising will subside within a few days.

Cost: Upwards of $600 to $800, depending on the practitioner and the amount of filler used.

Permanent Fillers: Aquamid is long-lasting dermal filler composed of 97.5% water and 2.5% polyacrylamide gel. It is injected in a clear gel in a sterile environment and it doesn’t break down in the body. Many surgeons use it to enhance the volume of the mouth on a permanent basis.

“I always try temporary fillers first,” explains Ear, Nose, Throat and facial Cosmetic Surgeon Dr William Mooney from Bondi Junction and Prince of Wales Hospitals in Sydney. “We want to make sure patients are happy and once they are we proceed with Aquamid. The benefit is that Aquamid is permanent, whereas temporary fillers tend to dissipate faster in the lips, more so than anywhere else. This is because of the constant movement of the lips on a day to day basis coupled with the high blood supply and elasticity of the mouth. Patients also report Aquamid feels better for kissing!”

“The disadvantage is that is costs a little more, it requires a dental block, and because it is permanent, you need to be very careful to avoid infection, which means a course of antibiotics after treatment.”

Pain/Downtime: Local anaesthetic dulls any pain. There may be some bruising and swelling, which usually subsides after a few days. Most patients can return to work the day after treatment, however many wish to take an extra day to recover.

Cost: Approximately $1500.

Smoker’s Lines: Whether a smoker or not, anyone over 30 is vulnerable to fine lines leading up from the lip border up towards the nose (smokers will undoubtedly experience them earlier). Injecting dermal fillers into the Vermilion border (see above), can soften these lines, however great results are being noted from Fraxel re:pair laser treatments.

Where previous laser treatments were ablative and required weeks of downtime, Fraxel re:pair laser treatments work by directing a high-energy beam of laser light specifically to trouble zones only, smoothing lines and stimulating collagen formation, which means results continue to improve over time. Because Fraxel re:pair laser leaves small bridges of skin untouched, it enables more efficient healing and means less down time.

“Usually two treatments are required over a two week period,” explains Sydney laser cosmetic surgeon Dr Jack Ting. “After ninety days we notice a smoother, less lined result, however, because patients like to see a fuller, smoother mouth instantly, we often team this with the use of dermal fillers.”

Botox or Dysport can also be used to help eliminate these lines. “Injecting the tiniest amount to the sides of the Vermillion Border causes the lip to evert, resulting in more of a pout, which helps to soften the lines” says Dr Rastogi.

Cost: Approximately $750 per Fraxel Laser Treatment, with two treatments required (includes other areas of the face such as crow’s feet or pigmentation). Fillers and Botox will add to the cost; however the amounts used will determine the additional spend.

Avoiding Trout Pout
“Trout pout is commonly caused by too much bulk to the Vermilion border,” says Dr Rastogi. “It causes it to turn out too much and create a shell out of the lip margins. The situation is made worse by adding volume behind the wet-dry margin of the lips, so when people smile the lips bounce off teeth and it becomes more pronounced.”

The golden rule is less is more. It is important to choose your surgeon or injector carefully. Ask to see as many before and after images as you can and talk to friends who have had procedures they have been happy with.

“The era of the ‘trout pout’ is definitely waning as cosmetic practitioners and patients alike recognise that bigger is not necessarily better in the lip area,” adds Dr Cath Porter, of Sydney’s Heber Davis clinic. “The trout pout is secondary to overfilling or disproportionate filling of the lips which results in an unnatural ‘done’ look. Ideally lip augmentation should complement the overall appearance of the face, be age appropriate and, above all, not be detectable.”

Don’t like the results?
Non-surgical procedures using temporary fillers are frequently favoured around the mouth, as there are fewer margins for error. However, if the patient is not happy with the result, there are simple techniques that can be administered to quickly fix the problem.

“Most fillers are comprised of hyaluronic acid in a similar composition of the skin’s naturally occurring hyaluronic acid,” explains Dr Rastogi. “If a patient is unhappy, we can inject Hylase, which is a medicated formula based on the naturally occurring substance in the body responsible for breaking down hyaluronic acid. It dissolves the filler and within twenty-four hours lips return to normal.”

3. DON’T BE DOWN IN THE MOUTH
The Cameron Diaz Smile: Muscle relaxants such as Botox or Dysport can be cleverly injected to create a beautifully upturned mouth. “There is a muscle called the Depressor Angularous Oris, which responsible for keeping the mouth downturned,” explains Dr Rastogi. “We inject this so it relaxes. The muscles responsible for smiling are then better able to lift the corner of the mouth when it is at rest, producing what we call the “Cameron Diaz” smile. Even when static, the corners of the mouth are slightly upturned, creating a happy, soft expression at all times.

Pain/Downtime: There is little pain, aside that of the injection. There is no downtime.

Cost: Upwards of $400, depending on the practitioner and the amount of filler used.

4. SURGICAL SOLUTIONS
The Lip Lift: Fillers aside, a new procedure called the Lip Lift, from $4500, provides permanent definition to lips. “We raise the margin of the lip,” explains Sydney plastic and cosmetic surgeon Dr Mark Kohout. “This makes the red part of the lip more prominent. We can also change the shape of the lip, making the Cupid’s bow more prominent, or increase the show of the outer lip.” It’s performed under local anaesthetic, with two week’s down time.

Fatty Fillers: Under local anaesthetic or twilight sedation in the doctor’s rooms, fat is removed from the abdomen, put into a purifying device to remove impurities and then injected into localised areas such as lips. “Expect to pay around $3500. Results are permanent results,” says Dr Kohout. “This has the advantage of using only your own tissue and is therefore safer in terms of exposure to infection.” Expect mild swelling after the procedure, which subsides within one week of treatment.

5. FAKE IT WITH MAKE UP
Clever make-up techniques can help create a youthful-looking, beautiful mouth too. Here’s some expert advice.

• Small lips will look fuller if you embrace lip liner, says New York make up artist Troy Surratt.   “Choose a shade close to your natural lip colour – it allows you to create symmetry and balance between upper and lower lips. Colour your entire lip with the liner to create the illusion that lips are fuller then apply lipstick. Finally, dab a bit of gloss to the centre of the lip – straight down from the Cupid’s bow. It creates a highlight and makes lips look fuller and poutier.”

•  “Lips require constant re-hydration,” says International make-up artist Elsa Morgan. “The wind, sun, saliva, spicy foods and alcohol can all zap moisture from your lips. Use a product with moisture benefits as well as anti-oxidant vitamins and sun protection.”  Try: Dr Spiller Aloe Vera Lip Balm, SPF15, $15.70; Nivea Sun SPF30, $3.98.

• Avoid brown lipsticks. “They age skin and make teeth appear yellow,” says make up artist Angie Barton. “They have a yellow base, so highlight any discoloUration on the teeth and skin.”  Barton suggests cool pink- or blue-based shades. “They create a beautiful contrast, counteracting yellowing on the teeth and instantly brightening the complexion.”

• Lips are vulnerable in winter. “Repair takes longer,” explains beauty therapist Liza Curwen-Begg founder of Skinlab in South Yarra, Melbourne. “If you chap or chafe them, it can create an ulceration that might be problematic all season.” Apply a super-hydrating lip balm frequently.  Try: The Original Lanolips Lip Ointment with Colour SPF15, $13.95.

• Plump up the volume with stimulating lip balms and colours, which employ ingredients such as cinnamon or capsicum oil to trigger a temporary plumping effect, or Maxi-Lip, which is made from collagen and sits under the epidermis, trapping moisture and improving the fullness of the lip. Try: Too Faced Lip Injection Extreme, $51.95; DuWop Lip Venom 2nd Sin, $50; Sally Hansen Lip Inflation Plumping Treatment, $15.45; Benefit Lip Plump, $39.

by Shonagh Walker

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