Lip Contouring

Lip augmentation commonly uses a hyaluronic acid filler to add volume, define the border, correct asymmetry or support tissue hydration.

Hyaluronic acid occurs naturally in the body, and the gel used for the lips is chosen to be supple and to follow movement when speaking, smiling and changing expression. Treatment may target the border only, volume only or both, depending on the goal. At Detalii Med in Baia Mare, the procedure is carried out by the plastic surgeons Dr Marius Pruna and Dr Valeria Pruna.

It suits adults seeking a proportionate, temporary change after assessment of the lips and the wider perioral region. For example:

• people with naturally thin lips or lips that have lost volume with age;
• people with mild asymmetry between the two halves of the lip or between the upper and lower lip;
• people with a less defined border or fine vertical lines above the lip.

Treatment is postponed during pregnancy and breastfeeding, or when there is an active cold sore or another local infection, and is assessed carefully in people with autoimmune conditions or known allergies.

It can increase volume and define shape but cannot reproduce another person’s lips exactly or correct every dental or structural concern in the area.

The result is limited by each patient’s anatomy: tissue thickness, the shape of the Cupid’s bow, the position of the teeth and the relationship with the nose and chin. More product does not mean a better result, and overcorrection can look unnatural. Where the issue relates to the bite or bone structure, the doctor may recommend assessment by another specialist.

Consultation establishes the goal, history of cold sores, previous treatments, asymmetry and a conservative product volume.

The doctor assesses the lips at rest and in motion, the proportion between the upper and lower lip and harmony with the rest of the face. Reference photos brought by the patient are discussed, with an explanation of what is realistic for their anatomy. For patients with recurrent cold sores, the doctor may recommend preventive treatment before the procedure. Medicines or supplements that may make bruising more likely are also checked.

Filler is injected progressively at selected points and planes. Balance between the upper lip, lower lip and the rest of the face guides treatment.

After the area is disinfected and anaesthetic cream applied, the doctor injects small amounts with a fine needle or cannula, checking symmetry along the way. At the end, the area may be gently moulded. A session usually takes about 30–45 minutes, including the time for the cream to work. At a first treatment a moderate amount is preferred, with the option of a later top-up.

Topical anaesthetic is commonly used, and many fillers also contain local anaesthetic.

The lips are a sensitive area, so the pricking or pressure sensation may be more noticeable than elsewhere on the face. General anaesthesia is not needed; in some cases the doctor may decide on additional local anaesthesia.

Swelling may be noticeable during the first days, with tenderness or bruising. Shape should not be judged definitively while the lips remain swollen.

Swelling is usually most pronounced during the first 24–72 hours, especially in the morning, and then gradually subsides. Gently applied cold compresses are generally advised, along with avoiding strenuous exercise, saunas, alcohol and pressure on the lips for the first few days. Lipstick and make-up are resumed as advised by the doctor. Routine activities can usually be resumed the same day.

Possible complications include asymmetry, nodules, infection, cold-sore reactivation and, rarely, vascular occlusion. Unusual signs require immediate medical contact.

Bruising and swelling are common and temporary. Less often, small palpable lumps, migration of product beyond the border or delayed inflammatory reactions may occur. Vascular occlusion, meaning blockage of a blood vessel, is rare but needs prompt treatment: severe pain, paleness, bluish discolouration or a mottled appearance of the skin are reasons to contact the doctor immediately. If needed, hyaluronic acid can be dissolved with a specific enzyme administered by the doctor.

Volume settles after swelling decreases. The effect is temporary and longevity varies with the product and metabolism.

The final shape is usually assessed after about two weeks, when a follow-up and, if needed, a top-up can be carried out. As a guide, the effect in the lips lasts from a few months to around a year, as the lips are a mobile area where the product is absorbed more quickly than in other regions. Maintenance sessions are planned individually.

Lip contouring with hyaluronic acid allows a change in volume and shape without surgery, with a temporary effect. A harmonious result depends on proportion, a cautious amount of product and patience until the swelling settles. At Detalii Med in Baia Mare, the plan is agreed at consultation with the plastic surgeon.