Most of us want an attractive smile, and this includes attractive lips. Some lips are full while others are thin and underdeveloped, often due to heredity. As we age, lips become smaller and thinner.Lips are usually larger or fuller in certain ethnic peoples, and fuller in one’s youth compared to one’s latter years. Lips have a certain proportion between the upper lip and the lower lip, and project out beyond the mouth several millimeters. There are often 3 small mounds (tubercles) of the lip, with 2 on the upper and one in the central lower lip, giving a nice 3 dimensional fullness.While there are many procedures designed to improve lips, none are perfect and few are permanent. Nevertheless, at Chatham Facial Plastic Surgery we do have several options, which include injectable fillers along the lip border such as Restylane or Juvederm. Surgery designed to improve the position of the border of the pink lip itself, and implant materials, both synthetic and tissue derived, to increase the size of the lip itself is also an option. Reducing the vertical wrinkles of the skin around the lip by resurfacing methods such as with deeper chemical peels, dermabrasion or some lasers can also enhance lips. Healing can vary from hours (injectables) to two weeks (implant).When filling the lip borders, another benefit for women is the ease with which lipstick better performs. Lipstick will define the border better with a small elevation and less readily “bleed” into small wrinkles.Even with very very thin lips that have shrunk, we usually can use one of the fillers to help create a small appearance of lip, and this really enhances the mouth region and may allow the use of lipstick for the first time in a long time.Surgical lip augmentation is performed under local anesthesia on an outpatient basis. Afterwards, expect some obvious swelling for several days, and usually about a week later, one expects to be able to go out in public. As with any implant, there are pros and cons of these. Few of our patients really want huge or giant lips, befitting a showgirl. Most want increased definition and fullness, but still within a natural size and shape. If lips are over-injected, then an unattractive duck-lip or fish-lip appearance can occur, and that is not attractive! Augmentation and enhancement of lips with fillers requires careful application in an artistic manner, without rushing or other distractions. The more experience a physician has, the better the results become.One decision each patient must make is whom do you trust your lips to? Do you want an experienced physician with an eye for artistry? Are you comfortable with any physician doing this? Do you prefer for a nurse or someone else whom the physician delegates to do your injection? Remember, once the filler is in, it cannot be removed except with slow degradation over a period of several months.Note that there are several other fillers, and we use Radiesse and Perlane, for example for other applications. Some other fillers may sometimes be used by other practitioners, but most of these have some significant downside, and we do not recommend them for use in lips.