Lip Augmentation




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    Plumping Thin Lips with Fillers and Beyond.

    We all love beautiful lips. Gorgeous looking lips have great proportion, volume and shape. Many patients are interested in improving or rejuvenating their lips, and we can help them by offering different treatment options tailored for specific needs. The final goal is a beautiful and natural-looking result, not simply large or overdone lips.

    What is a Lip Augmentation with Dermal Fillers?

    Dermal fillers are ideal solution for increasing lip volume, reshaping the lip edges and improving fine lip wrinkles. Fillers also can change the lip shape in different ways, such as enhancing the natural shape, or creating new shape and lip projection. Filler injections are non-surgical procedures done in a few minutes in the office with topical anesthesia and little downtime. Hyaluronic acid fillers (Restylane, Juvederm) are the most common used fillers for lip augmentation. They are absorbable and reversible, and can be repeated as needed. Most lip fillers last for 6-12 months.

    What is a Lip Augmentation with Fat Transfer?

    Lip augmentation may be also performed by using the patient’s own fat, a process called fat transfer or fat grafting. We will remove a small amount of your own fat using a very fine cannula, and then the fat is prepared and injected into your lips as a “natural” filler to create fuller and plumper lips. Fat transfer requires local anesthesia and a little more downtime, since there is a little more swelling and bruising than with dermal filler injections. Fat transfer has a permanent result for most people.

    What is the Main Difference between Lip Injections with a Lip Lift ?

    A lip lift is a procedure performed on people who have a longer and flat upper lip. As we age, the upper lip tends to get longer and flatter, with less projection and less vermillion show. Injecting fillers into long and flat lips can create the “duck lips” appearance and an overdone look. A lip lift can improve not only the upper lip shape but also the overall facial aging by revealing more of the upper lip, increasing upper teeth show when smiling and balancing the lower face proportions. The procedure can be done under local anesthesia and involves a small cut under the base of the nose. The cut is hidden in natural creases beneath the nostrils, leaving no obvious scarring.

    Can Perioral Peels Improve my Lips?

    Medium and deep peels are great options to improve “lipstick lines” or “smoker’s lips” by smoothing the skin in the perioral area, resurfacing several layers of skin and stimulating collagen production. It results in a permanent improvement of skin texture and lessening of deep lip lines.

    If you are interested in plumping your lips, in improving the lip shape, or even in having a mild improvement of the lip contouring and fine lines, come see us for a consultation and it will be a pleasure to evaluate you and define the best treatment for your goals.

    GABRIELE C. MIOTTO MD, MEd., is a Brazillian-American plastic surgeon specialized in aesthetic surgery and minimally invasive procedures, specially of the face, eyes, nose, breast and liposuction.

    Atlanta Lip Injections (Lip Augmentation)

    Today, full, pouty-looking lips (aka upper and lower vermilion zones) with a well-defined cupid’s bow are highly sought after facial features. Previously, unless an individual was born with the perfect pout, the only way to attain this facial feature was through surgery. However, thanks to advancements in the cosmetics industry, thinner vermilion zones can be transformed into the perfect pout without surgery. Now, even those born with thinner vermilion zones can easily attain the voluptuous lips they desire. Atlanta plastic surgeon and expert injector Dr. Gabriele C. Miotto uses injections of dermal filler to enhance her patients’ upper and lower vermilion zones. Dr. Miotto strategically places these hyaluronic acid dermal filler lip injections (aka lip fillers or a nonsurgical lip augmentation) to provide each patient with beautiful results. Each patient is unique, for this reason, Dr. Gabriele Miotto takes the time to create each patient a personalized treatment plan. The injection locations and brand of dermal filler Dr. Gabriele Miotto injects depends on the results the patient desires.

    Which Dermal Fillers Does Dr. Miotto Use for Lip Injections in Atlanta?

    The dermal fillers that Dr. Gabriele Miotto uses for upper and lower vermilion zone enhancement consist of hyaluronic acid (HA). The HA fillers Dr. Miotto uses for lip injections at ME Plastic Surgery in Atlanta include, Restylane, Restylane Kysse and Juvéderm Volbella. Dr. Miotto also offers Juvéderm Voluma XC, Radiesse and Sculptra; however, due to the consistency of these three fillers, none is a good option for enhancing the vermilion zone.

    Hyaluronic Acid is a Natural-Occurring Polymer

    Hyaluronic acid is a type of polymer that is naturally found in the body. After the patient receives HA filler injections into his or her vermilion zone, the body gradually absorbs the hyaluronic acid filler. Since HA is a naturally occurring polymer, this absorption process is completely safe.

    How Long Does It Take the Body to Absorb Dermal Fillers?

    The absorption process takes from six months to a year, at which point the patient can return for another set of HA filler injections.

    What Role Does Hyaluronic Acid Play in the Body?

    Although HA is present in all the body tissues of vertebrates, there are high concentrations of this polymer in the skin. Since the role of hyaluronic acid is to retain moisture, with one molecule holding up to 1,000 times its own weight in water, expert injectors use it to create smoother, younger-looking skin and fuller, more voluptuous lips.

    Are the Dermal Fillers Dr. Gabriele Miotto Uses for Lip Injections FDA-Approved?

    Yes. According to the FDA, any adult who is at least 21 is eligible to receive injections of the dermal fillers available at ME Plastic Surgery in Atlanta.

    Why Do People Choose to Have Lip Injections?

    People have Dr. Miotto enhance their vermilion zones with HA dermal fillers so they can attain the characteristics they desire.

    As an expert injector, Dr. Gabriele Miotto can:

    • Add volume.
    • Smooth lines.
    • Reduce the visibility of wrinkles.
    • Enhance the border.
    • Address vermilion zones that are asymmetrical.
    • Define the Cupid’s bow.
    • Address irregularities.
    • Raise the corners of the mouth.

    What Are the Benefits of Having HA Filler Injections into the Vermilion Zone?

    Dr. Miotto uses hyaluronic acid fillers to change the size and shape of an individual’s vermilion zone as well as to redefine the contours of the mouth. Since patients see results directly following their treatment, they decide whether Dr. Miotto adds additional filler or uses the enzyme hyaluronidase to reduce the HA filler.

    Hyaluronidase breaks down the natural-occurring hyaluronic acid in the body. Therefore, when a patient asks Dr. Miotto to remove some of the HA filler, she accomplishes this with hyaluronidase injections. Using this enzyme, Dr. Miotto can remove just some or all of the HA filler.

    Since the body produces hyaluronic acid naturally, it is highly unlikely that a patient will experience a negative reaction (e.g., an allergic reaction) to HA dermal fillers.

    Additional benefits of using HA dermal fillers to improve the appearance of the mouth:

    A More Youthful-Looking Appearance

    One of the main benefits of lip injections is that the patient’s overall appearance improves. The patient appears more youthful because adding volume to the vermilion zone causes the skin around the mouth to tighten, thus reducing the visibility of the fine, vertical lines and wrinkles that frequently develop in the area surrounding the mouth. In addition, having a more youthful appearance typically improves an individual’s self-image, which increases his or her confidence level.

    Minimal Side Effects

    The likelihood of an allergic reaction is extremely small; nonetheless, disclosing existing allergies as well as current medications to Dr. Gabriele Miotto during the initial consultation at ME Plastic Surgery in Atlanta is vital. Having this information before creating the patient’s treatment plan allows Dr. Miotto to choose the hyaluronic acid filler that she believes suits the patient best.

    The Possibility of a Gradual Injection Process

    Sometimes patients with thin lips prefer to have several injection sessions within a short period of time. For these patients, Dr. Miotto performs several injection sessions adding small amounts of filler at each session. By choosing the gradual injection process, patients with an extremely thin vermilion zone can still have the volume they desire, without calling attention to this change.

    Highly Customizable

    HA injections in Atlanta are highly customizable. By allowing the patient to immediately view the changes the filler makes he or she can determine whether to add more HA filler, to keep it as it is or to have Dr. Miotto decrease the amount of filler with hyaluronidase.

    Reasons Hyaluronic Acid Fillers Are Ideal for Creating the Perfect Pout

    Hyaluronic acid is the best material for enhancing the vermilion zones because HA gels are soft and, in the event the patient wants to make changes to the result, they are dissolvable. In addition, these fillers offer patients temporary results, which means, if they want, they can make changes to the way their lips look every six months.

    How Does Dr. Gabriele Miotto Determine Which Brand of Filler to Use?

    Each HA filler has its own characteristics, which is what determines the specific issues a filler can address. The filler Dr. Miotto chooses depends on the patient’s goals. She may choose to use a combination of fillers to add volume, define and contour the lips.

    Hyaluronic acid fillers and their uses:

    • Restylane

      Restylane — this filler adds volume to the vermilion zone (results last approximately six months).

    • Juvéderm Volbella

      Juvéderm Volbella — adds volume and smooths the vertical lines around the mouth (lasts up to a year).

    • Restylane Kysse

      Restylane Kysse — is the newest FDA-approved HA filler. While plumping the vermilion zone, Restylane Kysse also eliminates the vertical lines above the vermilion zone. This filler lasts up to 12 months and contains lidocaine, which eases any discomfort the patient may feel during treatment. Another benefit of Kysse is how nicely it moves with the lips as an individual is speaking, smiling or kissing someone.

    How Does Restylane Kysse Differ From the Other Dermal Fillers for Lip Augmentation?

    When compared to traditional HA fillers, Dr. Miotto can inject less product to receive the same results. Using Restylane Kysse, Dr. Gabriele Miotto gives her patients the pillowy, pouty and plush-looking lips they desire. Traditional HA fillers can create a more structured appearance than Kysse. Restylane Kysse quickly integrates into the vermilion zone allowing the patient to make more natural-looking expressions.

    Do Lip Injections in Atlanta Hurt?

    Today many dermal filler injection syringes already contain lidocaine. As such, Dr. Miotto injects the numbing agent at the same time she injects the filler. Lidocaine is the same numbing agent that dentists use; therefore, individuals who have had a reaction to lidocaine at the dentist’s office need to have dermal filler injections with dermal filler syringes that do not contain lidocaine. Nonetheless, Dr. Miotto may still be able to use a topical anesthetic.

    Since each patient is unique, recovery experiences vary. However, several factors can affect an individual’s comfort level.

    Factors include:

    • Which numbing agent Dr. Miotto uses.
    • The patient’s anxiety level.
    • The patient’s pain tolerance and sensitivity level.
    • His or her expectations.
    • The injector’s technique. The skill of the injector directly affects the results and the pain level a patient experiences, therefore, choosing an expert injector is crucial.
    • Whether the patient is currently menstruating, just finished menstruating or is close to starting her cycle. When women who are menstruating or are about to start menstruating receive dermal filler injections, they tend to be more likely to feel faint or nauseated following treatment. Furthermore, these women seem more sensitive to the injections themselves, therefore, Dr. Miotto advises women against having dermal filler treatments during these times.

    Possible Side Effects Associated After Injections of HA Fillers into the Upper and Lower Vermilion Zones

    Any procedure that breaks the skin can result in the onset of an infection. Therefore, patients must watch for any of the symptoms indicating there may be an infection developing.

    Symptoms of infection include:

    • An increase in inflammation.
    • Pain.
    • Nodule formation.
    • Redness.
    • Bruising.
    • Hypersensitivity.
    • The area may feel warm to the touch.

    Symptoms that Warrant a Call to ME Plastic Surgery

    Mild redness and inflammation are normal following lip injection treatments. However, patients who notice any of the symptoms below need to call Dr. Miotto at (404) 850-5851.

    Patients need to call Dr. Gabriele C. Miotto if:

    • Excessive bruising or inflammation lasts for more than a week.
    • While rare, an allergic reaction to a dermal filler is always possible. Symptoms of an allergic reaction include itching, increased inflammation and redness.

    Cold sores

    During the initial consultation, Dr. Gabriele Miotto asks the patient if he or she is prone to developing herpes simplex virus 1 (HSV-1), otherwise referred to as cold sores. She asks this question because dermal filler injections can cause an outbreak of HSV-1. Patients who have already experienced an outbreak following lip injections need to let Dr. Miotto know during their initial consultation. By discussing this with her ahead of time, Dr. Gabriele C. Miotto can prevent the outbreak by starting the patient on antiviral medication two days before his or her treatment session.

    Vascular Occlusion

    This complication results when an inexperienced injector accidentally injects the filler directly into or around an artery. Once injected, the filler reduces or stops blood flow. Without an adequate amount of blood reaching an area, the tissue and skin begin to die.

    Signs that indicate a patient may have a vascular occlusion include:

    • Severe pain that comes on suddenly.
    • Changes in the color of the skin (e.g., white patches).


    Patients see results immediately after their upper and lower vermilion treatment session in Atlanta. Initially, swelling is present. This inflammation makes the upper and lower vermilion zones look fuller than they actually are. After about four weeks, the filler settles, and the final result becomes evident. The results can last from six months to a year.

    How Frequently Does a Patient Need to Return for Dermal Filler Touch-Ups?

    Expert injector and plastic surgeon Dr. Gabriele C. Miotto usually recommends that patients return for their maintenance HA injections every four to six months. Returning at this point allows her to keep the patient’s vermilion zones looking naturally plump and beautifully contoured. Nonetheless, patients who receive Restylane Kysse injections may not need to return for 12 months.

    An Initial Consultation for Lip Injections in Atlanta

    Dr. Gabriele Miotto wants to give the patient the aesthetic improvements that he or she desires. In order to accomplish this, the patient needs to be able to verbalize these desires. Some patients find it helpful to bring in a photo of someone who has the type of lips that he or she would like.

    To keep inflammation and bruising down, patients should avoid drinking alcohol for at least a week before their upper and lower vermilion zone augmentation, and for a week after.

    Lip Filler Injections Aftercare

    Use Cryotherapy to Reduce Inflammation

    Directly following treatment patients should apply ice to their mouth. Ice reduces swelling, decreases itching and limits bruising. If pain is present, ice reduces this side effect as well. However, to prevent damage to the tissues and skin, be sure to place the ice or ice pack in a cloth before placing it against the skin. Gently hold the ice on the inflamed area for 10-minute intervals. Repeat this treatment every two hours the first day. On days two and three, just use the ice once or twice during the day.

    Patients Can Return to Their Daily, Low-Impact Activities

    Patients should expect to have some inflammation, redness or bruising at the injection sites following their treatment session with Dr. Miotto. These side effects are normal and are usually mild; therefore, patients can return to many of their usual activities following their treatment.

    Eat Well and Stay Hydrated

    Help the body heal by eating well and staying hydrated. Besides drinking water, patients can eat fruits and vegetables with a high water content to stay well hydrated.

    Hydrating fruits include:

    • Watermelon.
    • Cantaloupe.
    • Peaches.

    Hydrating vegetables include:

    • Cucumbers.
    • Lettuce.
    • Zucchini.

    Be sure to avoid foods that contain excess salt (e.g., potato chips, pretzels, french fries). Eating salty foods could cause an increase in inflammation.

    Avoid Excessive Heat

    Patients need to refrain from entering saunas, steam rooms or participating in heated exercise classes for at least 48 hours after their treatment session. Excessive heat can cause the inflammation to become more pronounced.

    Do Not Perform Strenuous Exercises

    Avoid performing strenuous exercises for at least 24 hours, but potentially 48, after having any dermal filler treatment. Elevating blood pressure and increasing the heart rate can promote inflammation and bruising which can potentially make these symptoms worse.
    Performing light activities like walking is fine.
    Do not take medications that thin the blood (e.g., ibuprofen, aspirin, NSAIDs). Doing so can make bruising more prevalent. If a patient needs to take pain medication, non-aspirin (aka Tylenol) is safe to take.

    If Preparing for a Special Event, When Should the Patient Have a Lip Augmentation?

    Individuals who are having vermilion zone enhancement for a special event need to leave themselves enough time to recover; therefore, the patient should schedule his or her HA injections at least three weeks before the event.

    Do Not Use Perfumed Cleansing Products

    Avoid using perfumed and harsh cleansing products on or around the mouth. Instead, try using a gentle cleanser or a sterile alcohol wipe. Keep in mind that the alcohol wipe may cause a stinging sensation.

    Refrain from Applying Makeup to the Lips

    For at least 24 hours following the HA injection procedure, apply nothing to the vermilion zone (e.g., lipstick, ChapStick®). Following this recommendation is essential because there could be a negative reaction between the product and the fillers. Patients who want to wear something on their upper and lower vermilion zones should ask Dr. Miotto for recommendations.

    Sleeping After Injections Into the Vermilion Zone

    While sleeping, patients should keep their head elevated. This helps keep inflammation down. In addition, patients need to avoid sleeping on their face.

    Do Not Drink Alcohol

    Alcohol has blood-thinning effects, which can cause or increase inflammation and bleeding. This increase in inflammation can make bruising worse. Patients need to refrain from drinking alcoholic beverages for at least a week before and a week after their upper and lower vermilion zone enhancement in Atlanta.

    Other blood thinning substances to avoid include:

    • Vitamin E Supplements.
    • Ibuprofen.
    • Paracetamol.
    • St. John’s Wort.
    • Flax Oil.
    • Ginkgo Biloba.
    • Garlic.
    • Cod Liver Oil.
    • Caffeine.

    Avoid Sweating

    Sweating could lead to dehydration; therefore, it must be avoided. HA fillers work by attracting water to the area, which is why dehydration can negatively affect the patient’s results.

    Stop Using Products that Contain Nicotine

    Nicotine negatively affects the body’s ability to heal by causing the blood vessels to contract. Once these vessels begin contracting, the blood flow through the body slows. This slower blood flow increases the amount of time it takes the nourishing, oxygenated blood to reach the injection sites.

    Avoid Cigarette Smoke

    Since smoking increases the likelihood of an individual developing an infection, patients need to refrain from spending time in areas where individuals are smoking. This recommendation needs to be followed for at least a week before and a week after their injections.

    Do Not Fly

    Following HA injections, patients should wait at least a week to fly because the air pressure within the plane can increase inflammation and bruising.

    Stay Away From Hot Drinks and Spicy Foods

    To ensure they do not burn themselves, as long as the lidocaine is still effective, patients need to avoid hot beverages.

    Spicy foods can cause burning or stinging sensations, especially while still in the early stages of healing.

    Once 48 hours have passed patients should be able to eat spicy foods and drink hot beverages without experiencing any negative effects.

    Choose Foods That Are Easy to Eat

    Eat foods that are easy to chew. Avoid foods with high-sugar content as well as refined carbohydrates. These foods can increase inflammation and bruising.

    Do Not Drink Through a Straw

    Drinking through a straw puts additional pressure on the lips, which may cause discomfort. Additionally, inflammation is present directly after the treatment, which could make managing a straw challenging. Ideally, patients should drink water without a straw after their treatment.

    A Lip Augmentation Using Autologous Fat

    Patients who would like long-term results should consider having an upper and lower vermilion zone enhancement using their own harvested fat. After Dr. Miotto uses liposuction to harvest fat from the patient’s body, before strategically injecting it, she purifies the fat.

    The recovery time following a lip augmentation using autologous fat is longer than the recovery following dermal filler injections. The autologous fat recovery time is longer because more inflammation and bruising results. Since some of the fat Dr. Miotto transfers will not survive, she typically transfers more fat than is necessary to provide the patient with the results he or she desires. The fat that does survive remains in that location permanently.

    How Much Does a Lip Augmentation with Dermal Fillers Cost?

    Each patient is unique; therefore, during the initial consultation, Dr. Gabriele Miotto determines how much the patient’s treatment will cost.

    How Much Will Vermilion Zone Enhancement Using Autologous Fat Cost?

    At the initial consultation, patients need to let Dr. Miotto know that they are interested in learning more about using their own fat to contour and increase the size of their vermilion zones.

    The key to attaining the beautifully contoured, voluptuous lips you desire is choosing a highly experienced expert injector and plastic surgeon like Dr. Gabriele C. Miotto to administer the injections. To schedule an initial consultation with Dr. Miotto, click here to contact the office or call (404) 850-5851. ME Plastic Surgery is in Atlanta at 3200 Downwood Circle Northwest, Suite #640.



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