Augmenting the lips with tissue transferred from the superficial musculoaponeurotic system (SMAS) is efficacious and safe, according to a retrospective 26-patient study in the January/February issue of JAMA Facial Plastic Surgery.
The study found that both the superior lip and the inferior lip had statistically significant increases in volume at 3 months, 1 year and 5 years after augmentation.
The investigators evaluated patients who underwent SMAS lip augmentation during a cervical facial rhytidectomy, from 2000 to 2015, at the Rousso Facial Plastic Surgery Clinic in Birmingham Ala.
“Patients were excluded from the study if they did not have adequate photos at 3 months, 1 year and 5-year follow up,” says Daniel Rousso, M.D., founder and medical director of the clinic, who has been using SMAS to augment lips at his practice for over 20 years.
Patients were also excluded if they had any fillers or other procedures performed on their lips.
A total of 26 patients were eventually identified and studied.
“Using a validated lip augmentation grading scale, these patients were graded by independent observers,” Dr. Rousso tells Cosmetic Surgery Times.
NEXT: SMAS Lip Technique
SMAS Lip Technique
The procedure itself is quite simple, according to Dr. Rousso. “A strip of SMAS is excised in the preauricular area during a routine cervical facial rhytidectomy,” he says. “The strip is trimmed to approximately 7 cm x 1 cm in size.”
An intramuscular tunnel is then created from the oral commissures bilaterally in both the upper and lower lip, after which the SMAS is placed into the upper and lower lip tunnels using a tendon passer.
“Care is taken to assure that the SMAS is symmetrically placed within the lips,” Dr. Rousso notes. “The oral commissure incisions are then closed with interrupted sutures of 5-0 gut.”
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Initially, the lips will be larger than the final result. “Patients must accept the fact that the lips will be fuller than expected for approximately 2 weeks,” Dr. Rousso says. “The lips may also stay slightly stiff for approximately 6 weeks after surgery.”
The greatest median increase was in the superior lip at 3 months, while the smallest median increase was in the inferior lip at 5 years.
“SMAS lip augmentation is a safe and permanent technique for improving the aesthetic appearance of the lips,” Dr. Rousso says. “It can easily be performed during a cervical facial rhytidectomy procedure and adds very minimal additional time or expense.”