Can thinner lips be a little larger and still look natural? What about Volbella?

Dr. Irwin
May 31, 2017
I searched "Volbella" on your website and got only a simple statement (from 2013) that it is not available in the US. There's a well-regarded doctor in Boston (where I used to live) who repaired my ear lobes and his website says that he is using Volbella for mouth wrinkles and lip volume. Are you not? If not, can I ask why (not)? I know nothing about it but am 59 (and 11 months) and do have some wrinkles around my mouth but my interest is more that the website says the product (or maybe the product as used by this particular doctor) will give "structure" and "slight" volume to thin lips that are a natural result of aging OR just always having thin lips. I'm in both categories. No one in my immediate family has ever had anything close to full lips. And no one has gotten a procedure-more out of concern that it will change our "appearance" or maybe a better word is that we'd look different to ourselves. But my naturally thin lips have gotten thinner due to aging and they also angle down at the ends so I tend to look unhappy. Is Volbella (if available in the US) uniquely "better" for someone (me) who just wants a very slight amount to 1) make my upper lips symmetrical (one side is thinner than the other) 2) add a very slight amount of volume that will not "change" how I look but maybe just give me a normal shape and volume that near 60-year-old women have? Or is it a "technique" that any (or at least another) filler can achieve? Also, is it an unusual request to ask to "ease" into lip "work"? My sister went to a doctor in NYC 10 years ago to ask (and said that she had no problem with paying for a full syringe but having him use only some of it). She said he told her that it was the first time anyone had made that request and also, he told her that he would absolutely bet that she would return in a week and ask for more. So she walked. So 2 questions-about Volbella and also how one finds a doctor who "gets" that I don't want large lips and how I explain this to a doctor. Thank you

Thank you for pointing out that I haven’t written about this for awhile.

On Volbella, everyone, including the marketing teams helping them, was very excited when Volbella was FDA approved here. It is in the Juvederm family (Allergan) and part of their “vycross” technology. What does vycross mean? It’s a marketing term (lay term) to describe a patented way of crosslinking the hyaluronic acid (HA) molecules present in all the HA gel fillers. It’s supposed to be less hydrophilic (water attracting) and to last longer (debatable).

We are not using Volbella in lips in our office due to the fairly high incidence (about 20-30%) of sometimes extreme and unpleasant (for the patient) swelling/poofiness that can occur. Most of our patients are requesting a very natural and not noticeable look. The swelling usually goes down in 2-4 days, but is very annoying if it happens. We use Juvederm Ultra or Juvederm Ulta Plus for this reason. These are not vycross technology.

IDEAS FOR COMMUNICATING ABOUT LIPS TO YOUR DERMATOLOGIST

  • In our experience, most patients want to go slowly and have a natural look. It’s great that you plan to explain this to your dermatologist
  • Since these come in full syringes mostly, ask your doctor to use very little in your lips and put the rest of the syringe somewhere else. There are always lots of good options for this in anyone over 40. That way you can see if you have any problems with the product used (unlikely) and get a sense for how it feels and also your doctor’s aesthetic eye (very important)!
  • Options for other spots are the nasolabial fold, the mesolabial fold, a little lift at the top of the cheekbones, the chin area, backs of the hands…….etc.
  • Technique is important and there are almost as many approaches as there are dermatologists. Only partially joking here. Ideally, you have friends who look great and might be honest with you about who they see. We often steriley transfer increments of about 0.2 cc from the large syringes to tiny (tuberculin) syringes so allow for tiny amounts to be used for a more natural look.  But …..other very small needles will work also.
  • The french (always fun and interesting) have a way of discussing this at conferences. They call it dehydration des levres. It means dehyration of the lips and they work to just make the lips look more hydrated without changing the natural shape. It works!
  • It’s fine to decline and go elsewhere if you’re not comfortable with the doctor’s approach!

Hope this helps, Dr. I

Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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