Composition and features of implants
The peculiarity of the mouth modeling technique is:
- lasting lifelong effect;
- predicting the appearance of the face after surgery is easier than when using injections of your own fat or fillers;
- the structures are easy to remove if necessary;
- tissue sensitivity is preserved;
- During the insertion of the implant, any other plastic surgery procedures can be performed;
- natural look;
- installation of aesthetic equipment lasts no more than 10 minutes.
Different types of implants have their own characteristics. This influences the choice of aesthetic equipment.
Types of implants:
- Natural - made from donor or animal tissues. Autoplasty is possible. The material for augmentation is taken from the patient. Such equipment does not cause allergic reactions or tissue rejection, but over time organic implants dissolve.
- Artificial - silicone or polytetrafluoroethylene. Install once, do not dissolve during the entire service life.
The choice of material for lip augmentation is the prerogative of the patient at the aesthetic surgery clinic.
Indications and contraindications for the procedure
It is believed that the indication for lip augmentation or any other form of lip correction is only the patient’s desire. This is not true.
Similar techniques are used for the following purposes:
- with drooping lower lip;
- tissue deformation, their fusion;
- conditions after removal of tumors in the outer part of the mouth to replenish lost volume;
- asymmetry, size correction;
- age-related changes;
- at the request of the patient.
Lip augmentation with implants is a surgical procedure. It has a number of contraindications, in which manipulations are not carried out even at the request of the patient.
Implantation is prohibited in the following cases:
- against the background of acne treatment with Akutan and its analogues. It promotes the growth of scar tissue and the formation of keloids;
- any connective tissue pathologies;
- lupus, other autoimmune processes - surgical intervention can lead to exacerbation of diseases, exit from a state of remission;
- any disease in the active stage;
- herpetic infection in any condition - active, remission;
- diabetes;
- allergies to medications;
- disruption of the thrombus formation process;
- mental illness;
- epilepsy;
- pregnancy, lactation;
- age up to 18 years.
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Technique of operations for clefts of the upper lip (second group)
The second group combines methods based on the movement of triangular skin flaps with different angles on the skin of the lip. Methods were proposed by Tennison and L.V. Obukhova.
Diagram of the stages of lip surgery for unilateral clefts.
Scheme of the stages of lip plastic surgery for unilateral clefts: a, b - according to Tennyson, c, d, e - according to Obukhova.
The positive side of the methods of this group is the possibility of obtaining any necessary lengthening of the lip tissue, which depends on the size of the triangular flap borrowed from a small part of the lip. The methods of Tennyson and Obukhova make it possible to compare lip tissues in full anatomical correspondence and obtain a symmetrical shape of Cupid's bow.
The anatomical nature of the methods makes it possible to clearly plan the operation, which makes it easier for young specialists to master. These methods have been recognized by many clinics around the world. The disadvantage of this method is the need to cross the filtrum line in the transverse direction.
The transverse direction of the postoperative scar reduces the cosmetic result of the operation. We recommend using these methods for incomplete clefts of the upper lip, if there is no deformity of the nose.
For complete clefts of the lip and incomplete ones, accompanied by deformation of the skin-cartilaginous part of the nose, a good anatomical and functional effect is achieved by combining one of the described methods with the Limberg method. This combination of two methods with some additional techniques is used in the clinic of the Department of Pediatric Dentistry of the Moscow Medical Dental Institute.
Scheme of the stages of upper lip plastic surgery for complete unilateral clefts.
Surgical intervention begins with the application of anatomical landmarks necessary for further surgery to the skin of the lip.
Planning for upper lip surgery.
Planning for plastic surgery of the upper lip (according to Limberg): a, b, c, d - stages of plastic surgery.
On the red border of the lips, the points of Cupid’s bow are marked (N1, M, A). The excess red border mucosa is then excised. A triangular Limberg flap is cut out at the base of the nasal wing, located on the side of the cleft. At the same time, the base of the wing is prepared from the edge of the pear-shaped opening. The Limberg flap, together with the wing, is moved to the midline and sutured into an incision made on the nasal septum along the border of the skin and mucous membrane.
The degree of shortening of the upper lip is determined by the difference in the length of the sides of the philtrum (N1N). In order to lengthen the lip, an incision is made on a larger fragment, coming from the high point of Cupid's bow (M) and dissecting the filter in the horizontal direction. The length of this incision (MN) depends on the degree of shortening of the lip tissue and can reach the middle or the opposite side of the filtrum.
The tissue defect formed after spreading the sides of the incision is closed with a triangular flap (ABC), cut from a small fragment of the lip. The dimensions of the triangular flap must correspond to the size of the defect, therefore, before the operation, the width of the base of the flap (AC) is outlined, which should be equal to the difference in the lengths of the sides of the philtrum (AC = NN1).
The area of lip skin located between the Limberg and Obukhova triangular flaps is excised. The described method allows you to get good cosmetic and functional results in a child of any age.
Upper lip plastic surgery.
Plastic surgery of the upper lip: a - child before surgery, b - child after surgery - before removal of sutures.
In the third group we included the Hagedorn and Le Mesurier methods, in which lip lengthening is achieved by moving a quadrangular flap cut out on a small fragment of the lip.
Schemes of the stages of plastic surgery of the upper lip for unilateral clefts.
Schemes of the stages of plastic surgery of the upper lip for unilateral clefts: a - according to Gagedorn, b - according to Le Mesurier.
Le Mesurier proposed a series of calculations to determine the length and width of the flap depending on the degree of deformation of the lip tissue due to cleft. The method is not anatomical enough. The quadrangular flap is inactive and inconvenient for plastic surgery of incomplete unilateral clefts, when large lengthening of the lip is not required.
“Childhood Dentistry”, A.A. Kolesov
Congenital clefts of the upper lip
Anatomical and functional disorders with clefts of the upper lip can be different. The degree of anatomical disturbances depends on the size of the cleft and on the combination of the cleft of the upper lip with the cleft of the alveolar process of the upper jaw. From the general complex of disorders, the main ones should be identified, on which the tactics and scope of surgical intervention on the lip depend. There are three such disorders: the presence of a cleft upper lip, shortening...
Classification of cleft lip
Currently, many groups of malformations of the upper lip have been proposed. A serious defect of many classifications of malformations of the upper lip is that they are burdened with excessive details and are therefore too complex to be suitable for everyday work. When diagnosing clefts of the upper lip, the Department of Pediatric Dentistry of the Moscow Medical Dental Institute uses a clinical classification based on...
Surgical treatment of cleft lip
Age indications for upper lip plastic surgery. Even in the last century, many clinics around the world tried to operate on newborns. This method became most widespread in the 30s of our century. However, due to the high percentage of postoperative complications and the insufficient cosmetic effect of operations, most surgeons abandoned early plastic interventions on the lip. Development of anesthesiology, resuscitation and improvement...
Technique of operations for clefts of the upper lip (first group)
A dental surgeon prepares a child for surgery together with an anesthesiologist and pediatrician. Newborn children are prepared in maternity hospitals by micropediatricians, under whose direct supervision the operation is performed. Local anesthesia is successfully used in children with incomplete clefts after premedication. In children under 1 year of age, local anesthesia is used in the form of infiltration anesthesia with a 0.25-0.5% solution of novocaine or a 0.25% solution of trimecaine without...
Plastic surgery of the upper lip for unilateral clefts
To restore the correct anatomical shape and full function of the lip, the surgeon needs to: eliminate the cleft, lengthen the upper lip, and correct the shape of the nose. To date, a large number of surgical intervention techniques have been developed, but most of them are of only historical interest. The methods of lip plastic surgery currently used by dental surgeons can be divided into three groups depending on the shape...
How does lip augmentation occur during implantation?
The surgical intervention takes place in 3 stages - preparation for 1.5 months, the procedure itself and the rehabilitation period.
Preparation
The preparatory period is long. The result of the operation and the duration of recovery depend on how carefully the patient followed the doctor’s recommendations.
Method of preparation for the procedure:
- Do not smoke for at least 6 weeks before the intervention - this will reduce the risk of rejection of the structure and scarring.
- Stop taking anticoagulants, homeopathic medications, and NSAIDs 2 weeks in advance—drugs can cause bleeding.
- Keep hydrated, which will shorten the rehabilitation period.
A general blood test, coagulogram, tests for HIV infection, and hepatitis are shown. An ECG is performed before the intervention.
What is it: basic principles
Cheiloplasty is aimed at changing the size and shape of the lips, as well as correcting their congenital and acquired deformities.
It usually takes at least an hour and is done under local or general anesthesia, the type of which is determined by a specialist. The patient does not experience pain during the procedure . Before going for surgery, he must undergo a full medical examination and tests. After the intervention, the patient can return to their normal lifestyle after 7-14 days.
Operation
Surgery is performed only at the aesthetic surgery clinic under aseptic conditions.
The total duration of the procedure is 30 minutes. At the initial stage, local anesthesia is indicated; general anesthesia is not used.
The doctor will make incisions in the corners of the mouth and create tunnels for installation of the structure. Then the lip implant is inserted and stitches are applied.
The patient remains in the clinic for several hours under the supervision of medical personnel. At the end of the day, you are discharged from the hospital.
Recovery period
After surgery, physiological tissue swelling will develop. It is relieved with cold compresses. Hematomas may appear. The basic rule of behavior after lip augmentation is not to touch, not to press, and not to smoke.
After surgery, the doctor will prescribe anti-inflammatory and painkillers. Antibiotics are not needed.
Photos before and after
We invite you to see photos before and after plastic surgery for cleft lip, upper and lower lips, and raising the corners by lifting:
