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SMAS lip augmentation is safe, yields natural, long-lasting results

Superficial musculoaponeurotic system lip augmentation was a safe and effective method resulting in long-lasting results with a natural appearance and minimal risk of complications, according to study results published in JAMA Facial Plastic Surgery.

For the cohort study, Matthew Allen Richardson, MD, and colleagues, reviewed patients who had undergone surgical lip augmentation using superficial musculoaponeurotic system (SMAS) tissue following biplanar extended SMAS rhytidectomy at a private facial plastic surgery practice between Jan. 1, 2000, and Nov. 16, 2015. They reviewed complications and rate of lip volume increase or decrease.

Of the 423 patients initially identified, 60 were selected for review of complications. Each patient had approximately 5 years or more of postoperative follow up including photographs. Complications more common with SMAS augmentation included postoperative lip edema, nodularity and mild asymmetry at 8 years after surgery, all of which were extremely mild. Only two of the 60 patients (3.3%) with complications desired intervention; one for edema at 2 weeks postoperatively and one who developed nodularity 8 years postoperatively.

Of the 60 patients reviewed, 26 met the criteria for an evaluation by 12 blinded observers to rate lip volume increase or decrease. Photographs were taken preoperatively and at 3-month, 1-year and 5-year follow up.

The researchers used a validated photonumeric 9-point scale with scales ranging from grade 1 (very thin) to grade 5 (very full) by 0.5-point increments.

According to the observer ratings, pairwise comparisons at each follow-up time period were significantly greater than the preoperative ratings. Separate pairwise comparisons of each lip at 3 months, 1 year and 5 years did not achieve statistical significance between the three periods.

The greatest median increase using the photonumeric scale was observed at 3 months (0.69-point increase), while the smallest median increase was observed at 1 year (0.41-point increase).

“The degree of increase in median volume appeared to weaken slightly over time,” the authors wrote, “but remained statistically significant compared with the preoperative ratings and close to a 0.5-point increase in the grading scale even at 5 years for both the superior and inferior lip, respectively.” – by Talitha Bennett

 Disclosure: The researchers report no relevant financial disclosures.