title: Lip augmentation in conjunction with facelift: preliminary experience with a new permanent implant.
abstract: BACKGROUND
  Classic facial rejuvenation has not addressed permanent perioral rejuvenation, but has relied mainly on temporary fillers. The Permafacial Implant (SurgiSil, Plano, TX), which is a permanent contoured soft silicone implant, was recently cleared by the US Food and Drug Administration. Currently, there are few reports on its effectiveness in lip augmentation.
  
  
  OBJECTIVE
  The authors, who have to date inserted more than 100 of these new implants, report their preliminary assessment of the implants' effectiveness for improvement of the aging lip in conjunction with facelift.
  
  
  METHODS
  Blunt scissor dissection was performed, followed by placement of a tendon passer along the course of the moist and dry vermilion junction. The implants were then threaded in the correct position. Placement location in the upper lip was critical. The key position is between the submucosa and the muscle, rather than intramuscularly, where the implant might migrate into a deep position. Bimanual palpation was performed to confirm the proper position.
  
  
  RESULTS
  Initial results in two cases are presented with six-months of follow-up. Both patients expressed satisfaction with the results. Neither experienced any distortion or migration.
  
  
  CONCLUSIONS
  The implants are easy to insert if proper care is taken. The results are permanent and address the aging mouth effectively. A formal two-year study is pending.
authors.affiliation: narsete@prodigy.net
authors.forename: Thomas
authors.initials: T
authors.lastname: Narsete
authors.forename: Robert
authors.initials: R
authors.lastname: Ersek
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008046:Lip / Q000601:surgery*; D008488:Medical Illustration; D008875:Middle Aged; D017060:Patient Satisfaction; D019736:Prostheses and Implants; D012060:Rejuvenation; D015361:Rhytidoplasty / Q000379:methods*; D020034:Silicone Gels
chemical_list: D020034:Silicone Gels