1. PermaLip
Mr Adrian Richards
Consultant Plastic Surgeon
Medical Director of Aurora Clinics and
Cosmetic Courses
FACE Conference
Saturday 16th June 2012

2. Good Bad

3. Techniques are separated into two
categories:
1. Temporary enhancement
2. Permanent enhancement

4. • Temporary
• Painful
• More expensive
Disadvantages of Temporary
Techniques

5. Disadvantages of Permanent
Enhancement
Before After

6. • Permanent
• Easily reversible
• Natural
• Safe
• Short and well tolerated procedure
The Ideal Solution

8. • 3 different lengths of
55mm, 60mm and
65mm
• 3 different widths of
3mm, 4mm and
5mm
Is PermaLip the Solution?

9. • Soft, solid injection molded silicone that cannot rupture
or deflate
• Tapered at both ends to allow for a more natural
contouring of the implant to the lip
• Have a smooth surface that reduces scar tissue
formation and tissue ingrowth
What is PermaLip?

10. • Can be performed in a simple clinic setting under
local anaesthesia
• Takes approximately 20 - 30 minutes to perform
• Typically requires only 5 - 10 cases to achieve
proficiency
Advantages of PermaLip

11. After a dental block is administered to the facial sensory nerves, a lip block
is performed directly to the substance of the lip along the plane of
dissection with emphasis on the commisure.
The PermaLip Procedure

12. The patient’s peri-oral region is prepped.

13. A 4 to 5 mm incision is made in each commisure with a curved pair of Iris
scissors, adding pressure to achieve haemostasis.

14. The curved Iris scissors are used to dissect a tunnel to the mid-line, along the
wet/dry border in the submucosal plane just superficial to the muscle, and
completed through similar dissection from the opposite commisure.

15. After selecting the appropriate PermaLip implant and soaking it in betadine
solution, a Perma-tunneler is guided through the dissected tunnel between the
thumb and index finger.

16. The instrument is guided through the tunnel until it emerges from the opposite
incision.

17. The implant is grasped with a good purchase.

18. The implant is pulled back through the dissected tunnel aided by Brown
Adson forceps grasping the opposite end of the implant, ensuring it is not
pulled completely through.

19. The implant is then worked from side to side to ensure proper positioning in
the mid-line, then minor modifications to placement are performed digitally.

20. A similar technique is then repeated for the lower lip.

21. Each incision is closed with one stitch using absorbable suture to grab deep
tissue in an interrupted figure of eight with eight knots.

22. Results
Before After

23. Before After

24. Before After

25. Before After

26. Pre-op Post-op
3 Months
Post-op
1 Year

27. Pre-op Post-op Post-op
3 Months 1 Year

28. • Safe simple technique
• Popular with patients
• Who can do it?
Conclusion

29. Thank you for
listening
Adrian Richards
Plastic Surgeon
Cosmetic Courses Podcasts
cosmeticcourses.co.uk
aurora-clinics.co.uk