Pout Not Trout

A full but natural-looking pout can be achieved with a volumising and defining combination of injectables to create lush lips.

The cosmetic approach to lips has swung back recently from the over-full ‘Angelina Jolie’ pout to more natural looking volume. People nowadays don’t want their lips to be the focus of attention. They want something that blends and harmonises with the rest of their features, subtly accentuating their mouth without screaming ‘overdone’.

When it comes to fillers, patients are requesting a more natural look that captures a youthful lip. There are wide range of injectables that can achieve a natural look without giving the so-called ‘trout pout look’. These Esthélis, Fortélis, Restylane, Juvéderm and Aquamid.

Dr Mark Hamilton from the Hamilton Face Clinic in Ireland says a beautiful lip is symmetrical and has all the landmark features. ‘A well defined vermillion border, philtral columns and appropriate volume for the age of the patient are the landmarks I try to enhance when creating beautiful lips,’ he says Dr Hamilton. ‘When it comes to the lips, I don’t think beauty is in the eye of the beholder – a huge pouty lip does not look natural, people often take a second glance to check for faults. I like to replicate a natural lip.’

Dr Hamilton says younger people can get away with more volume in their lips, but generally believes in a more conservative approach to adding volume. ‘Smaller lips shouldn’t be made into big lips because they can appear sausage-like. You can’t change the shape of the lips radically, but you can use an artistic eye to enhance them.

Temporary fillers tend to dissipate faster in the lips than anywhere else in the body because of the constant movement of the lips, high blood supply to the area and the elasticity of the mouth. However, it is recommended you try more temporary fillers first to ensure you’re happy with the results. Once you give the green light, an experienced injector can proceed with more permanent fillers, such as Aquamid.

Hyaluronic acid-based (HA) dermal fillers are homogeneous with normal skin tissue and integrate seamlessly when injected. This allows a smooth, elastic texture that works effectively to fill in lines, wrinkles and other depressions or to enhance the volume of the lips. Results usually last an average of six months, dependent on the filler used.

Prior to treatment you may have your lip area numbed with a local anaesthetic to make the treatment as comfortable as possible. After the procedure you can expect some swelling and possibly some bruising, which usually subsides after a few days in typical cases.

One of the possible side effects of using some fillers is the ‘Tindall effect’, which some fillers can cause. This results in the face taking on a bluish tint. Additionally, a filler that blends well and can be moulded and smoothed should be used so it doesn’t cause the ‘cordon effect’, which sees the filler stick unevenly in one place.

Fat transfer is another option if you want to bolster your pout. This can be done under local anaesthetic or twilight sedation, where fat is removed from elsewhere in the body (usually the abdomen), is rid of impurities and injected into the lips. Results are generally permanent and, as it uses only your own tissue, it offers less chance of infection.

A lip lift provides permanent surgical definition to lips. It raises the margin of the lip, can also change the shape of the lip, making the cupid’s bow more prominent, or increase the show of the outer lip.

Avoiding the trout pout look is a key concern for most patients. This is most commonly caused by too much bulk in the vermilion border and over-volumising the wet-dry margin of the lips, which in turn causes the lip to turn out too much and the lips then bounce off the teeth in a more pronounced way.

If this is a look you’d prefer to avoid, abide by the old adage ‘less is more’. Ensure you have your own ideas of what you find attractive so you can specify to your injector what you desire, and view their before and after photos prior to treatment.

A good lip augmentation should ideally complement the overall appearance of your face, be age appropriate and not be immediately obvious. ‘All women want a perfect pair of lips, but there’s no magic wand. What we can do is make small improvements to enhance the features the patient already has,’ Dr Hamilton concludes. acsm