The topic of lip enhancement is very popular these days, especially in Beverly Hills and Hollywood. As a quick review of the various options available, I would like to separate them into surgical and non-surgical. In the non-surgical category, we have Juvederm, Restylane and Perlane which are naturally occurring substances (hyaluronic acid) that exist between the cells of your body. Also, there is fat, which requires minor liposuction surgery to obtain but no surgery to place. All of these fillers are placed via a syringe and needle and eventually disappear over several months. However, there may be some percentage of persistence with fat transfer. I do not use permanent fillers like Artefil or liquid silicone in the lips (or elsewhere) because I think they produce an unsusal “foamy” appearance in the lips, especially on animation. Also, because they depend on the formation of tissue reaction to produce the volume, there may be some asymmetries. Regarding surgical alternatives, the primary method that I use is mucosal advancement flaps from inside the mouth (V to Y advancements). This usually also requires fat as a spacer after the flaps are advanced. I also perform liplifts which shorten an elongated “white” lip and can pull up the “red” lip, if it is so desired. The final technique which I use in rare instances is direct excision of tissue around the red lip with mucosal advancement. This procedure is great for designing a new shape for the lips. However, it does leave a fine scar around the lips which, if obvious, can be easily covered with lipstick. The use of Verafil lip implants is another technique which I used more frquently in the past but less so recently because of the occasional problem with symmetry, palpation and volume maintenance.