LAUSR

Lip augmentation has become an increasingly popular procedure in the last few years, either using various fillers or surgically. Fillers at the physician’s disposal include agarose gel, allogenic acellular dermis, and hyaluronic acid. Surgical options include using autologous tissue transfer with the help of tendon graspers from various sources such as superficial musculoaponeurotic system (SMAS), dermal/fat grafts from Cesarean section scars, with excellent, natural results. Here we introduce a technique for autologous transfer using the sheath of a suction-assisted endoscope in place of tendon graspers. Youthful and full lips hold significance in many cultures as trademarks of beauty − their volume, shape, and color are all regarded critical to one’s outward appearance. For this reason, procedures that target the lips to enhance one’s beauty have been popular. According to the American Society of Plastic Surgeons statistics, in 2015 alone there were 27,449 surgical lip augmentations, up 5% from 2014, a number that does not include injectables like hyaluronic acid.1 For longer lasting results that lend a natural appearance, autologous tissue transplantation is an option. Among the autologous grafts, such as sternocleidomastoid muscle, fat, fascia lata, dermis and galea, superficial musculoaponeurotic system (SMAS) lip augmentations tend to fade minimally over time, results last at least 5 years and the procedure has minimal postoperative complications with natural results.2 Additionally, while there has been success with autologous fat transplants, when compared to SMAS the longevity of fat transplants is less predictable due to varying resorption rates of fat, especially in the perioral area. For patients undergoing rhytidectomy, using SMAS for lip augmentation has the added benefits of being safe, easy to harvest, and economical (Figure 1). Lipofilling is also associated with a higher rate of nodule formation in the adipose tissue. Other irregular appearances such as a “double lip” have been documented, due to migration of the transplant following constant movement in the perioral area when talking and eating, as well as the effect of ptosis due to gravity.3 The purpose of this article is to describe a novel technique using an endoscope sheath to transfer SMAS for lip augmentation.