In the past lip augmentation was performed by surgical methods - cutting above the lip, realising frenulum between the lip and gum by V-Y plasty, cutting to the nose, implanting own tissues (dermis, muscle or fat). 
But  they had some disadvantages as:  too long interventions leaving scars or the results were difficult to reverse in case of a failure.  Rarely is  performed these days.

The implant with own tissues, specially with fat, is still performing in our country too. Although there are theories saying that by mixing fat with some man-made solutions would stimulate stem cells, this theory is not yet proven.  It is known that the fat injected is 50% reabsoarbed in two years and in time may lead to the formation of fibrous nodules .
First of all, the fat is harvested from another area and for a better result it must be repeated 2-3 times, on each 3 months. In addition, for 2 weeks the lips will be swollen and will present bruises . If you lose weight so the lips too!

In these days  several companies have developed  substances which are traded in prepackaged syringes, and are injected in less than 10 minutes with a immediately visible result, without previous tests.

The substances are divided according to the time of resorption (temporary or permanent) and chemical composition:
-  hyaluronic acid  - resorbable in 4-12 months ;
- calcium based substances - resorbable in 18-24 months;
- colagen - which comes from animals and can cause allergic reactions, resorbable in 3-6 months! require testing!
- semipermanent - acrylic gel - resorbable in 2-4 years, but being substances unrecognized by the body, it could cause rejection reactions (nodules or abscess!);
- permanent substances- but being substances unrecognized by the body, it could cause rejection reactions (nodules or abscess!).

From all these,  hyaluronic acid is the most tolerated by the body! It is  the only substance accepted in all parts of the body! 
 The other substances do not have approval to be injected into the lips!  Rate of complications from these substances  goes to 15%, and most often lead to swelling of the lips with abscess formation and fibrous nodules that could deform!   Their low price and longer duration of the result is however tempting,  for both patients and doctors!

Below are  presented a few cases  Most pictures are made several weeks after the injection and only few are made immediately after- where the lips are more red soon after.

You will notice that lips augmentation was discrete, natural. If the patient wishes, the same procedure can be repeated.