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According to Toronto plastic surgeon Dr. David Ellis., lip augmentation procedures should be performed based on the needs of the patients and clinical situation to achieve satisfactory results.

Procedure Considerations
a. He says that the important thing is not augmenting the lips, but choosing the appropriate
procedure for doing it.
b. If a patient is undecided about their lip augmentation, it is better to use a temporary filler in and then replace it with a permanent filler, whenever they wish so.
c. In the case of older patients, it is suggested to build up vermilion border ( The exposed margin of the upper or lower lip. ) since the feature usually flattens with time.
d. He also suggests that as young women already have a good lip border, they need to be
injected at the free margin. In case they need more lip augmentation, inject some more filler into the center of the lip instead the sides.
e. Dr. Ellis said that though the permanent filler Bio-Alcamid (Polymekon) for cosmetic use is also useful filler for old patients and it can be injected under local anesthetic using quiet needle technique. This procedure almost avoids any kind of bruising.