21 Sep 2023 | by Leonard Miller, MD, FACS, FRCS

The lips are one of the most important facial features, yet they are commonly overlooked in our beauty routine. Most women focus on the skin, while the mouth gets little to no attention. That is until the day we notice this delicate tissue starting to show our age. This change is almost inevitable, as genetics play a big part in how our mouth and lips age, as well as the harsh environment, smoking, and repetitive muscle movements.

The Boston Center for Plastic Surgery offers several treatments designed especially for the delicate tissue around the mouth and lips. With the help of Dr. Leonard Miller, these changes to the mouth and lips can be minimized to combat the early signs of aging.

View our before & after photos


As we age, our facial tissues change in predictable ways. Over time, the biochemical components of our skin, such as collagen and elastin, begin to diminish. This weakens the important structural support of the skin and lips. Bombarded by the effects of gravity, these tissues start to stretch. The upper lip may elongate and lose definition. The corners of the mouth may start to turn downward, replacing a perky smile with a constant frown. Fine wrinkles, fanning outward from the lips can appear, made deeper by smoking and years of sun damage. Nasolabial folds (funning from the nose to the lips) and marionette lines (from the corners of the lips down to the chin) become increasingly noticeable.


A beautiful mouth and full lips never go out of style. However, as we age, the help of a skilled cosmetic surgeon is often needed to keep our mouth looking flattering and youthful. Dr. Leonard Miller has extensive experience creating defined lips that look soft and attractive, bringing proportion to the facial features.

Dr. Miller has been performing his lip rejuvenation techniques for many years, possibly longer than anyone else in the United States. In the early 90s, Dr. Miller brought the microneedling technology from South Africa to the U.S. Although he had been performing this technique for over a decade in his home country, Dr. Miller was the first to bring a certain form of lip rejuvenation to the states. Before this, the only way to deal with fine lip lines and thinning skin around the mouth was either a strong chemical peel (Phenol Peel) or a strong laser resurfacing treatment (CO2  laser), both of which could be damaging to the tissues. Luckily, today Dr. Miller can provide beautiful results using more subtle alternatives and a less aggressive approach, often combining nanofat grafting with his own microneedling technique.

View our before & after photos


Nanofat grafting refers to a unique technique that transfers living fat cells, harvested from elsewhere on the body, to the lips. Using a game-changing process, the fat cells are emulsified with growth factors and peptides. Meticulously injected into the lips, this nanofat will plump and thicken the delicate skin around the mouth. When combined with medical microneedling, performed by an experienced physician, the lines above the lips will dramatically soften and fade. As the tissue heals, it continues to become smoother and tighter, offering exceptional, long-lasting results.

The combination nanofat grafting and microneedling procedure is performed under local anesthesia. Patients should expect downtime to last about five days. Redness is common for the first seven to ten days, although this can easily be camouflaged with makeup.

Dr. Miller’s subtle technique and innate eye for facial proportions ensure patients that their lip augmentation results will look normal. The lips will not appear over-inflated, unnatural, or duck-like. For more dramatic results, the nanofat grafting and microneedling procedure can be repeated after six months. Scarring and depigmentation are rare, although patients should avoid sun exposure while the lips are healing. Therefore, Dr. Miller does not recommend nanofat grafting and microneedling during the summer months.


Dr. Miller and the Boston Center for Plastic Surgery continue to lead the way for improving the appearance using minimally invasive techniques. If you would like to find out more, call the Boston Center for Plastic Surgery at (617) 735-8735 to schedule your consultation with Dr. Miller.

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