Adventures in lip augmentation

Children of the 80's may remember the British Disco synth-pop group "Dead or Alive" who had a couple minor hits which live on indefinitely on classic rock stations featuring the 80's new-wave music. The lead singer of that group, Pete Burns, has been a walking billboard for what resembles body dysmorphic pathology (a psychiatric condition re. body image) for years having had dozens of procedures which have left him progressively less humanoid looking.

Mr. Burns is now in the news after horrible complications from lip augmentation, a picture of which is shown below. (from This is London):

In 2000 Burns went to Dr Maurizio Viel at the London Centre for Aesthetic Surgery to have a lip implant removed.

But instead of having the original implant taken out, he was injected with a filler called Evolution and then later with another called Outline.

Despite complications, Dr Viel persisted and injected more of the substance - only for the problems to escalate, causing swelling, blisters, discharge and lumps.

Eventually the singer was left so disfigured he could not eat normally, could only drink through a straw and did not leave his house for months. He said his career would have been at its peak if it were not for the botched surgery, as he was about to record with the Pet Shop Boys and pursue a number of solo projects as well as launch a greatest hits album.

Lip augmentation is tricky business. There are hundreds of celebrity pictures with the infamous "trout pout" from aggressive collagen injections in years gone by. Hyaluronic acid fillers like Restylene or Juvederm have largely replaced collagen and tend to last longer with fewer potential allergic reactions. Many patients continue to ask for longer term options and that means lip implants (silicone, Gore-tex), fat grafting, long-acting temporary fillers, or permanent fillers.

As Mr. Burns case points out, permanent fillers can go real bad, real quick and has tempered the enthusiasm of many of us for such products. The perfect filler hasn't been developed yet but we know what we want. Ideally we have a very long lived or permanent product with some way to dissolve it if we needed to. Unfortunately, the only fillers we can dissolve easily are the hyaluronic acid ones which only last a few months anyways.

You also have to question the judgment of any physician willing to continue to perform elective surgery or cosmetic treatments to someone like Mr. Burn who is clearly body dysmorphic. In the insane (no pun intended) legal environment of the United States there have even been doctors sued with failure to diagnose body dysmorphia as a cause of action by patients during malpractice suits.