Implants such as silicone and alloderm introduced to augment the fullness in the crimson lip. The Italian lip carry is used and described, which doesn't include an incision under the columella (in the center), only on the sides. For the duration of a bullhorn process, Dr. Jacono cuts an incision https://grok.com/share/c2hhcmQtMw%3D%3D_150f7684-8e37-4948-be04-1d2f388f485c