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Lip augmentation is an increasingly popular procedure. With increasing demand from patients comes an increasing challenge to surgeons to evolve techniques that are suited to the particular concerns, desires, and anatomy of each patient. In the past, options were limited to only a few filler substances and relatively few surgical options. Today new filler products continue to rapidly evolve and become available to surgeons and are often directly marketed to patients via various media formats. Tissue grafts and autologous fat grafting are also giving surgeons options for lip enhancement that were limited in the past. Options for permanent lip augmentation with newly advanced alloplastic implants are now available to help patients achieve a more natural look and feel. The challenge for surgeons of any level of experience is to weigh the advantages and disadvantages of each newly emerging technique and incorporate these into his or her armamentarium. I will outline the evolution of my lip augmentation techniques, emphasizing the use of Advanta™ for permanent lip augmentation, and the rationale behind this evolution.