The youthful and aesthetic lip is comprised of a full upper lip with a definite demarcation between the red “mucosa” and white “cutaneous” surfaces. The upper lip arches gracefully upward forming a Cupid's bow. The lower lip is comprised of a full red mucosa slightly larger than the upper lip. With aging, there is a progressive atrophy of the mucosa, subcutaneous tissue, and muscle, resulting in a thinner, less defined, upper and lower lip complex. Various surgical techniques have evolved to treat and augment the thin and inadequate lip. We performed a retrospective review of 44 patients over the last five years who underwent augmentation cheiloplasty for thin and deficient lips. We describe our results here and offer a comparison of the different methods available for lip augmentation (surgical lip advancement, collagen injection, and alloplastic material). Finally, we show the evolution in our treatment of the aged, thin, and deficient lip over the last five years.