With booming trends shaping the future of cosmetic procedures around the world, lip enhancement remains the most popular treatment among women of all age groups.
Lips are a prominent feature of the lower third of the face. Non-surgical lip augmentation is a semi-permanent solution meant to shape, volumize and hydrate the lips to restore its proportions in respect to the chin and nose. In the past, fuller lips were considered as a symbol of beauty and youth, however, recent studies have considered 3-dimensional analysis of the lips in proportions to the face to determine its attractiveness.1
Additionally, surface changes on the lips like dryness, fine lines and wrinkles also need to be addressed with help of treatments that restore lip hydration. A variety of semi-permanent dermal fillers are available in the market containing Hyaluronic Acid (HA) varying in content, viscosity and crosslinking.
Depending on the viscoelasticity and molecular properties of these fillers, it can be used to reshape and augment thin lips or restore hydration in aging or dry lips.
Lip Augmentation
The best approach to lip fillers is to identify the anatomical imperfections in the lips bearing in mind the patient’s desire. A perfect synchronization of physician’s expertise with patients’ expectations gives a beautiful, desirable and a predictable end result.
Common concerns that most patients present with are thin lips, asymmetry, drooping corners and gummy smile.
Various fillers can be used depending on the anatomical correction required on basis of its viscoelastic properties, G prime, structural integrity, and bio-stimulatory effects. The depth of the placement of these fillers determine the extent of homogenous lifting of lips.2
Lip Augmentation Techniques: Bolus, Serial puncture, Linear Threading, Cross-hatching, Cannula.
Areas treated: Vermillion border, cupids bow, lip bulk, philtrum columns, angle correction, lip height, asymmetry.
Analytic Considerations: Gender of patient, cranio-facial structure, chin-lip distance, nose-lip distance, upper lip projection, dentition, upper lip to lower lip ratio, smile dynamics. 1-3
Fillers used: Juvéderm Volift, Restylane Kysse, Belotero Balance
Pre-treatment History: Age, Smoking, Previous history of fillers, Previous reactions to filler, history of blood thinners/supplements, recent/active viral infection, medical/surgical history.
Lip Hydration
Aging causes structural and soft tissue changes in the lip due to loss of collagen and elastin which leads to reduction in the lip volume. Furthermore, depletion of glycosaminoglycans leads to increased trans-epidermal water loss and dehydrated lips that are prone to fine lines. Repeated dynamic activity of the lips lead to formation of static wrinkles in and around the oral commissures. 4
HA owing to its hygroscopic property, attracts water into the dermal matrix resulting in hydration and textural improvement. Small particle HA fillers are injected superficially, intradermally, to give smoother, hydrated and supple lips.
Lip Hydration Techniques: Bolus, Serial puncture, Linear Threading.
Areas treated: Vermillion border, lip bulk, perioral lines, lateral commissures.
Analytic Considerations: Age of the patient, dynamic wrinkles, static wrinkles, textural changes, overlying dermatitis, cheilitis, fine lines, angular stomatitis, dryness
Fillers used: Juvéderm Volbella, Stylage Special Lips, Teosyal RHA Kiss
Pre-treatment History: Age, Smoking, Previous history of fillers, Previous reactions to filler, Atopy, history of cheilitis, history of blood thinners/supplements, recent/active viral infection, medical/surgical history.
References:
- Popenko NA, Tripathi PB, Devcic Z, Karimi K, Osann K, Wong BJF. A Quantitative Approach to Determining the Ideal Female Lip Aesthetic and Its Effect on Facial Attractiveness. JAMA Facial Plast Surg. 2017;19(4):261-267. doi:10.1001/jamafacial.2016.2049
- Arsiwala SZ. Current Trends in Facial Rejuvenation with Fillers. J Cutan Aesthet Surg. 2015;8(3):125-126. doi:10.4103/0974-2077.167261
- Luthra A. Shaping Lips with Fillers. J Cutan Aesthet Surg. 2015;8(3):139-142. doi:10.4103/0974-2077.167269
- Adapted from – https://www.thepmfajournal.com/features/post/anatomy-of-the-ageing-lip