Since the beginning of time, youth and beauty have been always associated with full lips for women of all races and ethnicity. Therefore, lip enhancement and augmentation is considered to be one of the most demanded aesthetic procedure in any cosmetic clinic. With the improvement of hyaluronic acid fillers, lip augmentation procedure is more appreciable than ever.
Hyaluronic acid fillers, such as Juvederm and Restylane, have many of advantages in the field of cosmetic injectables.
First, they are available in a different grade of cross-linking. This means that they come in different viscosity. Lower viscosity correlates with more softer fillers, and the opposite is correct. The fact the different grades, the same filler, are available give both the client and the injector more freedom in choosing the right filler to shape the lips according to the client liking. One more important advantage of HA fillers is that they are reversible. They can be dissolved any time for any reason by injection an enzyme to reverse their effect.
There is not perfect “spell” or “one size fit all” for perfect lips, but we can achieve a great client satisfaction through following a systemic 5-step protocol.
Here is a brief description for this protocol:
Step one, communication: it is essential to establish a clear frank dialogue between the client and the injector before preformation lip fillers. The client is the one who looks at herself in the mirror daily, so it is essential to have a mutual understanding of the results before start injection the fillers. This will help the injector to choose the right filler and the client to have reasonable expectations of the lip shape after lip augmentation procedure.
Step two, Understanding the golden ratio: Some people attribute 1.6:1 golden ration to Da Vinci himself in his masterpiece “Joconda Lisa” or better known as “Mona Lisa”. When it comes to the perfect lips, the volume of the lower lip should be 1.6 from the upper lips. Some women, with sharp facial features, can defy with the golden ratio. We can see a 1:1 ratio with lots of African American celebrity, this is a particular case and should be fit with other facial ratios.
Step three, understand different lip’s planes and areas:
Lines of the lips:
- Define the Philtrum Columns which is light columns at the center of the upper lip. The trend today is to have a well-defined and sculpt Philtrum Columns. The question is to what extent we should boost these two lines. This mainly depends on the style of the lips and age of the client. With a younger client, the injector can raise the columns significantly without negatively affecting the look of the lips and the face adversely.
- The fashion today is to have pouty Cupid bow. This is the U shape line in the central upper lip. Injection a tiny amount of filler in this area will support the outward projection of the upper lip, which is indeed considered sexy nowadays.
- Enhance the Vermillion boarders of the upper lips. This the line between the red and the white lip. The injector should enhance of this fine line only in the “medial” central part of the lip and avoid the lateral portions that are near the corner of the mouth
For these lines, it is recommended to use a soft filler such as Juvederm Volbela and Restylane refine. Using a higher-grade filler could results in bulges as the filler is placed in a very shallow place.
The pillow of the lips: The injector may choose a thicker filler to augment these parts of the lip. The injection plane is deeper than the lip lines, and we need to have a more prominent augmentation.
- Enhance the upper lips tubercles “pillows”. A study shows that women with natural prominent upper lips tubercles has a better orgasm than other! Even from the cosmetic point of view, have a prominent upper lips pillow goes side by side with defined lips lines. It would not be cosmetically right to boost the pillow to an extent that overshadows the lines and opposite is correct. The three points for the upper lips pillows correlate with the lines mentioned above. There are three pillows in the upper lips, the central one under the Cupid bow and two side ones under the Philtrum columns. If you look to a newly born baby, you will be able to see these three pillows mainly the central one.
- The lower lip has two pillows as well, and they are located inferior and lateral (down and to the sides) to the upper-lip central lower lip pillow. It is very sexy to crease a shallow groove or channel in the central part of the lower lip between the two pillows. The central pillow of the upper lip and the central groove of the lower lip as like a sword and its cover.
Step four, filling the nasolabial folds: These are the creases between the cheek and the nose. Even though these are not part of the lips, but filling them may help to evert upper lips, which is highly demanded by the today’s fashion.
Step five, supporting the oral commissures: The oral commissures are the located at the mouth corners, where the upper and lower lips connect. Injecting fillers at both angles provide upward support the lower lips. The injector may choose to augment the effect by injection some Botox in targeted muscle “Anguli Oris” what works as a depressor muscle and pull the mouth side downwards. Relaxing this muscle with Botox will give the client a naturally smiley face.
The main limitation to this protocol is the financial issue; there is no single filler in the market that would perfectly fit all the injection sites mentioned above. Most of the clients want to have invest in only one syringe of filler, and that is understandable as HA fillers are very expensive (average price of 1 cc syringe of fillers in Edmonton is $600). Therefore, the injector would have to compromise to choose one filler for all the injection site.
The choice of the fillers depends mainly on what is needed to be done; if a client has defined vermilion border, then we need to use most of the filler syringe in enhancing the lips pillows. Vice versa, if a client is mainly concern about improved the lip lines since they have excellent volume, then we need to go with softer fillers.
My clients ask me all the time, what is my favorite fillers; and I always say, “my favorite fillers is the one that gives you the best results and sexiest lips.”
In Albany Cosmetic and Laser Centre in Edmonton, we do not limit ourselves to one brand or one grade of fillers, but we try our best to get a variety of different fillers to choose the best results for all our clients with different lip shape and different expectation. The main two brands that we use are Juvederm with all different grades (Volbela, Vollift and Voluma) and Restylane in all its grades (kysse, Refyne, Defyne and Volyme)
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