| LIP ENHANCEMENTS | arTicle
Volume, projection and eversion
Convexity, surface enhancement and hydration of vermillion
Figure 5 Where to inject for volume, projection and eversion (green). Where to inject for vermilion hydration and convexity (blue)
propose a surgical shortening [8] of the white lip
(surgical lip lifting with an incision approach, dissimulated in the nostrils) to recover an acceptable length of white lip to take full advantage of filling.
Normal volume of red lip with normal length of white lip This is also a very good scenario. It is certainly not easy to define the term ‘normal’ and to establish what a ‘normal volume’ is. For us normal means moderately thick, that is, between thin and thick. Sometimes we can further enhance the lips by gentle
filling, often in the vermilion to recover a smooth surface, hydration and concavity. Never forget that harmony is more important than volume and often ‘less is more’. Sometimes
also, the
Thickness In this author’s experience, it is the exception for patients to be uncomfortable with thick lips. On the contrary, moderate thickness is beneficial to the aesthetic appearance. Requests for thinning of the lips are very rare. One situation merits consideration: the prognathes who appear to always have thick and fleshy lips, even if they are thin. This it is due to the fact that the lip is more anteriorly projected by a stronger posterior teeth–bone support that occurs with prognathy.
How to enhance lips with fillers? One must consider two questions: where to inject and what to inject?
hyaluronic injections
are the ‘gold standard technique’ for lip
osteodentin involution due to ageing decreases the quality of resting. The red lip loses its posterior support, becomes less anteriorly projected, less everted, more vertical, more retrused. Even if the red lip volume is normal, it looks thinner. In this case, filling is beneficial because the level is the same.
enhancement and lip rejuvenation.
Where to inject in the red lip? Hyaluronic injections are the ‘gold standard technique’
for lip
enhancement and lip rejuvenation. Volume, projection and eversion are strongly linked as discussed
previously, so any filling in the red lip will enhance volume, anterior projection and eversion. For volume: inject deep in or behind the orbicularis
Normal volume of red lip with long length of white lip Even if the volume is normal, the red lip can look thinner because it doesn’t rest on the posterior teeth bone support. We are in the same situation as 3.2.
muscle, at the same level of the teeth support just in front of it, to benefit from the strong support (posterior dam) (Figure 5). This gives a better anterior projection and of course eversion – our goals (Figure 6). To harmonise and enhance the vermilion, inject ‘en
nappe’ (like a sheet) superficially just under the vermilion (Figure 5). This improves the smoothness of the surface, its hydration, and restores convexity (Figure 6).
Figure 6 Before and after
prime-journal.com | March 2011 ❚
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