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| TreATIng The lIps | article


Figure 9 Anaesthesia is inserted near the lip commissure


Figure 11 Hyaluronic acid is injected with a retrograde injection


Figure 10 The cannula is inserted until the tip of the lip


necessary, vertical rhytides are treated directly using an intradermal implant.


Results Botulinum toxin A The toxin begins to take action after a period of 3–10 days1


Figure 12 The same process is followed in the inferior lip ,


a little earlier than that in the upper third of the face. Aesthetic improvement was satisfactory and the patients were pleased with the results. The following parameters were documented: ■ An obvious reduction of the wrinkles in the dynamic phase ■ light improvement in the static phase ■ Increased projection of the lip edge. patients in the first cohort did not want further


treatment with hyaluronic acid because they were already satisfied with the result of the toxin alone, and therefore avoided the discomfort of injecting the filler, which is much more traumatic than the toxin and with more visible consequences (e.g. oedema, haematoma, pain). All patients were satisfied and gave a result higher than 2 on the assessment scale, but most patients gave a result of 3–4 on the scale of 1–5, where 1 is a poor result and 5 is excellent. The average result was 3. The score of patients’


and physicians’ satisfaction, and the final result after receiving botulinum toxin, are shown in Figure 13 (overleaf). There is likely very little difference between Vistabex and Azzalure: Azzalure seems to be a little stronger than Vistabex, with the doses used in this case history, but further studies are needed to precisely evaluate the difference between the two products. They are not interchangeable.


in all patients


treated with botulinum toxin, there was a reduction in the amount of hyaluronic acid necessary for the correction.


Hyaluronic acid patients from the second cohort were injected using the paris lip technique; only minor corrections were carried out in some cases, according to the author’s philosophy. results were always good, with most patients declaring a result of 3, using the same scale of 1 (poor result) to 5 (excellent result) (Figure 14 — overleaf). In all patients treated with botulinum toxin, there was a


reduction in the amount of hyaluronic acid necessary for the correction.


Side-effects The post-botulinum toxin feeling of patients is shown in Figure 15 (overleaf). The patients were informed that the toxin begins to work after 3–6 days, after which,


prime-journal.com | October 2011 ❚ 37


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