Dermal Filler Injection Guide
Dr. Vartanian Defines Lip Aesthetics
Anatomically, the lips and perioral complex can be defined as the area bounded by the subnasale superiorly, mentolabial sulcus (sulcus inferioris) inferiorly, and the melolabial folds laterally. Lip shape is mostly defined by the vermillion border, red lip volume, and amount of dental lip support. Upper lip landmarks include the philtral columns, Cupid’s bow, the tubercle, and the white skin roll. Cupid’s bow is formed by M-shaped paramedian elevation of the vermillion border that frames the superior border of the pout. The lower lip is more continuous and uniform in shape. A subtle mirroring of the upper lip shape can be noticed in the paramedian aspects of the lower lips. The histological layers of the lips consist of mucosa, submucosa, layers of circular muscle fibers, adipose tissue, and skin. Like other facial structures, idealized proportions of the lip have been described and serve as a useful guide for some patients. Described aesthetic norms are mostly based on data from Caucasian aesthetic norms and may vary based on the patient’s individual features, race, and individual esthetic goals. Lip projection can be measured on lateral view photographs, where the upper lip should lead the lower lip by 2 to 3-mm. On frontal view, the upper lip should be 60-70% of the size of the lower lip. The aesthetic goal in lip enhancement depends on the patient’s request and facial features, tempered by the surgeon’s aesthetic judgment.
Lip Enhancement Methods
Lip augmentation can be achieved using temporary injectable fillers, temporary biologic implants, autogenous tissue transfers, surgical tissue advancement techniques, and with the placement of alloplastic implants.
Injectable Fillers Remain the First Line Treament for Most…
An expanding list of injectable filler material is becoming available and approved by the United States Food and Drug Administration (FDA) for use in the face. In most practices, dermal fillers remain the initial method of choice for lip augmentation owing to their ready availability and ease of obtaining outstanding results. The use of many dermal fillers in the lips is considered off-label by the FDA and must be explained to the patient during the informed consent process. A common shortcoming of most temporary dermal fillers is their lack of longevity, which is even more short-lived in the highly vascular and mobile milieu of the lips. Not all current and future dermal filers are appropriate for placement in the lips.
Lip injection techniques must address three areas / aesthetic qualities of the lip:
1.The vermillion border
2.Lip volume
3. Proportionamilty of the lip
Dr. John Vartanian recommends injection techniques and volumes that will enhance the lip in a natural appearing symmetric manner. Dr. Vartanian, having treated numerous celebrities and models, has come up with an injection pattern that minimizes bruising, lumpiness, and maximizes a natual enhancement of the lip. With customized results based on the patient’s exact request, he can deliver the highest degree of patient satisfaction.
More info on Dr. John Vartanian’s lip enhancement technique at: www.facial-plastic.com
About the Author
Dr. John Vartanian is a double board certified facial plastic surgeon with offices in the Los Angeles area (Beverly Hills & Glendale, CA). He specializes in rhinoplasty, revision rhinoplasty, and facial aging reversal surgery and procedures. More info at: http://www.facial-plastic.com
520 E. Broadway Ave., Suite 200
Glendale, CA 91205
818.662.0600
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