With age, volume loss occurs in not only face and hands but
also the lips. The upper lip lengthens
with a drooping of the cupid’s bow. The
lips loose volume and become more flattened.
This causes the mouth to appear wider and the corners of the mouth
droop.
Here’s how it looks:
Filling of the lips is an artform. Too much in the wrong place and one can look
ducky. But placed correctly, it gives an instant
facelift, giving a younger youthful appearance immediately.
Besides adding volume to the red part of the lip, the upper
lip skin needs to be addressed first, as this is where the lift comes
from. The lengthening of the upper lip
has to be shortened, the cupid’s bow has to be restored and the philtrum
rebuilt. After this, the red of the lip
can be slightly inflated. It is natural
for the upper lip to project slightly beyond the lower lip. The lower lip needs equal attention to match
the upper.
Fillers such as Juvederm UltraPlus XC, Restylane, Perlane
and Voluma are great choices for lips.
They are made of hyaluronic acid (sugar polymer) which is naturally
occurring in our skin and is hydrophilic (attracts water). This gives a good plumpness and longevity of
at least 1-2 years. We have found that
lip fillers tend to hold much longer than fillers applied to other parts of the
face. The same is true for under eye
fillers, which also tend to last longer than injections elsewhere on the face.
Treatment is performed with a tiny needle. A nerve block or topical numbing can be
applied ahead of time. However, I find
this is usually not necessary. Many
patients don’t like the numb feeling that can persist after a nerve block for a
few hours. Topical numbing is not overly
effective. Recently a patient who had
filler by another physician insisted on topical numbing cream. I told her to try without, and she actually
found it less painful with my technique.
And, of course, she loved the results!
The products we use all have local anesthetic mixed into the formula,
providing increased comfort for the patients.
There will be some immediate swelling and possible
bruising. This can be minimized by icing
afterwards, taking arnica montana tablets, and avoiding aspirin, ibuprofen,
fish oil, and garlic supplements prior to the procedure. Most patients, however, love the swollen
appearance, and wish it would stay just so! After a few days to a week, the
swelling will settle down, revealing new plump lips. If more volume is desired, it can always be
added in at this point. I recommend
starting with a minimal amount and building up gradually to the final desired
appearance. Each patient’s desires and
end goals are different and being in tune with that goal is extremely important
to achieving the right result for each patient.
It is truly one of the most enjoyable and rewarding aspects of my
work.
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