Young Lips

Plumped lips are now craved, non-permanent Hyaluronic acid (HA) fillers are the most common way of achieving those. Lip fillers is one of the commonest nonsurgical aesthetic procedure. During the procedure lips are assessed for proportion with rest of the face, for symmetry, for balance between the upper and lower lip and for aging changes. This section provides the information lip augmentation with HA filler.

What are different types of lip fillers?
Hyaluronic acid filler is a non-permanent method but the commonest, permanent fillers like Silicon are still used, other methods are fat grafting, subdermal tissue grafting, and surgical implants.

What are the different kind HA fillers used for lip augmentation?
Fillers beneath are form two major brands Galderma and Allergan placed respectively according to the firmness, and plumpness desired.
Restylane Refyne, Kyesse, Silk, L,
Juvederm Vobella, Ultra, Ultra +
Versa and Boletero are other HA form Prollimious and Merz respectively could be used for lip augmentation.

How is a filler chosen from above list of fillers?
It depends on the assessment of the lip and providing what is needed e.g.
Restylane Refyne, Silk and Juvederm Vobella are good for fine lines around the lip
If plumpness is desired, then Restylane Silk and Juvederm Ultra could be selected
For shape Restylane L, Juvederm Ultra +
For subtle change Juvederm Vobella
For the balance of firmness and plumpness Galderma recently introduced Restylane Kysse.

Does it look and feel natural?
The appearance and feel of the natural depends more on the volume and method of injection, then the type of the filler.

How much filler is needed for the lip augmentation?
Most of the situations is 1ml of HA filler is used.

Are lip fillers painful?
The skin of the lip is very thin and is meant to increase the sensation further due to placement of lot more nerve endings as compared to any other portion of the skin. Hence lip fillers are more sensitive then fillers in the other areas. Lips are numbed topically or with injections of lidocaine either in the body of the lip or the dental block.

How long is lip filler procedure?
About 15-30 mins.

How long does the lip filler last?
Lip fillers last from 2 months -9 months.

What are the common side effects of the lip fillers?
The most common side effect is people like the effects and soon want more or repeat as soon as they are gone. Other than that lips are also common areas of lumpiness, asymmetry, tiny nodularity, especially where the wet lip meets the dry lip. Bruising, swelling, some pain, rarely infections.

What is a serious complication of injecting lip filler?
Vascular complication i.e. filler accidently entering the blood vessels, generally this not clear right away and get more prominent in 24 hours. This has to be treated aggressively, but despite treatment there will be ulceration, for some time and healing with scarring could happen. Although most cases heal without long term serious complication.

Are there any delayed complications?
Rarely filler can coalesce and clump forming nodularity, biofilm formation, delayed reaction of the body to the filler, these are rare but general complications of dermal fillers.

Can the filler be reversed?
As mentioned above natural life of the filler is between 2-9 months but if the results are not liked or presence of complication, the filler could be dissolved with enzyme called Hyaluronidase, which is very simple procedure may take 10-30 mins, and 1-3 sessions depending on the type and amount of filler. The effect in observed form one hour post treatment and completes in two days.

Do the lips get wrinkly, loose, and stretched after the lip filler is stopped?
It may appear logically that the lips may turn into loose lose hanging skin, due to the stretch created with frequent filler used, but this not observed clinically, this one way is possible due to frequent stimulation of collagen with passage of needle, cannula and filler.

What other treatment could be used in conjunction with lip filler?
Energy based devices like fractional resurfacing laser, Radiofrequency with micro needling, skin peels, botulinum toxin lip flip are other procedures which can complement the lip fillers. PDO threads could also be used for enhancing lip margin.

Are there any cautions to be used before lip filler?
Avoiding blood thinner like OTC pain killers, fish oil, alcohol, if some one has history of cold sores will need prophylactic medication prior to the procedure. No make up on the day of the procedure. Avoid procedure if any local site of infection, tooth ache, cold symptoms within last 1 week.

What are post filler cautions?
Lips swell more than any other area, the swelling increases for the first 2 nights and then starts to go down. Keeping head elevated on pillow, ibuprofen if medically clear to take, arnica topical or oral will help to reduce swelling. It takes about a week for the swelling to go down completely. During this stage of swelling, they may be more irregular, bumpy which improves in first 7-10 days. We suggest not to massage during this healing stage as the massage in the swollen are will still make the swelling worse.

What is cannula method of lip filler?
Blunt tip micro cannula is the name suggest does not have cutting bevel of the needle, it is technically more advanced, slight more painful, but less risk of serious vascular complication, or bruising, lumps. It also needs less number of punctures in the skin due to longer length.

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