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“I had a filler patient today that came in for a second opinion after having her lips injected for the first time. The patient had over 2 ml of one of the products, the HA products, the primary to use in this country are Restylane and Juvederm although Belotero’s making a good inroad from the Merz company as an HA filler. All these fillers are the primary fillers used for the lips, the HA’s are long chain sugars that are cross lengths, there are subtle differences in their performance, talked about this before, the main ones being that the Juvederm holds a little more body waters so it gives a little bit more of a puffy look. Restylane holds less, it’s a little stiffer and holds its structure and there’s Restylane silk and of course now volbellas some newer ones we’ve talked about that can be used for fine lines respectively but in general when someone’s coming for a first-time consultation for lips, that is a good question is “How much do you need” and there is not a right answer for that. I would say that the national average for lips is about 1 ml and so if someone for first time injection even if they want really big lips and they’re starting with small lips, doing 2 ml is a really extreme amount of filler to do and of course that be on the swelling is not going to drowned dramatically.
So, in general, there’s a formula that we use for patients, for people who have small to moderate size lips. I typically don’t go both beyond .5 to 1 ml props. For people who have larger lips or have had experienced with it, I will sometimes exceed 1 maybe 1.5 ml, if we’re just talking about enhancing the vermillion part of the lip. Now I’m not talking about commissures where the fine lines secreases around the mouth because that’s a different indication on different discussion.
So, if you’re wondering about how much you need and that’s the question that’s often asked because it’s directly correlated to the condition you’re starting with. I would just tell you starting with a half to 1 ml of any one of the products I described and they all as I’ve said they have different characteristics that maybe an advantage for you or disadvantage then I would tell you to stay in that range.
The main goals we want are getting back to the beautiful lip. A beautiful lip is the diamond in shape that turns sideways with the vermillion being the high point on each side. So a diamond in shape is what we’re looking at, we don’t want to be the rectangle that it becomes when we age and so the white lips get longer, want to keep that nice fullness Definition of the vermillion boarder is very important where we often see this smokers lines with age having lip volume particularly in the body of the lip, very good study looking lip attractiveness showed that a lot of volume in the middle of the lip is unattractive we call that the tubercle so it’s the lateral, the body of the lip in the upper and the central lower lip I saw a patient last week that have a lot of augmentation of the lower lip out by the commissure corner and that looks unnatural and unattractive. Most of the volume should be in the middle portion of the lip, we do it technique, we call the pillow technique which really supplements or augments the natural cleft that’s in the center of the lip that’s actually an embryologic feature, something really important with.
So, if you have any questions about lip augmentation or enhancement, to volume or technique or specifications, are you a candidate and there’s a lot of great question I’ve had, please don’t hesitate to send me a photo, a video or a question you can do that, shared privately or publicly, send that to DrMaas.com and as always, I’m happy to keep you looking your best.”
