* The following auto-generated transcript has not been proofread for grammar, spelling or accuracy.
“I wanted to talk a little bit today about a common issue and that’s the lips. People come in and they talk about thin lips that they were born with or thin lips that they develop with aging. Lines around the lips down turn corners to the lips, the ratio of the white part of the lip to the red and that’s really how the lip is structured. There’s the white lip which is the part of the lower nose and then the vermillion or red lip which is the border the we commonly think of us are lip and the lower lip which extends from the chin all the way up to this vermillion or red part of the lower lip. So those components to those ratios become very important in terms of statics and how we look overall. When we age one of the features is the perioral area, that area becomes quiet noticeable or quiet significant. In the upper face we see sagging and wrinkles around the eyes, we’ll see shallowness or depression Ptosis of the cheek area and of course the jowls around the neckline and loss of the contour of the neck but in all of patients and all of our just people in general the area around the mouth becomes a significant feature in the aging process and a significant feature in general for aesthetics, for both men and women.
The primary treatments that’s being provided everyone now is just filling the lips and I can tell everyone that, that’s really only a small part of the picture. Although a significant one and one that cannot add some very nice benefits we like to look at the lip as an entire complex. When you look at a youthful lip, you’ll see that a youthful lip is very commonly more diamond shaped so there’s fullness through the mid portion of the lip and if we look at the aging lip in contrast it’s more elongated, when we look at a youthful lip the ratio of the white part of the lip from the bottom of the nose down to the vermillion or red boarder to the red lip itself can be 1 to 1 in some cases at people like Angelina Jolie that are thought was having full lips, 1 to 2 is nice, that’s white to red lips. When she’s get below 1 to 3 that means in the area or a ratio of 1 part lip white lip to 4 parts red lip, the lip is getting quiet thin and there are number of options for addressing that which I’ll talk about.
In addition to the shape the diamond, the lip that we talked about and the ratio of the red to the white lip we also think about the features of the white lip itself as it smooths skin or do we see the little radial so called smokers lines there on the upper and lower lip and so those areas are really important and once that’s often not talked about is the little role it’s at right at the boarder of the vermillion and the white just slightly loops out we call that the white roll and that white roll is a very important part of definition in fact women are accentuated very commonly by using lip liner.
So the youthful lip has those feature, a nice lip roll, a nice ratio of white to red lip, 1 to 2, 1 to 1 in that ratio 1 to 3 is still good. There are very smooth skin that we see in the upper and lower lips that approach the lip and the texture of the vermillion or red part of the lip itself is important. The fullness of the lips is very well defined and in some patients have a very nice philtrum which are the 2 lines that extend from the nose down to the center portion of the mouth which are the lateral or outside aspects of the so-called cupids bow, the little curvature that we see in the mid portion of the lip.
There is a very attractive lip configuration that doesn’t have a filter where we have lateral lobules then there’s a number of actresses over the years that have that lips that we would recognize that have a absence of the philtrum but a nice full lateral lobule to the lip either of those can be attractive, most of us have a cultural configuration with the cupids bow.
In contrast with the aging lip or lips that are thin and this can happen in younger people we see a ratio of white to red lip that is extended beyond 1 to 4 can be 1 to 5 and some patients that i’ve seen it’s really just a very small boarder or line of red lip that we see when speaking or even in repost when we’re relaxing. There are corners of the mouth that begin to turn down the effect of a jawling as the tissue sink here in the cheek, gives the down turn lip and in somewhat in impacted by the action of the depressor anguli oris, a muscle that is inserted at the corner of our mouth can actually pulls it down as we age that gets more powerful and creates a downward force that pulls the lip down forcing is into an expression that makes us look angry or frustrated and so we can correct those in a couple of fashions which we’ll talk about later.
Again, getting back to the key feature which I think people focused on primarily, volume. Volume is a very relatively simple process that can be done in the office, there are number of different injectable fillers, the HA fillers primarily that I think are safe, effective and most importantly adjustable that we can get just perfect, in the end we like everybody to have a natural youthful lip that in parts a bigger and happiness and not a sour or dower expression to our faces whether its age related or whether it’s something that you were born with.
So in summary what we’re looking for is the ideal configuration to the perioral or around the mouth area including the lips. We’d like to see nice contour in shape to the lower lip better to avoid the deep lines or downward turn or a dower expression and that in parts the impression of being vigorous and happy ad youthful, something that we want at any age. The options that we have surgically or non-surgically include the fillers that I mentioned earlier there’s a lip lift that we can do, there’s a couple of approaches to that and I’ll get into that in more detail later, there’s a corner of the mouth lip that if it’s a severe down turn, of course we like the idea of making sure that there’s no radial lines that the skin of the white part of the lip is nice and smooth and all of those procedures or approaches are beneficial and trying to get closer to the perfect lip for you. As always I welcome any questions that you have and I very much appreciate your watching and listening. This is Corey S. Maas MDTM on looking your best.”
