by Dr. David Deng
The lips are the most beautiful and attractive region of a woman’s face. Therefore, it is an important area when it comes to facial aesthetic enhancement. Aging results in a decrease in lips volume and definition. These days, lips filler has been popularised as a lunch time procedure. According to the American Society of Plastic Surgeons report, there is an increase of 66% in lips augmentations for 18 to 55 plus year olds between the year 2000 and 2018.
However, lips filler to get the perfect lips is not always so straightforward. The most common misconception of lips filler that patients have is that it will result in over-volumized and unnatural looking lips. This is further fuelled by social media images of botched lips filler results. In addition, the traditional lips filler approach that aims to volumize the lips for that “Kim Kardashian” look may not be suitable for all Asians who generally have a softer facial aesthetic profile compared to their Caucasian counterparts.
Hence, it is important that medical practitioners discuss with their patients on the goals of treatment prior to administering lips filler. This is because no two lips are the same and no two patients want the same results. The amount of lips definition and volume enhancement should be customised depending on the patient’s lips size and
shape as well as the desired results.
From experience treating mainly Asian patients, they tend to prefer natural subtly enhanced and curvy lips versus the traditional lips filler approach that inflates the entire lips.
So, what is the solution? The cupid’s bow lips filler procedure. In this procedure, micro amounts of filler product is used to accentuate the borders of the lips, in particular the cupid’s bow and also to balance the volume of the top and bottom lips following the Golden Phi Ratio (upper lip volume should be 2/3 that of the lower lip) to achieve the ideal lips (Figure 1) whilst being careful not to over volumize the lips.
Figure 1: The ideal Lips
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How is this done to achieve the desired results?
- Type of Filler
In order to achieve natural looking lips, the choice of filler is important. First and foremost, hyaluronic acid (HA) filler is recommended. This is as opposed to semi-permanent fillers such as Calcium Hydroxyapatite (CaHA) and Polycaprolactone (PCL) which are irreversible and more prone to forming lumps.
Next, amongst the multitude of types of HA fillers, those that are thinner in consistency and higher in elasticity should be used in order to provide the most lips definition in a natural way.
- Technique
Lips filler is routinely injected using a needle (Figure 2). This involves multiple needle pricks in order to shape and volumize the entire lips. As the lips is a sensitive area, this often results in more pain, swelling and higher tendency to bruise.
A cannula technique (Figures 2 and 3) to place the fillers in the lips will typically result in less pain and swelling since it is blunt-tip and not sharp. In this technique, a needle is only used initially to introduce an entry point on both corners of the lips. Thereafter, the blunt-tip cannula is introduced into the lips through the entry points created for filler placement and there is no need for further needle pricks. With the cannula technique, most patients see an immediate result with very little swelling. Swelling if any, is typically limited to around 1 to 2 days. Icing the affected area post-procedure will help to reduce swelling and prevent bruising.
Figure 2: Needle versus cannula techniques
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Figure 3: Lips filler using the cannula technique
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Last but not least, should the patient be unhappy with the results, lips fillers using HA fillers can be easily dissolved using hyaluronidase enzyme, returning the lips to their natural shape and form.
In summary, a combination of using the right filler product and the cannula technique to perform the cupid’s bow filler procedure can provide the most satisfactory results in a natural fashion with no to minimal swelling. It is important that medical practitioners have a thorough examination and consultation prior to embarking on lips filler for their patients, to debunk misconceptions and achieve naturally looking results.