Lips-Beautiful Lips! Part 2

Our next blog in the Beautiful Lips series covers the popular choice of FILLERS. Fillers that are best for lips are made of a water loving molecule called hyaluronic acid (“HA”).  Here is part of the definition from the US FDA website:

“Hyaluronic acid is a type of sugar (polysaccharide) that is present in body tissues, such as in skin and cartilage. It is able to combine with water and swell when in gel form, causing a smoothing/filling effect. Sources of hyaluronic acid used in dermal fillers can be from bacteria or rooster combs (avian). Hyaluronic acid used in dermal fillers is chemically modified (crosslinked) to make it last longer in the body”

Pros to the use of filler is that it can add fullness, soften or erase lines, and improve the shape.  Fillers typically last 6 months to 18 months, depending on the product used and your body’s response to filler.

Cons can be bruising, shorter than typical duration, and in rare cases, wounds from injecting into a blood vessel or late onset swelling or lumps or hypersensitivity.  During the consent process, we explain the potential complications.  More information is available to consumers on each product’s product information page.  Complications are rare and can be lessened by careful patient screening, as well as advanced injector training and their injection techniques. Dignity Medical Aesthetics prides itself in being a training center for injectors outside of our practice.

Now back to the starting point.  If you select filler as your option, which one should be used?

Dignity Medical Aesthetics prefers the use of fillers made by Allergan. They have a menu of fillers to meet the needs of our patients.  We love their duration which adds to the value of the product. 

Currently there are over 30 fillers approved for use in Europe.  America takes a different approach, and filler choices are more limited. This is because of the testing and safety requirements by the FDA.  When a product is approved in the US, it is often for one particular area, such as this definition for Juvederm Ultra: “Juvederm Ultra XC is for injection into the lips and perioral area for lip augmentation in adults over the age of 21.”

More information can be found on the FDA’s website here.

Now for the everyday discussion of filler choices:

1. We believe in patient comfort during injections!  We strongly advocate the use of a topical gel anesthetic 30 minutes prior to injections which is provided to our patients at no additional charge.  In addition, we use products that contain Lidocaine that numbs the lips within 3 seconds of injections. If a patient feels discomfort even after both of the above, we add ice.  We have many patients who deeply appreciate our focus not only on beautiful outcomes, but patient comfort during the treatment.
2. You have a large part in preventing bruises.  Avoid taking things that increase the chance of bruising for one week prior to treatments. Common causes of bruises are the use of Aspirin and NSAIDS (Ibuprofen, Advil, Aleve, Celebrex, and other anti-inflammatories), fish oil and other supplements.  Avoid alcohol for 2-3 days prior and the day of treatment as well.
3. Plan for some swelling after injections.  We encourage of post treatment visit 2 weeks after the first time a patient has filler because swelling and bruising can last up to two weeks.  In rare cases, swelling can develop later as well.  Ice is helpful for the first day or two, but if swelling persists, try switching to warm compresses.
4. Current fillers on the market typically have between .55 ml and 1 ml of product in the syringe.  To put it in perspective, a teaspoon contains 5 mls.  It is difficult to have overdone or overfilled lips with just one syringe.  In fact, many photos we see on the covers of celebrity magazines have lips caused by lip implants with scarring or multiple syringes of fillers.
5. Understand that your body’s metabolization of fillers affects the duration.  Some patients get much longer durations or much shorter durations.  Short durations, also called “Hypermetabolization” can occur in some people for no known reason.  One contributing factor for some people who get shorter durations has been reported in some people who exercise heavily and frequently.

Now for information on product choice:

1. For basic lip augmentation for a soft, natural feel, we suggest Juvederm Ultra XC.  It is approved by the FDA for the use in lips.  As reported on the Allergan website:

• 78% (58/74) of people treated experienced improvement in satisfaction with the look and feel of their lips 1 year later
• When treated again after 1 year, patients needed less product to achieve their results.

1. For more projection, that is, for lips that will appear fuller and may “Puff out” more than typical, or for people who metabolize the first choice faster than expected, some of our patients select Juvederm Ultra Plus XC. This product is “Off label” by the FDA for lips but commonly used in practices.

In conclusion, there are several great options for lip enhancement and beauty.  Many patients choose to combine 2 or even all three treatment options.  We highly encourage people considering lip treatments to schedule a new patient consultation to find out all about the options available, view before and after photos as well as ask questions about outcomes and expectations.

Before & After