Nearly everyone who comes in wanting their lips done say, “I don’t want to look like Angelina Jolie”. A lot of people think their lips are going to be too large after the enhancement however usually their lips are smaller than they imagined they would be.
The standard amount injected to enhance lips is around 1 ml. It is very unusual for a person to want two mls of filler. However, you can always build up on what you have had at any time after the swelling has settled down in two weeks time (most of the swelling goes after two to three days however there is a small amount of swelling for two weeks).
I occasionally like to do an half ampule to give a lovely, subtle and natural look to the lip, which is cost effective for people on a budget.
A small amount is injected into the lip line border and the Cupid’s bow is enhanced with a subtle ‘micropearl’ drop into the top of the central columns of the Cupid’s bow. The central portion of the bottom lip is often augmented to give a slightly more voluminous look. Often this smaller amount requires no lip or dental block (some numbing cream beforehand is used) and the swelling is usually minimal with a half ampule. Indeed, people often can get this done at the end of the working day and be back at work the next morning.
Sometimes people come in showing us photos of movie stars or models whose lips they admire. To be perfectly honest, it is not really possible to dramatically change the shape of a lip with filler. You can modify the shape of your lip and enhance certain features. You can lift up the corners and add volume, increase the Cupid’s bow and make the lip border more distinct and increase the volume of the body of the lip, however you cannot truly drastically alter the shape.
A lot of people don’t have their lips injected because they fear it’s going to be very painful. I often give a lip block (sometimes known as a dental block) and infiltrate a small amount of local anaesthetic just on the inside of the gum line which numbs the lips generally very well. Also, some numbing gel can be placed on the gum beforehand so the needle prick is less uncomfortable. (I also like to use a vibrating tool on the chin or cheek to minimise the discomfort as well).
Sometimes you can feel a little bit of discomfort in the corners of the mouth or in the centre of the lip, however, overall usually the lip feels very numb.
The next thing that people often say when they come in for the consultation is that they don’t want to have “fish lips” or “trout pout”. This happens when too much filler is injected into the lip border, especially in younger people who have distinct and already full lip borders.
In more mature people, the lip shrinks considerably as we age and the lip line border can become softer and more poorly defined, especially in smokers, wind instrument players, whistlers or even people who unconsciously store tension in their lip.
Injecting into the lip border in these circumstances really adds volume and creates a more youthful looking lip. However one should never overdo this. It is best to inject the body of the lip more, rather than infiltrate too much in the lip border.
The ratio of the top lip to the bottom lip is said ideally to be 1: 1.6. This means, the bottom lip should be approximately 50% bigger than the top lip.
Asiatic people have a tendency to admire lips where the top and bottom lip are in equal proportion. Australians have a tendency to admire a more voluptuous bottom lip compared to the top lip.
Not only is the lip body important, the lip corners are, as well.
As we mature, our lips turn down in the mouth somewhat, so we can look stern, serious or glum. Some filler injected into the corners of the mouth can elevate the corners and give a playful subtle smile to the mouth which can significantly change the overall expression in the face.
Also, above the lip is important as well. The vertical lines in the upper lip in a mature aged person are often called the ‘barcode’ to a woman’s age. These occur when people have smoked or they are chronic pursers of their lip. Some people just carry more tension in their lips and purse them more often and it’s these people who tend to have more vertical lip lines. These can be softened with filler. It’s impossible to make them go away altogether, however you can improve them.
Permanent fillers can be used in the lip; however there is an old cosmetic adage saying, “permanent fillers, permanent problems”. I have used a permanent filler in the past, however had one patient that ended up with a chronic red and inflamed area due to an immune reaction to the filler. It’s very difficult to remove permanent fillers and my inclination is not to use them. However the incidence of problems are really low and I know many reputable injectors and surgeons who use permanent fillers . It is my personal choice not to. There are however surgeons in our practice who use permanent fillers if you would like them.
Whichever way you go, it is important to see someone who has had lots of experience in injecting lips. There is an artistry to it and the secret to success is making them look natural. There is nothing worse than a person’s lips entering the room before they do.
The good news though is, if you don’t like your lips, you can always use an injection to remove or dissolve the dermal filler. This type of injection does cause swelling though and potentially bruising like any injection to the lip. Remember, though, it takes time for the swelling to settle and also it takes some time to get ‘used to’ the new look. It is often like a new hairstyle. When you first get it, you want to go home and wash it out. It is the same with lips, it takes a while to get used to the new look. Initally the swelling is difficult to deal with, then people tend to get used to the swelling and then miss it when it disappears. A little swelling even persists for up to two weeks and when that disappears, people have often already forgotten how their lips used to look and feel as if they cannot even see the difference after the lip filler. The self image adjusts very quickly to the new look and memory is short of how we used to look. That is one of the reasons why it is very important to take a photo prior to the procedure. We will do that in the clinic however it is a good idea for you to take one , even on your mobile phone, prior to coming in.
Another new technique I am using more often is the new needlefree microcannula. This is a very small blunt cannula or tube which is gently inserted into the lip and has a lower incidence of discomfort, swelling and bruising. There is an extra charge for the cannula however for many it is money well spent.