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Wan J, Chan LKW, Lee KWA, Cartier H, Yi K. Volumizing threads and hyaluronic acid filler for lip augmentation. Skin Res Technol 2024; 30:e13797. [PMID: 38887137 PMCID: PMC11182780 DOI: 10.1111/srt.13797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/17/2024] [Accepted: 05/27/2024] [Indexed: 06/20/2024]
Affiliation(s)
- Jovian Wan
- Asia‐Pacific Aesthetic AcademyHong KongHong Kong
| | | | | | | | - Kyu‐Ho Yi
- Division in Anatomy and Developmental Biology, Department of Oral BiologyHuman Identification Research Institute, BK21 FOUR Project, Yonsei University College of DentistrySeoulSouth Korea
- Maylin Clinic (Apgujeong)SeoulSouth Korea
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Loyo M, Kontis T. Creating Ideal Lips with Toxins and Fillers. Clin Plast Surg 2023; 50:455-464. [PMID: 37169411 DOI: 10.1016/j.cps.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Affiliation(s)
- Myriam Loyo
- Division of Facial Plastic & Reconstructive Surgery, Department of Otolaryngology & Head and Neck Surgery, Oregon Health & Sciences University, CH5E, 3303 SW Bond Avenue, Portland, OR 97239, USA.
| | - Theda Kontis
- Department of Otolaryngology-Head and Neck Surgery, Department of Plastic and Reconstructive Surgery, Johns Hopkins, 1838 Greene Tree Road, Suite 370, Baltimore, MD 21208, USA
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Creating Ideal Lips with Toxins and Fillers. Facial Plast Surg Clin North Am 2022; 30:365-374. [DOI: 10.1016/j.fsc.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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A New Approach for Lip Filler Injection Using an Inverted Mercedes Benz Sign. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3999. [PMID: 34912660 PMCID: PMC8670592 DOI: 10.1097/gox.0000000000003999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 10/27/2021] [Indexed: 11/26/2022]
Abstract
Lip fillers have a great impact on the facial aesthetic industry, where several techniques have been proposed for lip beautification in terms of both the results and delivering a safe injection procedure. The study aimed to report a personal experience with a new lip filler technique, via inserting a microcannula through three entry points, resembling an inverted Mercedes Benz sign. Ten female patients between 22 and 29 years of age had a lip filler treatment with a cross-linked hyaluronic acid injected using a microcannula through two entry points at both Glogau-Klein points of the upper lip and one entry point at the midline of the lower lip. The filler product was deposited in both retrograde and aliquots fashion in the superficial muscular plane. All patients reported a high degree of satisfaction with the results of the procedure, with slight swelling and bruising transiently present in some of the patients. Unlike the conventional cannula technique, this new technique offers artistry in accentuating the cupid’s bow and redrawing the lips.
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Peng J, Peng HP. Classifications and injection strategy for lip reshaping in Asians. J Cosmet Dermatol 2020; 19:2519-2528. [DOI: 10.1111/jocd.13635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/12/2020] [Accepted: 07/14/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Jui‐Hui Peng
- Kaohsiung Chang‐Gung Memorial Hospital Kaohsiung Taiwan
| | - Hsien‐Li Peter Peng
- P‐Skin Professional Clinic Kaohsiung Taiwan
- Department of Dermatology Tri‐Service General Hospital National Defense Medical Center Taipei Taiwan
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Jeong TK, Kim YM, Min KH. Classification of Mouth Corners in Asian Women. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2608. [PMID: 32309070 PMCID: PMC7159957 DOI: 10.1097/gox.0000000000002608] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 11/08/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is increasing interest in mouth corner lift (MCL), as well as lip augmentation. Procedures for lip corner lifting to create smiling lips include botulinum toxin, injectable filler, and surgery. However, there is no proper system to classify mouth corners, thereby causing difficulties in patient counseling, treatment planning, and communicating with medical staff. We developed a new classification system to analyze the shape of mouth corners in Asian women. METHODS Lip shapes were classified as types I (arched upper lip) and II (flat upper lip), each of which was further classified as subtypes a (upturned mouth corner) and b (flat or downturned mouth corner). Atypical cases were classified as type III. The anterior-posterior view of facial photographs were taken of female patients aged 20-40 years who visited HB Plastic Surgery Clinic between January 2017 and December 2018. Patients who visited for surgery other than lip plastic surgery (group A) and those who visited for MCL (group B) were compared. Changes in mouth corner type across age were examined. RESULTS The most common type was IIb in group A and Ib in group B. IIa and IIb were more common in group A, whereas Ib was more common in group B, at a statistically significant level. With increasing age, the proportions of IIb and III tended to increase, and Ia and IIa tended to decrease. CONCLUSION This relatively simple classification system for mouth corners might be helpful in patient counseling and communication with medical staff during plastic surgery.
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Affiliation(s)
| | - Young Min Kim
- Department of Plastic and Reconstructive Surgery, Eulji University School of Medicine, Eulji General Hospital, Seoul, Korea
| | - Kyung Hee Min
- Department of Plastic and Reconstructive Surgery, Eulji University School of Medicine, Eulji General Hospital, Seoul, Korea
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Sito G, Consolini L, Trévidic P. Proposed Guide to Lip Treatment in Caucasian Women Using Objective and Measurable Parameters. Aesthet Surg J 2019; 39:NP474-NP483. [PMID: 30783659 DOI: 10.1093/asj/sjz026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The lips are a focal point of the face; however, their aesthetic proportions and effect on perceived facial beauty remain poorly defined. Perioral aging is highly individual, with several distinct and often simultaneous processes contributing to changes in lip contour and surface. These processes can affect lip volume and length, shape, and the degree of vermilion inversion. OBJECTIVES We aimed to develop a treatment guide for Caucasian women that combined a complete analysis of the lips (including the effects of aging) with consideration of the rheological characteristics of the products used to assist practitioners in tailoring rejuvenation treatment to individual patients. METHODS We reviewed existing literature to analyze the parameters that make the lips of Caucasian women "attractive" and investigated the rheological characteristics of different hyaluronic fillers to provide guidance on the optimal treatment for each woman. RESULTS Our numerical definition of the lips is based on 4 specific parameters: philtrum height, upper vermillion height, ratio between philtrum and upper vermillion height, and golden ratio between upper and lower vermillion height. In our opinion, conserving the length of hyaluronic acid chains results in dynamic fillers that may provide better results with lower risk of asymmetry compared with conventional products. CONCLUSIONS This new classification and associated treatment guideline aims to allow accurate assessment and enable practitioners to customize treatment for individual patients.
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Surgical Management of the Superior Lip as a Complement in Facial Features Remodeling Surgery. J Craniofac Surg 2019; 30:918-920. [PMID: 31048618 DOI: 10.1097/scs.0000000000005382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The lower 3rd of the face is an essential area to pay attention to achieve excellent results in facial features remodeling surgery (FFRS). Because of its importance in facial remodeling surgery, special care has been taken in upper lip procedures. A combination of treatments has been used for the upper lip, which include surgical and nonsurgical procedures, depending on the patient assessment. The authors use a subnasal lip lift when surgery is required. This study describes the use of lip lift in combination with FFRS.
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Abstract
This article examines 6 questions about lip augmentation answered by 3 experts in their field of facial plastic surgery. The topics covered include high-yield areas such as injection, surgical enhancement, rhytid resurfacing, implants, complications, and technique changes over the years. All the authors answered these questions in a "How I do it" manner to provide the reader with a true understanding of their thoughts and techniques. This article provides a practical resource to all physicians and practitioners performing lip augmentation on some of the most common questions and issues.
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Pascali M, Quarato D, Carinci F. Filling Procedures for Lip and Perioral Rejuvenation: A Systematic Review. Rejuvenation Res 2018; 21:553-559. [PMID: 29911505 DOI: 10.1089/rej.2017.1941] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The ideal perioral and lip rejuvenation technique provides the longest period of efficacy, lowest complication rate, and best esthetic results. Genetics, intrinsic aging, sun exposure, and repetitive muscle twitching of the orbicularis oris produce angular, radial, and vertical lines of the perioral lines and, for this reason, the needs of patients in the treatment of this anatomical area can range from simple lip enhancement to a broader and more comprehensive treatment with simultaneous correction of perioral wrinkles. A myriad of materials have been described for rejuvenation of this area. At present, the most popular and commonly used lip enhancers are dermal fillers, but there is still no agreement on what the best material for filling soft tissue of the face and in particular of the perioral region is. This systematic review will focus on the various dermal fillers, of different materials approved by the US Food and Drug Administration (FDA) namely poly-L-lactic acid, calcium hydroxylapatite, and hyaluronic acid and also different grafts, for perioral rejuvenation, with the goal of determining the optimal approach. A systematic search for English studies involving perioral rejuvenation was performed using these databases: PubMed, Google Scholar, and Ovid, using a combined keyword search or medical subject headings. At the end of our study selection process, 17 relevant publications were included. For each study, year of publication, type of material used for filling, number of patients, subject of study assessment, and efficacy of the filler procedure for lip rejuvenation were analyzed.
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Affiliation(s)
- Michele Pascali
- 1 Department of Plastic and Reconstructive Surgery, University of Rome Tor Vergata, Rome, Italy
| | | | - Francesco Carinci
- 3 Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
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Kim SW, Rousso DE. Determining the 2-Dimensional Threshold for Perception of Artificial-Appearing Lips. JAMA FACIAL PLAST SU 2017; 19:392-398. [PMID: 28384792 DOI: 10.1001/jamafacial.2017.0052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Recognizing the perceptual threshold for artificial-appearing lips is important to avoid an undesirable outcome of treatment. Objective To characterize the quantitative measurements for the perceptual threshold of artificial- and unnatural-appearing lips. Design, Setting, and Participants Photographs of a female model's lips were digitally altered incrementally in 5 sets of features (the upper lip, lower lip, upper and lower lips, and shape of the Cupid's bow). From December 1, 2013, to January 30, 2014, participants viewed the photographs in random sequence using an online survey and responded to 2 questionnaires after each photograph. The participants were prompted to respond whether each altered photograph of the lips appeared to have received any cosmetic treatment, and whether the lips looked attractive and natural or artificial and unnatural. The measurement of each lip at which 50% of the observers perceived the lips as being treated and 50% of the observers perceived the lips as being artificial was determined. The difference in these 2 measurements was defined as dTA50, which represents the threshold differential between the perception of treated lips and artificial lips for 50% of the observers. Main Outcomes and Measures Survey responses of the participants to the appearance of the lips in the photographs. Results A total of 98 participants (76 females and 22 males; mean age, 42 years) provided usable responses to the survey. Each area of the lips had a unique quantitative measurement at which the observers perceived the lips as being treated and artificial. Enhancement of the upper lip alone had a narrower margin for artificial appearance (dTA50, 0.9 mm) compared with enhancement of both the upper and lower lips (dTA50, 1.5 mm). Any alteration to the Cupid's bow resulted in the narrowest margin for artificial appearance (dTA50, 0.3 mm). The difference in the perceptual threshold between the age of the observers was the most significant for the upper lip. Conclusions and Relevance The perceptual threshold for treated and/or artificial appearance is unique for each area of the lips. Level of Evidence NA.
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Affiliation(s)
- Sang W Kim
- Natural Face Clinics, Syracuse, New York
| | - Daniel E Rousso
- Rousso Facial Plastic Surgery Clinic, Birmingham, Alabama.,Department of Surgery, University of Alabama at Birmingham
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Bagheri H, Sirinturk S, Govsa F, Pinar Y, Ozer MA. Computer-assisted analysis contour lines of aesthetic unit for the assessment of lip augmentation. EUROPEAN JOURNAL OF PLASTIC SURGERY 2016. [DOI: 10.1007/s00238-016-1190-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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An Open-Label, Multicenter, Evaluator-Blinded Study to Assess the Efficacy and Safety of a New Hyaluronic Acid–Based Gel Product for Lip Enhancement. Dermatol Surg 2015; 41:1052-9. [DOI: 10.1097/dss.0000000000000432] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Systematic review of "filling" procedures for lip augmentation regarding types of material, outcomes and complications. J Craniomaxillofac Surg 2015; 43:883-906. [PMID: 25957105 DOI: 10.1016/j.jcms.2015.03.032] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 03/25/2015] [Accepted: 03/26/2015] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The ideal lip augmentation technique provides the longest period of efficacy, lowest complication rate, and best aesthetic results. A myriad of techniques have been described for lip augmentation, but the optimal approach has not yet been established. This systematic review with meta-regression will focus on the various filling procedures for lip augmentation (FPLA), with the goal of determining the optimal approach. METHODS A systematic search for all English, French, Spanish, German, Italian, Portuguese and Dutch language studies involving FPLA was performed using these databases: Elsevier Science Direct, PubMed, Highwire Press, Springer Standard Collection, SAGE, DOAJ, Sweetswise, Free E-Journals, Ovid Lippincott Williams & Wilkins, Willey Online Library Journals, and Cochrane Plus. The reference section of every study selected through this database search was subsequently examined to identify additional relevant studies. RESULTS The database search yielded 29 studies. Nine more studies were retrieved from the reference sections of these 29 studies. The level of evidence ratings of these 38 studies were as follows: level Ib, four studies; level IIb, four studies; level IIIb, one study; and level IV, 29 studies. Ten studies were prospective. CONCLUSIONS This systematic review sought to highlight all the quality data currently available regarding FPLA. Because of the considerable diversity of procedures, no definitive comparisons or conclusions were possible. Additional prospective studies and clinical trials are required to more conclusively determine the most appropriate approach for this procedure. LEVEL OF EVIDENCE IV.
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A Randomized, Evaluator-Blinded, Controlled Study of Effectiveness and Safety of Small Particle Hyaluronic Acid Plus Lidocaine for Lip Augmentation and Perioral Rhytides. Dermatol Surg 2015; 41 Suppl 1:S127-36. [DOI: 10.1097/dss.0000000000000199] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Classification of the Aging Lips: A Foundation for an Integrated Approach to Perioral Rejuvenation. Aesthetic Plast Surg 2015; 39:1-7. [PMID: 25409624 DOI: 10.1007/s00266-014-0415-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 10/03/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Although perioral aging is highly individual with several distinct processes taking part simultaneously, there is scarce systematic information which helps to indicate the right rejuvenation approach among the multitude of proposed procedures. Existing data about perioral aging has not yet been transformed into a consistent therapeutic concept. The intention of this study was to provide a simple, yet reproducible classification and to offer appropriate rejuvenation approaches. METHODS To identify reliable and constant landmarks of the ongoing process of perioral aging, 462 perioral photo documentations were morphometrically analyzed. Based upon the identified landmarks a two-dimensional classification was developed. The classification was validated by three plastic surgeons. Inter- and intra-rater reliability was calculated using Cohen's kappa coefficient. RESULTS Perioral aging can be broken down into changes of the lip shape and changes of the lip surface. Both processes can be classified into three stages each: Lip shape according to the shape in profile view, the lip length in relation to the frontal incisors, and the degree of vermilion inversion. Lip surface according to the presence and degree of radial wrinkles and the visibility of the structural elements Cupid's bow, philtrum, and white roll. Inter-observer reliability was rated very good (kappa values between 0.819 and 0.963) and perfect for intra-observer reliability (1.0). CONCLUSION A better understanding of perioral aging leads to a simple classification for the aging lips. Using the classification helps to tailor an appropriate treatment to the individual patient and aids to achieve a natural rejuvenation result.
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Gassia V, Raspaldo H, Niforos FR, Michaud T. Global 3-dimensional approach to natural rejuvenation: recommendations for perioral, nose, and ear rejuvenation. J Cosmet Dermatol 2014; 12:123-36. [PMID: 23725306 DOI: 10.1111/jocd.12035] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is a move toward a global, 3-dimensional approach to facial rejuvenation that has been prompted by advances in techniques and available products. However, little published literature exists on the procedures involved in this global approach, and currently, no validated recommendations exist. OBJECTIVES To provide a detailed, practical guide to rejuvenation of the perioral area, nose, and ears based on expert consensus recommendations. METHODS The aim of this approach was to take into account both volumetric and dynamic aspects of treatment, as well as the benefits of treatment combinations, for example, combining botulinum toxins with hyaluronic acid (HA) fillers and volumizers. Each set of recommendations was documented, comprising a clinical definition of the aging severity scale, together with recommendations of appropriate products, doses, site, depth, and injection techniques, as well as indication-specific rules to be respected. RESULTS HA fillers are ideal for replenishing volume loss in the lips, while rhytides around the lips can be treated with small doses of botulinum toxin. Botulinum toxin can also be used to raise the tip of the nose, to reshape nostrils, and to narrow nasal flare, with HA fillers also be used to correct small defects. HA fillers can also be used to rejuvenate sagging, atrophic or irregular ear lobes, repair torn earlobes, or erase vertical rhytides. CONCLUSIONS By providing practical guidance on rejuvenation of the perioral area, nose, and ears, esthetic facial physicians can achieve optimum patient outcomes.
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Fagien S, Maas C, Murphy DK, Thomas JA, Beddingfield FC. Juvederm ultra for lip enhancement: an open-label, multicenter study. Aesthet Surg J 2013; 33:414-20. [PMID: 23515385 DOI: 10.1177/1090820x13478609] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Juvéderm Ultra injectable gel (Allergan, Inc, Irvine, California) is approved in the United States to treat moderate to severe wrinkles and folds, such as nasolabial folds. It is also used to enhance the appearance of the lips. OBJECTIVES The authors evaluated the safety and effectiveness of Juvéderm Ultra injectable gel for lip enhancement and assessed the utility of 3 new lip-specific effectiveness scales. METHODS In this multicenter study, 50 subjects received lip enhancement with Juvéderm Ultra injectable gel. The subjects were observed closely by the treating investigator and results were evaluated by a blinded independent rater and by subject self-assessment for up to 48 weeks to determine the durability of the effects. A validated lip fullness scale (LFS) was used for analysis. Treatment satisfaction was assessed by investigators and subjects using an 11-point scale. RESULTS At week 12, 71% of subjects had achieved their goals for lip fullness and had maintained improvement of at least 1 grade on the LFS, which greatly exceeded the a priori criterion of 40% for success. At week 24, improvement in lip fullness was still present for 56% of subjects. Satisfaction and goal achievement exceeded 90% for subjects as well as investigators. Common side effects were predominantly mild or moderate in intensity and resolved within 1 week in the majority of subjects. CONCLUSIONS Juvéderm Ultra injectable gel is safe and effective for lip enhancement. Scales for assessing lip fullness provide an objective method to determine the effectiveness of treatment.
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Cohen JL, Dayan SH, Brandt FS, Nelson DB, Axford-Gatley RA, Theisen MJ, Narins RS. Systematic Review of Clinical Trials of Small- and Large-Gel-Particle Hyaluronic Acid Injectable Fillers for Aesthetic Soft Tissue Augmentation. Dermatol Surg 2013; 39:205-31. [DOI: 10.1111/dsu.12036] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Maloney BP, Truswell W, Waldman SR. Lip augmentation: discussion and debate. Facial Plast Surg Clin North Am 2012; 20:327-46. [PMID: 22910023 DOI: 10.1016/j.fsc.2012.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Brian P. Maloney, William Truswell IV, and S. Randolph Waldman, address questions for discussion and debate:
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Affiliation(s)
- Brian P Maloney
- Maloney Center for Facial Plastic Surgery, Atlanta, GA 30328, USA.
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Lemperle G, Anderson R, Knapp TR. An index for quantitative assessment of lip augmentation. Aesthet Surg J 2010; 30:301-10. [PMID: 20601553 DOI: 10.1177/1090820x10374095] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Lip dimensions and their relation to the whole face have been discussed mainly in the dental literature. There have been few attempts to scientifically measure the degree of lip augmentation, regardless of method. OBJECTIVES The authors describe a Lip Index that will allow reliable, quantitative analysis of the human lip complex, which is necessary to assess the efficacy and duration of attempts at lip augmentation. METHODS The authors developed a Lip Index as the basis for objective measurements of the effect and duration of lip augmentation with dermal fillers. Measurements may be taken directly from the patient, from standardized photos, or from the computer screen. Using a metric ruler, the height of the vermilion in the middle of the Cupid's bow is first measured (in mm) on the frontal view. The point of maximum protrusion of the vermilion is then measured (in mm) on a standardized side view perpendicular to a vertical line connecting the base of the columella to the fold demarcating lower lip and chin. Vermilion height multiplied by horizontal protrusion directly correlates with the central volume of the lips, upper and lower. RESULTS The easily applied ruler provided consistent measures before and after the injection of dermal fillers or soft implants. Adding upper and lower lip indices resulted in the Overall Lip Index for each patient, which was found to be approximately 50 in average females of Caucasian descent, about 100 in females of Asian descent, and nearly 200 in females of African descent. CONCLUSIONS The Lip Index allows for the practical evaluation of the clinical effects and duration of dermal filler injectables or implants. Quantitative assessments of results over time are easy to calculate, without the need for complex measurements or sophisticated analyses.
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Affiliation(s)
- Gottfried Lemperle
- Division of Plastic Surgery at the University of California, San Diego, CA, USA.
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