Sustained attractiveness and natural youthful appearance by upper lip rejuvenation: Minimally invasive procedures to combat facial aging

Comparing the Effects of Different Injection Techniques Used in Lip Augmentation on Filler Migration and Patient Satisfaction

OBJECTIVE

Lip rejuvenation has several aims, including enhancing lip volume, adjusting the upper and lower lip's length, diminishing fine lines, contouring and redefining the cupid bow and vermilion border, and eversion of the vermilion. Within the scope of this research, we aimed to compare popular injection techniques to augment the size of the lips.

MATERIALS AND METHODS

This randomized retrospective study included 216 female patients aged 19 to 39, who desired a lip filler treatment from 2017 to 2023. Pre- and post-procedure results were elaborated with top-to-the-bottom technique in Group 1, bottom-to-the-top technique in Group 2, and lateral-to-medial techniques in Groups 3 and 4.Once the patients were sufficiently anesthetized, the hyaluronic acid at a concentration of 20 mg/mL with 0.3% (3 mg/mL) lidocaine, was used in all groups. Patients were followed up for three weeks. Patient satisfaction scores were evaluated on a scale from 0 to 5 using a survey on the last follow-up day.

RESULTS

A statistically significant difference was found between the groups regarding satisfaction scores (p<0.05). The patient satisfaction scores after injection were 4.78/5 in Group 1, 3.70/5 in Group 2, 4.15/5 in Group 3, and 3.85/5 in Group 4. Kruskal-Wallis variance analysis for more than two groups revealed statistically significant differences between Group 1 and Group 2 (p<0.001), Group 1 and Group 3 (p<0.001), Group 1 and Group 4 (p<0.001), and Group 2 and Group 3 (p=0.009) (Mann Whitney U-Test with Bonferroni adjusted). No major complication was observed in any of the patients.

CONCLUSION

In this study, patient satisfaction was found to be highest in the group with needle orientation top to bottom, taking into account migration to the upper lip. These findings showed that the direction of the needle during injection also determines the direction of distribution of the filler on the lip and may be an important factor in patient satisfaction.

Facial vascular danger zones for filler injections

Filler injections are widely used for facial rejuvenation. The technique is safe as long as some precautions are respected. In this review we will focus on vascular anatomy in the upper, middle and lower face. We performed a PUBMED research on "facial danger zones" and "filler injections" and "hyaluronic acid" and "vascular compromise" with a focus on the last decade. This is of particular importance since vascular compromise is one of the most severe adverse events possibly leading to tissue necrosis and in rare cases to loss of vision. We describe the danger zones in these esthetic units and provide recommendations how to avoid severe adverse events. We report on temporal region, glabella and nose, infraorbital region, nasolabial folds and nasal triangle, lips, and chin. Although we focus on hyaluronic acid fillers, our recommendations will also scope other filler types and autologous adipose tissue transfer. We also take a closer look on innovations to improve the safety of facial filler injections. Facial rejuvenation with hyaluronic acid fillers is a popular method. It is safe if the facial danger zones are recognized and proper injection techniques and fillers are used.

Lip enhancement and mouth corner lift with fillers and botulinum toxin A

Beautiful lips are responsible for facial attractiveness and a youthful appearance. During aging process, lips become thinner and the red lips borders get poor defined. Downturn of the corners of the mouth suggests negative emotions. Lip surgery and underlying pathology may result in asymmetries and lip incontinence. Minor invasive procedures with hyaluronic acid fillers and botulinum toxin A are versatile tools to improve appearance of the lips, restore function and improve psycho-social well-being. In this review, we discuss anatomy, safety concerns, injections techniques as well as esthetic and medical indications.

Lip Augmentation Using Post-Auricular Fibroareolar Tissue as a New Autogenous Filler

BACKGROUND

Augmentation of facial components is an acceptable approach in facial aesthetics. The best filler material and the optimal technique for facial soft tissue augmentation still remain to be determined. This study has assessed the lip augmentation using post-auricular fibroareolar tissue as a new autogenous filler.

METHODS

This prospective study enrolled patients who were candidate for lip augmentation. Loose fibroareolar tissue was harvested from post-auricular region and was inserted in the prepared lip pocket. Standard digital photography was used for lip analysis in each patient before and 6 months after surgery (the height and projection of the upper lip and lower lip).

RESULTS

At a mean follow-up period of 6 months, average upper and lower lip height increased from 5.27 to 8.72 mm (p<0.001), and the average upper and lower lip projection increased from 3.97 to 7.75 mm (p<0.001).

CONCLUSION

Our technique was minimally invasive and a safe method, in which post-auricular loose fibroareolar tissue was applied for lip augmentation with minimum donor site morbidity and long-term results. On the follow-up, all patients were satisfied with the results and no patients required any revision operation. Moreover, the complication rate was negligible.