Lip Fillers

Author: Dr. Oreste Di Mattei Di Matteo

Date: 21/11/2019

Lip fillers are injectable fillers that gently enhance the lips and face.

Lip fillers are used for lip enhancement; this procedure allows you to strategically inject dermal fillers into: 
• parts of the lip
• areas surrounding the lip
to enhance:
 shape, including contour and perioral area
• add volume to your lips.  
With lip fillers, wrinkles around the mouth can also be reduced, strengthening the skin and making it less prone to developing wrinkles. 
Loss of lip volume occurs naturally over time, and replacing this lost volume can lead to a more youthful appearance of the face.
Filling around the lips can be as important as filling the lips themselves. In what way? 
For example, correcting the fine lines of the upper lip, or lifting the corners of the mouth can be as important as increasing the volume of the lips themselves. 

Lip fillers: a complex balance for natural results
From a clinical point of view it is necessary to detect certain characteristics such as: 
 shape and proportions of the lips 
• perioral soft tissue
• bone tissue and teeth that support the lips
From a structural point of view 
when stationary: 
the lower lip will be more fleshy and voluminous than the upper lip 
• the upperlip must appear defined and with a slight eversion of the Cupid's bow and the ridges of the philtrum
when in motion
A beautiful smile is represented by:
 displaying all of the top front teeth • displaying the lower teeth partially ornot at all 
These evaluation criteria are necessary for: 
• the correct analysis of the patient
• their current condition
• their expectations
• the likelihood of satisfaction

What areas of the lip can be improved with lip fillers?
Below are the perioral and lip areas that can be treated with lip fillers: 
• vermilion is the red part of the lips, the area that is most commonly enhanced. Typically the volume of both the upper and lower lips is increased in many cases to achieve a natural balance.
• the junction between the white and red parts of the lips can be improved by injecting dermal fillers to improve the definition of the lips. 
• Correction of vertical lines of the upper lip, if present, is also important for lip enhancement. 
• corners of the mouth can also be filled. This area usually increases with age due to the effect of gravity on the skin of the cheek. Filling this area transforms the corners of the lips giving you a positive and happy expression.
• The philtrum consists of 2 lines in the middle of the upper lip that connect to the nose. By improving the appearance of this area, you can give the upper lip added sensuality.
• the Cupid's bow, or the V-shaped area in the centre of the upper lip, can also be improved with dermal fillers. 

What types of dermal fillers are available?
To obtain natural results, resorbable lip fillers are available that integrate and respect the tissues into which they are injected, giving natural results both during facial movements and at rest. 
These products last for a temporary period. 
If you opt for a longer duration, then you can resort to the use of autologous adipose tissue: 
taken, properly treated and injected; the result is natural and with the advantage of using tissue derived from the same person. 
Many lip fillers are in the form of a transparent gel composed of a substance that is naturally found in the skin, hyaluronic acid. 
The main differences between fillers are:
• viscosity
• longevity.  
The thinner and more uniform ones tend not to last long.
Thicker, viscous fillers last longer. 
Most preparations also contain lidocaine, a local anaesthetic, which is used to reduce pain during injection. It is possible to fill a sensitive area like the lips with minimal discomfort.
Thefollowing can be used on the perioral area:

• hyaluronic acid fillers

• biostimulation

• laser

• peeling

in order to improve tone, fine lines and texture.
There are also outpatient surgical procedures that can be performed to reduce an excessively long lip (lip-lift) or to remove, even partially, previous permanent materials used to increase the volume of the lips and that over time have created distortions to the normal shape. 

How are lip fillers injected?
Lip enhancement is usually performed with dermal lip fillers. 
There are many types of dermal fillers and the results can be temporary with varying durations depending on the type of dermal filler used. 
Each has its pros and cons and adapts to different needs.
The first step is to consult an experienced doctor and schedule a visit to discuss the goals and personal expectations for your lip enhancement; you must be aware of what can be achieved in reality. 
It is important to understand that your lips can be improved, but they cannot be changed. They can be fuller, more defined and rejuvenated, but not transformed. 
What techniques are used to inject lip fillers?
The techniques used are non-invasive, are well tolerated and it is possible to use:
• very thin needles 
• micro-cannulas. 

Depending on the lip filler, if you opt for temporary ones, you can have results that last from 4 to 24 months. 

The side effects of lip fillers 

The most common are: 

• temporary redness after injections

• swelling after the procedure and after any type of lip enhancement. Post-treatment swelling tends to improve over time. 
• There can be bruising, which normally disappears in 1 or 2 weeks, and disappears completely.
• Asymmetry: asymmetry is a possible risk. But it can be corrected. 
• Lumps Lumps can form, but will disappear in a few weeks, or they can be eliminated with the use of injectable hyaluronidase. 
• Infection is a rare complication. Bacterial infections and viral infections can occur in post-filler treatment. This complication can be prevented by proper skin cleansing with an antiseptic before treatment. 
• Cold sores. Note that if you have a history of cold sores and the treatment area is around your mouth, you should inform your doctor as the filling treatment can exacerbate the virus. 
You may be required to take anti-viral medication before treatment if this is the case.
• Injecting fillers directly into a blood vessel, or occluding a blood vessel by filler injections is a rare but serious side effect of lip filler injections. 
In general, dermal filler treatment is a very safe non-surgical treatment.

You should follow all the recommendations that the experienced doctor suggests so as not to compromise the result. 

The results of lip fillers 

The result must, in all cases, aim to achieve a natural appearance in both shape and expression, with respect for the target area.

The effect of the filler often takes 3 or more days to see the actual improvement without swelling. Hyaluronic acid fillers, on the other hand, often take up to 1 week. 
The final results of fillers are therefore visible approximately after 1 week or longer, which is the time it takes for the swelling to reduce.

A Quick Overview of Lip Fillers

The shape of the lips and the perioral areas are both important for lip filler treatment. 
There may be swelling and bruising after treatment. 
Fillers are gently and carefully injected into the lips and the areas around the lips in order to enhance their shape and size.

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