How often should I be getting lip injections?

Dr. Dean Kane Q & A Q. I started small with 1/4 a syringe of restalyne and added another 1/4th last week, happy with the results but wanting more volume, it’s been a week, is it too soon to be getting another 1/4, is it better to get more of it at once as opposed to small portions frequently? Thanks in advance. A. ​A 1/4 of a syringe of Restylane to the lips will produce very little “fill” particularly if this includes both the upper and lower lip. ​ There are various ways to reduce lines around the mouth and lips. Each depends on the level of the wrinkle deformity, ie., epidermis, dermis, fat, muscle and skin color. The duration also depends on the qualities of the filler and the site it is injected. The most popular of the fillers, Restylane and Perlane, a jelly-like clear skin filler is used to fill lines, wrinkles and folds. Juvederm and its longer lasting “cousin” Juvederm Ultra Plus are similar skin fillers, used to soften and fill the nasolabial (“parentheses”) and marionette folds, the brow (“number 11”) lines and fill and lift the cheeks and lateral brow or chin. Voluma and Lyft are the longest lasting HA fillers, up to 2 years and 1.5 years duration HA. Each one is used to expand, project or volumize the loss of tissue associated with expression, weathering or aging. All the fillers come with numbing anesthetic!. ​ Restylane Silk is a wonderful new addition to the filler family. It is thinner and smoothening, particularly for the lines around the mouth and lips. I have also found it useful for the crow’s feet and forehead lines too. Scuptra is the latest of the injectibles stimulation collagen at different levels of the skin adding volume but primarily firming and adding resistance to the formation of wrinkles, folds and descent. Botox and Dysport too have been found to rebalance excessive facial expression, provide a non-surgical brow lift and lip lift and reshape the nose, as well as reducing wrinkles even around the mouth!
  • ​1. Fillers in the lip like fillers elsewhere require and understanding of the anatomy and injectable results. For example:
  • ​ Upper lipstick lines : beyond the white roll, upper and lower lip wrinkles improve with Botox and smoothening fillers such as Silk in the dermis
  • ​ White roll and philtral projection :the white line and philtrum project better with smoothening or volumizing fillers like Silk or Restylane
  • ​Dry vermillion lines: the lipstick lines of the dry (pink) vermillion are best injected with a volumizing filler like Restylane in the sub-mucosal layer
  • ​ Dry vermillion atrophy :lip fullness is best with projecting to volumizing fillers such as Lyft, Juvederm Ultra Plus (JUP) along the wet/dry border of the vermillion lip
  • ​ Wet vermillion pout: lip pout can be improved with stiffer filler injections in the buccal mucosa (ie., back of the lip, inside the mouth) such as Voluma and Lyft allowing the lip to push off the teeth.
  • Lip corners and marionette fold: require stiffer dermal injection such as Restylane/JU or Lyft/ JUP and volume to fill the folds depression such as Restylane/JU and Silk
  • ​2. Artistic use of Botox and similar injectable muscle relaxers just outside the upper and lower lip white line will reduce lip creasing and increase the pout of the lip(s) without fillers.
  • Dr. Obagi’s new, second generation ZO Skin Health programs may be added to personalized chemical peels, light and laser resurfacing and tightening and will, smoothen and even the color of your skin. IPL and fractionated lasers such as CO2 and erbium and now RF (radiofrequency) are additions to smooth the texture of the skin, tighten and reduce red and brown uneven pigmentation. ​ ​These options maybe used similarly around the eyes with the caveat that the Injector must understand the art and science behind the injectables he or she are using and the anatomy and dynamics of facial expression. All surgical, minimally invasive and non-invasive procedures and their combinations should be discussed following a proper examination with a well versed, Board Certified Plastic Surgeon who performs all of these options so you will not receive a biased approach because he limited in his skills.
  This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.
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