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  • How Are Injectible Fillers Used in the Lips?
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So we're going to get started with the injection of the Juvederm. I like to usually start with the upper lip. There are seven different zones in the lip. If you just fill it like a sausage link and put the exact amount of filler across the lip, the lip is going to look unnatural and it's going to look like a sausage. What I do is I inject different zones, I come back and I modify it. The lip is very vascular. It has lots of blood vessel so bleeding and bruising is actually fairly common from the lip. Are you feeling this? The dental block makes it so much easier, makes it easier on the patient, makes it easier on the surgeon because now I don't have to feel rushed. If she was in pain, I would feel more rushed that I’d want to get it over with sooner for her. But when she’s numb, I can take my time.

We’re injecting along the red lip right now. It goes in like little pearls. What I do is I take my fingers then, massage it. Once, or twice, or three times of this, and what happens is it just smooths up. And then I go back and I fill on the zones that I want to fill in, and give her the [inaudible 00:01:36] that I want. You can already see the fullness, very little bleeding. We have used less than half of the syringe. What I do now is I go to the lower lips. They'll come back. If I have any left, I’m going to contour. [Inaudible 00:02:12] I’m just going to make sure everything’s nice and symmetric. Although classically, the lower lip should be fuller than the upper lips, a lot of young women these days, they like both lips to be the same size. But sometimes, you can have a fuller upper lip; it's more of a youthful look.

Now, we evaluate how they look, and go back. There's very little bleeding. [inaudible 00:02:58] completely normal. The lips are extremely vascular, we expect nothing less. She's not feeling any of this so I can take my time and make sure everything is nice and symmetric the way I want it to be. When I massage, I also feel with my fingers the amount of fullness of substance, whether it's Juvederm or Restylane. By doing so, what I can do is determine if I am symmetric, if I need more on one side. If there's a little bleeding, hold pressure, that minimizes the risk of bruising. The lower lips look good, we're just going to contour the upper lips.

Now, I'm going to the vermillion border, which is the zone between the white and the red lip. This gives the projection that we need. We're done with the injections. Now what I’m going to do is gently massage it; make sure there's no lumps, or bumps, or nodules. You never want to send any patients home with lumps, or bumps, or nodules. We're going to just massage it for them here. And we’re done. Her lips are numb so she will not be able to have great control of them. I usually tell them to avoid any kind of drinking or eating for a couple of hours after an injection.

But, this pretty much concludes our injection of Juvederm to the lips. And it's a procedure that most patients repeat twice a year. It takes about 10 to 15 minutes to do the whole procedure, and the cost depends on the filler; can be somewhere between $600 to $700, depends on how many syringes the patients use. Most patients use one syringe. I do have some patients that require more than one syringe and obviously, the cost goes up from there. But there's really no better alternative as far as permanent filler for the lips. There are longer lasting fillers but they don't belong into the lips, they're not safe for the lips. They can cause nodules, and lumps, and bumps that then, have to be excised. So the options are either implants or safe fillers like Juvederm and Restylane. Thank you.

How Are Injectible Fillers Used in the Lips?

Dr. Shervin Naderi explains the different zones of the lip and how he determines the best injection points to produce the desired results.