Is lip filler above lip line inevitable and would a blunt cannula prevent this in the future? (Photo)

Question

Been getting lip filler for a few years. Tried a new place recently but lots of filler ended up above my lip. Went back, had it dissolved & redone 3 months later. Same issue - great shape but a ridge of filler. The PA injector was really nice but said she didn't know how it happened or how to ensure it didn't happen. Her trainer made it sound like it was a problem w/my anatomy even though I've had it done before. Needles were used. Would a blunt cannula prevent this in the future? What can I do?

Nelson Lee Novick, MD · Answer

I have injecting lip fillers for well over three decades, since the early days with the original Zyderm and Zyplast collagen fillers. The short answer to your question is NO, it is not inevitable for the filler to spill over the vermilion and give a duck-like or sausage-like lip. I personally prefer needles as product placement is more precise with their use as compared to cannulas. However, cannulas are perfectly fine. Since you are obviously unhappy with the result, it would appear wise to have the injectable filler dissolved and then to seek consultation and treatment by a board certified aesthetic physician and be certain to ask to see his/her personal before and after photos before agreeing to proceed. Best of luck and stay safe.

Rebecca Fitzgerald, MD · Answer

Placement of filler makes all the difference. As to cannula or needle, a cannula means fewer needle sticks and less bruising, but the issue you are experiencing is placement and amount of filler.It's not the best idea to repeatedly dissolve fillers, so "less" is always better than too much.It's always best to be treated by someone who has high-level training and a more than fundamental understanding of facial proportions and muscle movement in the lip area.

Jason Emer, MD · Answer

this is a "look" that people are doing now/lately and I hate it, looks overdone. this is technique and the type of filler. needle versus cannula wont matter. you just need a better injector and a better product.  lip hydrators and plumpers should be used daily too and help soften the look of fillers (see link to emeragecosmetics.com lip package). Best, Dr. Emer.

Gary Linkov, MD · Answer

There are surgical and non-surgical approaches to lip augmentation. Non-surgical approaches include botox (slight lift, reducing gum show) and filler (volume restoration). Surgically, you can have two separate incisions under the nose (italian), one incision under the nose (bull horn), one incision at the red/white upper lip junction (gull wing) or two separate incision at the corners, or a combination, depending on your desired look and anatomy. My preferred surgical technique is called the Elelyft, which is a version of the bullhorn approach. 
In your situation, the filler at the vermilion is a result of the injection technique. I would recommend you find someone closer to home who is a board certified dermatologist or a plastic surgeon with significant face experience.
Consult with an experienced lip surgeon for a complete range of options that are appropriate for your situation.
Gary Linkov, MD
Lip Specialist / RealSelf Lip Lift Medical Reviewer
Manhattan

Daniel Barrett, MD · Answer

Dear lrp2012,
I perform a lot of lip injections with fillers such as juvederm and it works great. Many times I need to put more in one side than the other to attempt to even out the vermillion border (The red line of the lip). This helps provide more symmetry at times.For patients looking for a more long lasting result, I recommend fat grafting. That is, using your own bodies fat to make your lips naturally look more shapely. The bonus is that the results last many many years.
In general, I avoid using permanent prosthesis because I find that the lips are such dynamic and sensitive structures, the end result is not natural.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Nelson Castillo, MD · Answer

Thank you for sharing your question.  In most cases this is technique related as well as the total amount of product placed.

Leonard Grossman, MD · Answer

An enhanced lip roll from fillers is related not to the needle or a blunt tip cannula, it is purely related to the technique of the injector. If not happy with the outcome, let the product slowly dissolve and find yourself a different injector. I hope this helps and good luck from New York City plastic surgery

Rita Rakus, MBBS - Account Suspended · Answer

Hello and thanks for your question. This ridge occurs when the vermillion border is overfilled. It's actually a delicate area to treat and you need a very fine needle and very soft filler for a natural result. Cannula treatment in lips is useful however only for the body of the lip not for definition. Always go to a qualified and experienced practitioner for any injectable treatment, best wishes

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