It’s only natural

T here is no doubt about it, the rise of popular culture, social media and influencers has had a significant effect on the demand for cosmetic and aesthetic procedures. The rise in facial enhancements has most definitely been due to the popularity of social media apps such as Snapchat and Instagram, which allow photos to be edited and filtered. The quest for the ‘perfect face’ can been seen as a direct result of this desire to enhance appearance. By adapting their photos, people see how their looks can potentially be improved or altered; and seeing what they could potentially look like, encourages people to favour this modified appearance in preference to their natural look.

Previously, patients would use celebrities as comparisons or benchmarks. Nowadays, clients will show photos of their younger self or edited versions of themselves

Previously, patients would use celebrities as comparisons or benchmarks. Nowadays, more often than not, clients will show photos of their younger self or edited versions of themselves.

One of the most popular treatments has been lip enhancement. Celebrity lip enhancement has received vast amounts of attention (Kylie Jenner being the most prominent), and their tales have fueled the market in the non-surgical aesthetic world. It has become more socially and publicly acceptable to undertake ‘tweakments’, so for this reason I would like to focus this article on the art of the natural lip.

Hydrated, fuller and more voluminous lips have, for many years, been considered a pillar of youth and beauty. Our lips are one of the first places to show signs of ageing. With time, lips become dehydrated, lose volume and definition and appear more wrinkly. This is especially prevalent among smokers and those frequently exposed to damaging UV rays. Lines appear more obvious due to increased muscular activity of lips around a cigarette. The gradual loss of collagen, which is a naturally hydrating and plumping protein structure, makes lips appear thinner. The introduction of lip injectables to combat this has developed vastly over the past 20 years and is considered extremely effective at tackling this problem.

TYPES OF LIP ENHANCEMENT

There are several types of dermal fillers that can be used. The most common product used today contains hyaluronic acid which is a substance naturally found in the body.

This helps provide physical volume when injected to the structure, and also absorbs water to the site. The tissue appears hydrated and naturally plumped. Other lip injectables include collagen and fat injections, but these have been phased out due to the greater risk of side effects and lack of predictable results.

The first generation of fillers available were collagen based and not FDA approved. The product was extremely expensive and was considered the preserve of the rich and famous. Nowadays, dermal fillers are much safer and more affordable to the general public.

The current trend for lip augmentation is to produce a more natural yet effective result. Patients want to be enhanced, so that they feel more confident in themselves, rather than changed. Undetectable beauty is desired, as opposed to the ‘duck mouth’ look, the ‘trout pout’ or having had ‘something done’.

Undetectable beauty is desired, as opposed to the ‘duck mouth’ look

SKILLED PRACTITIONERS

The success of lip augmentation is highly dependent on the skill of the injector, and will stem from appropriate high-end training and experience. Bespoke treatment plans, tailored to the individual during a consultation appointment, are recommended in order to ensure Aesthetic Medicine • July/August 2019 patients are happy with the injector. The consultation also is a time when you can discuss your goals. These may include

•Enhancing overall fullness in the upper, lower or both lips

•Reducing wrinkling around the lips due to a loss of lip volume over time

•Slightly altering the shape of the lips, such as increasing the volume at the top or bow of the lips

Unnatural, overfilled and lumpy lips can result due to poor technique, inappropriate product and inaccurate placement. If filler is injected into an artery, it can occlude (block) the artery and therefore lead to tissue necrosis (tissue death).. This is a highly serious complication and must be treated as a medical emergency.

To ensure a natural result, use a small, direct needle suitable for intricate detailing and a cannula for the main body filler. A cannula is a wide bored needle that vastly reduces the trauma to the lip tissue, therefore resulting in less post-operative bruising and swelling. The first place to inject would be the area where the skin under the nose meets the top of the lip. This approach is frequently used for filling and shaping the upper lip. Linear threads (filler drawn in lines) are injected along the vermillion boarder to define and contour the lip shape. This is also a particularly useful technique when trying to combat smokers lines.

Another area where injections are commonly placed is where the wet, inner portion of the lip meets the dry, outer portion. It is important that the injector does not over fill the ‘wet’ portion of the lip as this will result in the ‘duck mouth’ ‘trout pout’ appearance.

The amount of filler used will also determine how natural the result. If an injector overfills the lips to the point where they unbalance the facial harmony, it will appear more obvious that the client has had work done.

It is also important to consider the age of the patient who wants the treatment. How young is too young? The influence of Facebook, Instagram and Twitter most definitely increases the appeal of cosmetic treatments to the younger generations.

There is a growing concern that younger individuals are embarking on anti-wrinkle, facial filler and lip augmentation treatments too early. While these treatments are semipermanent, they are still medical, and patients must be aware there are possible detrimental consequences if not undertaken correctly. There is no definitive answer to the above. Patients who suffer with grinding issues, excessive sweating and migraines would be entitled to muscle relaxant treatment in the form of botulinum toxin injections at an earlier age. This would be acting in the best interests of the patient, to combat their issues and enhance their medial health.

Aesthetic treatment can be both preventative and corrective. The right time to start preventative treatment needs to be tailored to the individual. The time to start enhancing lips or cheeks with facial filler injections varies and the clinical decision is the responsibility of the injector. Every patient is unique, and some may warrant injections for corrective facial sculpting (or surgical options) at a younger age, while others are advised to wait until they have progressed further in their physical and psychological maturity.

As a general rule of thumb, the legal age of consent for medical or dental procedures is 18 years old. Facial filler should not be undertaken until the individual has reached their mid-20s. Exceptions to this might apply if there is a serious facial asymmetry, cleft treatment or a deformity which can be helped with dermal filler.

In conclusion, the use of lip fillers should not be considered a fad, or undertaken lightly. A reputable practitioner will examine, advise and carry out the procedure safely and to the benefit of the patient. Patients should do their own research beforehand, even though this is a non-surgical procedure. For a pleasing result, lip augmentation must be done for the right reasons. AM

Dr Krystyna Wilczynski is passionate about aesthetics. She is a qualified cosmetic dental surgeon and facial aesthetician. Since graduating from the University of Leeds in dentistry in 2010, she has undertaken a vast amount of post-graduate training in both dental and facial aesthetic procedures, including several advanced training programmes in both New York and London’s Harley Street.