The Secret to Natural and Beautiful Lips With Dr. Bouzoukis Video Highlights
The video featuring Dr. Bouzoukis from Rejuvent in Scottsdale, discusses basic lip anatomy, proportions, age-related changes and the goals and limits of lip filler injections.
Learn all About Lip Anatomy:
Lip anatomy is very relevant to an injector as they are essentially sculpting the lip shape using fillers.
It’s important to be aware of the different three-dimensional shapes of the separate regions or subunits of the lips.
The upper lip has three central bumps and they can vary in size. In some patients, the central one is larger and the two on either side are smaller. In some patients, the two just lateral to the midline of the upper lip is larger and the central one is smaller. In the lower lip, there are two large midline bumps that comprise roughly the central two-thirds of the lower lip. The lateral edges of both the upper and lower lip are flatter than the midline portion, and the border of the upper lip tends to be a sharp edge.
Using medical terminology the three central bumps of the upper lip are called tubercles, the lower lip bumps are also called tubercles. Note there’s three in the upper lip and two in the lower lip. In most patients, the midline tubercle of the upper lip is not as prominent as the two on either side of it. The border between the red lips and the surrounding upper and lower white lips is referred to as the Vermilion border. In youthful lips, this is a slightly prominent Ridge that serves to framing the lips.
The corners of the lips are referred to as the oral commissures.
With age and volume loss, the commissures can start to spread out and become wider. The small depression that runs from the midline upper lip to the base of the nose, is referred to as the philtrum. This comes from the ancient Greek phrase for love potion because the Greeks found the philtrum to be a sexually attractive region of the face. The curved border of the upper lip centrally is referred to as Cupid’s bow.
What an Expert Lip Injector Takes in Consideration Before Injecting
In addition to the anatomical subunits, there are also certain proportions that one must keep in mind when analyzing lips and planning for either an augmentation with filler or a volume restoration with filler. The ratio of the vertical height of the upper lip to the lower lip in a Caucasian female is thought to be ideally. This ratio is known as Phi. This ratio has been found throughout nature and is also applicable and analyzing facial beauty. Phi is also referred to as the golden ratio, and it’s very interesting to study. It should be noted that in women of color to ratio approaching one to one is also considered attractive, so a patient’s ethnicity and overall facial structure must be taking into account when planning the ideal height of the upper lip in relative proportion to the lower lip.
This diagram also highlights that the width of the nose ideally should be the same distance as the width between the corners of the eye. This is also the width of the central two-thirds of the lower lip, which are the largest relative to the lateral one-third of the lower lip.
When evaluated in profile, what’s considered more ideal is if the upper lip projects more interior than the lower lip.
In this different patient, you can see that her lower lip actually projects more interior than or upper lip and it’s not quite as pleasing to the eye.
What Happens to Your Lips as You Age?
With age lips lose volume, shape, and definition. In addition, the commissures start to thin out and widen and the commissures also start to turn down. The skin of the upper lip also shows age. The dermis becomes thinner, losing collagen and elastin. This leads to the vertical lines that develop above the upper lip.
Factors such as sun exposure and smoking accelerate the loss of collagen, loss of elastin, and the development of these fine lines. Men have less of a problem with vertical lines on their upper lip with age because the whiskers that we have helps support the skin.
As is true for many things in life, an ounce of prevention is worth a pound of cure. It’s much simpler to maintain the quality of the skin and prevent the formation of the lines than it is to try and treat the lines once they formed.
Skin care products that boost the production of collagen and elastin and thicken the dermis, daily use of sunscreen, and avoidance of drinking from straws, when started in the late 30s and 40s can really delay the onset of these upper lines that typically develop in patients when they are in their 50s and 60s.
Once significant vertical lines develop in the upper right lip trying to correct them with filler can run the risk of the upper lip becoming more convex in appearance which can lead to more of an ape-like appearance and is not attractive.
Another change that occurs with aging is the skin of the red lips themselves loses elasticity. When this happens there’s a limit to how much expansion can occur when the filler is injected to re-inflate or volumize the lips.
Regular use of Jan Marini C-ESTA Eye Complex (Since C-ESTA Lips was discontinued, Dr. Bomer tested C-ESTA Eyes and found that it provided the same benefits) in combination with Clinicians Complex Lip Enhancer can restore collagen and elastin to the skin of the red lips thus increasing their elasticity.
When the filler is then injected, the lips can actually expand and become more volumized with more of a youthful shape.
When planning an injection of the lips, there are multiple products that can be used, they all have slightly different properties and the choice of which filler to use is based upon the patient’s anatomy and the specific aesthetic desires for that patient. But what is more important than the choice of a specific filler is the skill and experience of the injector. Many patients don’t realize that lip augmentation or restoration of lost volume is challenging and requires experience, knowledge of anatomy, and a good visual eye.
Most Used Lip Filler Brands
Lip fillers commonly used are Juvéderm, Juvéderm Ultra and Ultra Plus, Volbella, Restylane Silk, Restylane Refyne and Defyne. As with any filler injection, the experience of the lip injector is the most important factor. Only an experienced lip injector knows which filler to best use for each patient’s lips and concerns. Not all filers are the same just like not all concerns and lips are the same.
IMPORTANT TIP: Before your lip injection appointment view as many before and after images as possible. Preferably, look for photos taken 3 weeks post-injection. Why? Because photos taken right after injection shows the lips with some swelling and not exactly what they will look like after the filler settles down. Rejuvent doctors have been taking photos of our patients’ beautiful lips since we opened in 2004!
Hyaluronic Acid Dermal Fillers – Versatile and Not Permanent!
A great property of all of these fillers is that they are hyaluronic acid and can be dissolved if necessary.
The woman in this photograph had received filler to her lips elsewhere. One can see that the misplaced filler led to a flattening of her Cupid’s bow. There’s also an asymmetry to the upper lip as well.
This is another photo of a woman who’d received filler elsewhere and specifically came to us to try and improve the appearance. One can see that the specific subunits of the upper and lower lip were not fully respected and the lip is a bit too wide laterally, with almost a sausage type appearance.
This is an example where Vitrace can be used effectively to melt a portion of the filler to try and reduce the areas that are too full to improve the natural appearance of her lips.
As is the case with all the other facial features there’s a tremendous variability from one patient to another in the anatomy of their lips.
In this example, you can see a patient on the left with very thin lips and the patient on the right has very large full lips.
It’s a common myth that you can go from a patient on the left to the patient on the right with simply applying enough filler in the right locations. This is not true, there are definite limits to what can be achieved with filler in one session, and going from a naturally very thin small lip to a very full luscious lip is not achievable. Most patients with thin lips require more than one lip injection session to achieve full lips.
In one lip session, we can certainly improve the contour and overall shape of the lips on the left and give them more volume but we can never volumize them to the size of the lips on the right while retaining a natural shape and appearance.
This next patient is a woman in her 30s who has a nice shape and proportion to her lips but has always desired slightly larger lips.
Filler was used to augment the size of her lips while retaining a natural and attractive shape and contour.
This is a photo of a woman in her 50s who has typical age-related changes to her lips, the lips have lost volume, and their shape has changed from when she was more youthful. In addition, she is thinning of the white skin of her upper lip with the beginnings of some vertical lines.
After filler injection, her age-related lost lip volume has been restored, and the contour and shape of her lips have been improved while still remaining natural in proportion.
So whether we’re injecting lips to enhance naturally small lips or to restore lost volume in aging lips, it’s essential that the end result is a natural attractive lip that is in harmony with the rest of the face. And for those of you interested in maintaining youthful appearance of your lips as we age it’s really essential to maintain the quality of the skin specifically to boost the collagen and elastin content of both white and red lip a couple products we have to a great job at this the C-ESTA Eyes as well as the Clinicians Complex Lip Enhancer and Dr. Bomer has an excellent video discussing the best lip products and the use of these products. It’s much easier again to prevent than to try and correct down the road.
Lip Augmentation & Augmentation at Rejuvent Scottsdale
Dr. Bomer and Dr. Bouzoukis are expert injectors and achieve beautiful, natural results for their patients. You can view some of their before and after lip augmentation photos and call for a complimentary consultation for Lip Augmentation at Rejuvent. Call 480-889-8880 today.
Rejuvent is located in Scottsdale, Arizona and conveniently located close to Paradise Valley, Tempe, and surrounding Phoenix cities.