today get your spritzers ready because it's the second part of the lip for the
special hi guys welcome back to the channel my name is dr. Sarah talks I'm a
cosmetic physician in London today it's the second part of my lip for the
special where I am talking about different ways that we can do lip
augmentation last week you will have seen that there is definitely more than
one way to do your lip filler and we covered some cannula treatment this week
I am talking a little bit about needles last week you will have seen that there
is more than one way to do a lip filler and we covered mostly cannula sort of
work this week we are talking more about using a needle let's not mess around
let's just get straight over to it slightly older lady I find that the
older the patient is the more terrified they are about having lip fillers done
the last thing anybody wants over a certain age is to look like they've had
something done certainly at least where I work it may be different in different
parts of the country or different parts of the world nevertheless as we get
older we do lose volume in the lip in the same way that we lose it from the
rest of the face in patients who are having full face aesthetic treatment
particularly if they're having volume restoration it is super important to
also fill the lip because otherwise it looks kind of weird you've filled up the
rest of the face and really plumped out their skin back to half closer to how it
used to be but the lip is still this skinny little thing you can tell on this
first patient that I've got here with me today she definitely will have had a
full pair of lips when she was younger the shape of them is still very very
good is loss of volume as you can see with
these small vertical lines all the way through the lips you can also see we
have some lipstick bleed lines outside the lip - I personally do not advise
treating those lipstick lines on their own
particularly with the technique you sometimes see which is going directly
into the line and following the line up vertically I find that it can make the
lip look like it's coming over like this really what you need to do is augment
the border of the lip and restore volume in this triangle here and that will give
a much nicer result not actually doing that on this lady I just thought you
might like to know on her it's actually enough to use a straightforward
injection technique I'm using here Juvederm vol Bella because it's a pretty
soft product and it spreads quite well I'm using the traditional technique of
going directly into the Vermilion of the lip which is the edge of the pink bit
basically all the way along the upper lip I'm switching my techniques slightly
to do the lower lip where I'm changing to a 32 gauge needle and just doing the
middle third if you remember that's because I like to have most of my volume
in the middle third of the lower lip okay so let's have a look at our lady
afterwards mmm bit cheaty she does have some lip gloss
on I think anyway you can see the shape of the lip in general is pretty much how
it was before hand so we've really preserved her natural lip structure and
the reason that I used that product so the Juvederm wobbly was because it
doesn't really change the shape of the lip too much it will just give some
hydration to the lip and a little bit of fullness but everything else pretty much
stays the same you see she's got less of the
vertical lines here all in all I think a pretty nice subtle result I didn't think
anybody would necessarily know that she's decided to have her lips done and
just a quick peek of her smiling you see we've got a little bit less gingival
show in the afters she still got the the tilt that she had beforehand it's really
difficult to completely eradicate something like this if you put more
filler on one side of the lip than the other to try and correct it when she's
smiling it won't look the same while she has her face static so it's a bit of a
trade-off really next patient guys so this lady didn't really want to change
the shape of her lip she's got a really nice shape anyway she just wanted to
have them a little bit bigger so I decided I was gonna do this using a
needle now looking at her lip beforehand don't know if it's very clear on here
but just above the lip she does have a bit of fullness there and there which is
kind of pushing the lip down slightly as I mentioned in the previous video if
somebody has got a fullness above the edge of the lip line it can kind of
compromise the results sometimes so that means you have to employ a slightly
different method in order to get the lip to rotate round and that's what I did
for her there is a bit of cheek discrepancy too so you can see that the
cheek on this side is not as full as it is over here and that has an impact on
the position of the lip so you can see that the cheek on this side is not as
full as it is on the other side and that has an impact on the position of the lip
it's kind of cheating but I'm just gonna show you how that looks once she's
smiling there's a muscle which goes from the
cheekbone here downwards to the edge of the lip so if your cheekbone and
fullness on one side of the face is different to the other it means that you
you won't have the lip the same because the muscle is different does that make
sense so this sounds lower which means this side of the lip is lower basically
so I don't often use this technique it's lip tenting where you inject straight
down from outside the lip to inside the lip nevertheless I decided to do it for
this patient so I'm doing it all the way along the upper lip and also to the
middle part of the upper lip I'm also going to do it to the middle part of the
lower lip keeping the vast majority of the volume in the middle third
well then switching to a different needle to do the border of the lower lip
again in the middle portion and I'm also going to use the same needle to do the
border of the upper lip with the same technique so tiny little injections all
the way along the border of the upper lip try and flip this out I used for her
one and a half mil of Giroud and voila left it's very unusual to use one and a
half mil kind of cost-effective wise it doesn't really make that much sense to
break into a half mil unless you're going to use the other bit somewhere
else but nevertheless that's what we did and here are her before and afters so
the shape pretty much the same as it was before hand just a little bit more full
I think it still looks quite natural I already sneakily showed you a picture
of her smiling and here it is a game okay next up another lovely lady so she
just wanted to keep the shape of the lip the same as it was currently and I think
you'll agree she's got a great lip shape so the way that I decided to do her lip
was we initially did some lip tenting to kind of rotate the lip around for her
it's not a technique that I do very often nevertheless I decided to use it
for her then I use the same technique on the lower lip in the middle third and
switch the needle over to a shorter one so the
could do the edge of the lip itself and going back to the upper lip again to do
the border so in total for her I use 1.5 mils of Juvederm volift let's go over to
her results now you can see in her before that she has this kind of
undulating shape to the lip here but she still has in the after you you can't
really do too much about that so she's got this sort of bifurcation here in the
way you would normally have the medial tubercle
she's instead got um kind of a blob if you like a volume on either side so we
can't eradicate those completely because it will just look really weird so we
have kept them and this is how she looks on smiling so you can see that you can
see a bit more of her upper lip on smiling than you could previously okay
moving on next patient okay moving on next patient again we've got this kind
of fullness in the upper lip right here which makes it a little bit tricky to do
I would just love to get my hands on her tear trough and you see where she's just
starting to get rid of separation on both sides here and that's because these
two fat compartments as you get older they begin to separate and I don't know
why but that just really drew my eye then we're also getting a bit of volume
loss right here aren't we anyway back to the lip um she was happy with her shape
she just wanted to go a little bit bigger with that so the first thing that
I did was use a cannula in the upper and lower lip using a quarter of a mil in
each quadrant then I used a 32 gauge needle all the way along the upper and
lower lip in the Vermilion border I emphasize the glyco Klein point using
that shochu gauge needle and then went back to the middle third of the lower
lip to just emphasize that by doing small injections into the middle third
you know I like doing that in total for her we've used one and a half mil so
let's go over to our before and afters you
see that we've really kept the shape of the lip exactly the same as it was
before they're pretty much the same but just slightly bigger the more eagle-eyed
amongst you will see that in her before picture this side of the lip is not
quite as long as this side is and that's something which is really actually quite
tricky to balance out try to make this side a little bit longer with a cannula
which if we just go back and have a look you can see it does look a wee bit
longer but yeah super difficult to get it bang on I think it looks much better
and let's just have a look at her smiling there we are
lovely exactly the same but just a little bit fuller okay guys so that's it
for this week I hope you enjoyed the video join me again next week when I'm
actually doing a third part of this lip for the special because I know you guys
all love your lips don't you I'll see you then