Thank you for your question. You submitted a photo and also a photo in which you have
enhanced your lip, and you're asking a question about how many syringes of Juvederm would
you need to get the kind of results that you desire in the photo that you retouched.
Well, certainly I can help you with this. I'm a Board-certified cosmetic surgeon practicing
in Manhattan and Long Island for over 20 years. I am also a licensed provider of the Y Lift™,
a non-surgical structural volumizing facelift solution using fillers such as Juvederm and
Voluma. So you can be sure that we use a lot of hyaluronic acid fillers for procedures
such as the Y Lift™. I can give you a certain perspective as to how I answer this question
when patients come and ask about this type of procedure, which is something we deal with
everyday.
So when you look at your lips, and I think that certainly you're on the right track about
trying to balance out your upper lip to the lower lip. In aesthetics, we use the term
such as the golden ratio of 1.6 to 1 in various areas of the face. There's also another ratio
where we compare the upper lip to the lower lip, and it's kind of a 1/3 to 2/3 rule where
the upper lip is a certain volume and the lower lip is almost double that volume, but
it has to look right and aesthetic.
Now when people do these types of photos, the one thing that you have to be mindful
of is the three-dimensionality and the tissue spaces that are augmented. Although we try
to get the balance, you can't expect that it will be exactly like the photo. Anatomically
speaking, the lip has essentially two areas which we can augment with hyaluronic acid
fillers, technically a little bit more when you think slightly above the lip, but there
is the vermilion border, the border along the lip which you typically would use to enhance
with the lip liner, and then there's the body of the lip which when you augment, you want
to augment very artfully. So many of our patients who come to see us for the first time we'll
say “I don't want to look like a duck”, and they'll name a celebrity that you can
think of, and they don't want what has often been referred to as “trout pout”.
So whenever a relatively young patient comes who wants to have some type of augmentation,
I'll usually start with just one syringe. The reason I do that is that very often with
younger people, the border of the lip, the vermilion border, the area that I referred
to as the lip liner, can be very well augmented and defined, and create the perception of
fullness. So there's a lot of art to doing this. For other people, we’ll put some of
that syringe into the body of the lip, to try to get some balance.
The one thing that I have to mention is that one syringe is basically one cc or one milliliter.
That's basically equivalent to a baby teaspoon. The more volume you need, the more syringes
you need, so sometimes we have to go from one to two syringes in order to get the best
result. But, as I explain to many of my patients, and what we normally do is we see our patients
after two weeks to see how they look in case they need any enhancement or anything else,
we can always add. It's possible to subtract, because there is an enzyme called hyaluronidase,
which can be used to dissolve, but that's something we don't want to do. We'd rather
be conservative the first go around, and then add later on—that’s a personal style.
So you would probably be safe with starting with 1 syringe, and then you can always add
more on that. So meet with doctors and learn about their style, and learn about what you
think would be the aesthetic that makes sense to you, understanding that just a two dimensional
photo can't really be fully representative of a three-dimensional human being and facial
structure. So I hope that was helpful and I wish you the best of luck. Thank you for
your question.