hi I'm dr. Johnny and today we're
talking about widening the mouth with
dermal filler
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okay so lip filler we all know everyone
seems to want lip filler whether it's to
create shape to make the lip look
youthful to create a sexy looking lip or
for vertical lip lines people all refer
to those things as lip filler and
rejuvenation of the perioral area and
I'm just right now I'm preparing a
lecture for Bangkok we had a conference
over there on the whole perioral
rejuvenation and I had a question off
the youtube channel hey doctor honey can
you talk about how to make the mouth
wider with filler when I thought about
that question the first thing that comes
to mind is why do you want it wider well
the new look or the look of all the
models and the superstars is a wider
looking mouth many factors go into
whether that can be created why are we
wanting that now and the facial numbers
and structure so does it fit with the
face so I thought I'd go through three
factors that we consider with making the
mouth wider you can follow along on
Instagram as well we have a lot of great
topics on lip filler and everything
about facial rejuvenation there and some
upcoming videos with regard to the lip
we'll be talking about the Ergo tread or
the distance from the top of the lip to
the nose another hot topic and the lip
lift either surgical or non and also I'm
going to review all natural lip fillers
because a lot of people might not want
fillers or other substances placed in
the body like silicon for their lips or
maybe they're not allowed to do it and
so they're looking for an all-natural
option so those are on the dock to get
set up so look forward to those so the
first factor about widening the mouth is
considering product and I was in Miami
last weekend and someone
in the audience had asked the duck lip
why do we create the duck lip and where
did it come from well one of the reasons
is we only had collagen back in 2000
2003 in this country and it didn't last
long if we put it in the body of the lip
but it was soft and elegant didn't draw
water and so the best place to put that
product was in the Vermilion border and
then we got hyaluronic acid fillers so
new structural products that we can
create sheep with and people continue to
put it in the border of the lip like we
did with collagen the problem is it's a
more robust filler so as we got these
new products we were able to do more
things but we had to adjust over time
for filling not like we did with
collagen but more like we do with
hyaluronic acids since that time we have
new hyaluronic acids with your
structural create support and don't draw
water in that's another key component of
making the mouth wider we need
structural products and the older
products wouldn't have worked for this
and they didn't last then we went to
wrestling 2003 was the first one
Juvederm then came in 2007 that does
draw a little water in you can create
structure and support with that too but
over time if it's not done right or you
try and create too much structure with
too much filler as it draws the water in
which is a very nice property in some
circumstances but if not it can create a
sausage lip and then we went through
that phase but now we do have products
that are structural supportive and then
don't draw water in this is allowing us
to create a wider lip so the first
consideration is product what product
people want to use to create that and we
do have that product that can do it I
will caution there's a lot of products
out there some are permanent silicon
some people use PMMA people use crazy
stuff flix fix it flat I just heard of
overseas getting product in it's called
very similar to a product here the name
is very similar to a product that we
have here and I called to say hey what
are the concentration to ask a few
questions about it it was nothing like
what we get in this country it's very
very scary so know what you're getting
know what product your injectors already
thinking if you're one a wider mouth
what product to use and what would be
best but just know find out what you're
gonna get in your lip and the key is
making sure it's an approved product in
this country and hyaluronic acids are
the number one we use because they are
dissolvable they do go down over time
but they also don't have the permanent
products that you problems that you can
get in a lip such as PMMA or silicon the
body fights sociogram you look
granulomas bumps and lumps and remember
the bone changes around the face so that
the lip filler might look great for 10
or 20 years but as that ergo tread
lengthens as the piriform aperture opens
and the lip takes a different shape that
permanent product might not be in the
right place other areas I don't mind
permanent products we have PMMA we have
long-term projects like Sculptra but
stay away from it for the lip so that's
the first consideration is what product
and it's nice to know we do have the
product the second consideration is
anatomy can they take it will the lip
look good if we have that wider mouth
and its really importantly no a lot of
people want to inject themselves at home
people want to go to the cheapest place
the most well call it cost-effective
place but what you're paying for and why
someone else is doing it to you is
because they can look at all angles and
dimensions and what's going through your
injectors mind just like I talked about
one of my last videos on the brow lift
is angles folds and as they inject
they're watching what's possible because
it's not always possible as we inject we
switch gears we use different techniques
we might do
the body Vermilion border the Vermilion
border lip then go to the body the
wet-dry border and then inject the
philtrum or the Cupid's ball based on
what we're seeing or we might avoid some
of those things so it's an art in
progress and it's not only based on just
standard anatomy most important
it's your anatomy and everyone if I
inject seven or eight lips in a day
every single one is different even
though in their mind they might know
what they want what we can actually
create is different from maybe what they
want and it's based on their Anatomy and
knowing the anatomy and the angles if
you take this diagram for instance and
you take a line you draw it straight
down from the inner portion of the
colored eye you will see that that
usually lines up with the lateral border
of the lip but it's not that simple
because there are genetic differences
course differences around the world so
cultural differences also massive
differences a wider master takes a wider
mouth and then there are designer
differences so Anatomy those top two
pillows of the of the lip there's two
lateral one on each side and a central
pillow and on the bottom there's only
two so you can imagine if you're trying
to fill the lip laterally to create a
wider looking mouth and it's making that
pillow of the lip look funky if it's
making it look drawn-out if its resting
on their lower lip in an unusual way and
you can often only tell from a lateral
view then the injector will stop and
switch gears and sometimes we're using
the injection technique a standard
technique and another time other times
you might switch to the piller technique
and you'll watch my video on that
because you're gonna get different
projections so switching gears based on
the anatomy is it correct is it gonna
look good could it work for you and
always evaluating as we're filling
because multiple ideas multiple
injection techniques are going through
your injectors mind
as they inject the correct product that
we talked about the third concept to
consider creating a wider mouth is that
this occurs often over time it's one of
those areas that we fill that we kind of
like an implant we create a little bit
of stretch on the tissue we're also
looking to see how it fills and we want
more fill towards the center of course
and a lateral taper if we flip the lip
board and there's many ways to do it
with filler and sometimes we add toxin
to order all modulators then and it
looks good it looks natural then that
allows us to taper it laterally with
more product if however it's looking too
full in the center we really can't go
laterally with the filler overtime we
can kind of create balance and harmony
and actually get volume laterally but
it's something that occurs over time we
know the stretch of fibers creates long
term collagen and that's a benefit of
fillers and we found this out long ago
because as the filler dissipates there
was still effect lifting effect volume
effect and type two and three collagen
are produced around stretching that
that's a theories this stretch of the
fibers but in this case it's stretching
that creates volume and allows us to go
laterally so think a lot of people come
in now and they'll purchase a vial of
filler and they'll purchase two more
because really what their goal they know
they're gonna use it the filler
dissipates and oftentimes at one to two
months if it's the first time getting
filler is a good time to allow the
filler to accommodate in the patient to
accommodate to one vial and then you can
add another vial and then it might be a
year maybe eight months might be a year
and a half before they add more but
often times places will offer a volume
discount and you're developing a
relationship with your provider over
time to get the look also they have your
pictures and you can look what did it
look like when I came in after one vial
two vials maybe you don't want the third
you want to put that to something
different but in general purchasing
three vials would be pretty normal for
someone wanting lip filler and creating
a look over time most importantly is
following the patients look so we're not
creating bizarre looks unusual looks and
it has to be congruent with the whole
face we can't have new lips on an older
looking frame and face so that's
something to have a good discussion with
your provider and as a provider it's
important to give the full facial
consult so people know hey once you do
the lip area you at least if you're of a
stage where there's hollow around the
temple the preauricular area or there's
that downturn of the mouth addressing
that sometimes you get a wider look is
much more important because if you get a
wider look to the lip it might
accentuate a squaring look that's
created with age we all square as we age
and there's a wider lip can look not
balanced on a square face so lifting the
edge of the mouth and watch my video on
that the downturn mouth or how to lift
the corners of the mouth that's why a
lot of times when people purchase
multiple miles for the lip filler they
dress the lip but also now with the new
flexible structural fillers we can
address the downturn of the mouth with
PDO threads with fillers with
neuromodulators so it all works together
in harmony
so there's three things to consider
about lip fillers about widening the
mouth join us for further videos I'm
teeing up some videos right now on the
ergo tread which is the length between
the Cupid's bow and the nose it's a big
topic a lot of people ask about it they
know surgery's possible but non-surgical
methods can work for some as well and
the all natural lip filler join us here
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to keep your skin and body and beautiful
healthy and vibrant
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