Fillers. LP injection modes for the lower middle third of the face

The lip region is an extremely important area when it comes to facial aesthetic enhancement. The lips have since time immemorial been highlighted along with the eyes as the two most beautiful regions of a woman’s or a man’s face.

With the passage of time, photodamage, hereditary factors, and smoking contribute to loss of lip volume, perioral rhytides, and prominence of mentolabial folds. Genetically thin lips and cosmetic asymmetries of the lips are also issues that can be dealt with similarly, that is, by soft tissue augmentations using fillers. Successful rejuvenation of the perioral region requires sophistication in using a combination of technologies and injectables.

Various fillers, temporary and permanent, have been tried in shaping the lips, with gratifying results. Disasters in the form of granulomas have been reported with both temporary and permanent fillers, more often with the latter.

Hyaluronic acid (HA) and polyacrylamide (PA) are the two main fillers widely available. HA is the predominant one, with PA being virtually out of the race because of fears of granuloma. Worldwide usage and published reports clearly confirm the efficacy and safety of HA fillers. They are one of the key components of successful combination treatments of the aging face and lips.[1]

Common commercial preparations of HA that are widely available include the Anteis range (Fortélis^® and Esthélis^®, Switzerland), Galderma range, USA (Restylane and Perlane), and the Allergan range, Irvine, CA 92612 (Juvéderm Ultra^® and Juvéderm Ultra Plus^®). Other brands such as Revanesse^®, Prollenium Medical Technologies Inc., Canada and Amazing Fill^® are also available.[2]