Lip rejuvenation and filler complications in the perioral region

Abstract

Lip and perioral augmentation procedures have become increasingly popular over the last two decades due to cultural trends, emphasizing youth and beauty. An understanding of lip anatomy and aesthetics has traditionally formed the basis for successful results. However, as new technology becomes available, patient standards have increased, requiring an intricate understanding of filler properties and the advantages of different technical approaches. This chapter touches on pertinent anatomy and aesthetics of perioral evaluation. It also provides an overview of the properties of the fillers currently available in the United States marketplace for perioral rejuvenation. The technique and materials currently favored by the senior author are described in greater detail. Finally, the chapter will overview potential complications and recommended management.

Keywords

Hyaluronic acid / filler / lip augmentation / perioral augmentation / rheology

References

[1] 2019 Plastic Surgery Statistics Report. Available from: https://www.plasticsurgery.org/documents/News/Statistics/2019/plastic-surgery-statistics-report-2019.pdf [Last accessed on 5 Jan 2022]

[2] Dayan S,Kilmer S.Safety and effectiveness of the hyaluronic acid filler, HYC-24L, for lip and perioral augmentation.Dermatol Surg2015;41 Suppl 1:S293-301

[3] Bosniak S,Glavas IP.Nonanimal stabilized hyaluronic acid for lip augmentation and facial rhytid ablation.Arch Facial Plast Surg2004;6:379-83

[4] Pascali M,Carinci F.Filling procedures for lip and perioral rejuvenation: a systematic review.Rejuvenation Res2018;21:553-9

[5] Rohrich RJ,Dayan E.Practical approach and safety of hyaluronic acid fillers.Plast Reconstr Surg Glob Open2019;7:e2172 PMCID:PMC6635180

[6] Byrne PJ.Lip augmentation.Facial Plast Surg2004;20:31-8

[7] Popenko NA,Devcic Z,Osann K.A quantitative approach to determining the ideal female lip aesthetic and its effect on facial attractiveness.JAMA Facial Plast Surg2017;19:261-7 PMCID:PMC5543334

[8] Linkov G,Kallogjeri D,Branham GH.Perception of upper lip augmentation utilizing simulated photography.Arch Plast Surg2019;46:248-54 PMCID:PMC6536866

[9] Mannino GN.Current concepts in lip augmentation.Cutis2016;98:325-329

[10] Öhrlund Å.Evaluation of rheometry amplitude sweep cross-over point as an index of flexibility for HA fillers.JCDSA2018;8:47-54

[11] Fagien S,von Grote E.Rheologic and physicochemical properties used to differentiate injectable hyaluronic acid filler products.Plast Reconstr Surg2019;143:707e-20e PMCID:PMC7597953

[12] Lee SH,Choi YJ,Kim HJ.Topographic anatomy of the superior labial artery for dermal filler injection.Plast Reconstr Surg2015;135:445-50

[13] Cotofana S,Schenck TL.Anatomy of the superior and inferior labial arteries revised: an ultrasound investigation and implication for lip volumization.Aesthet Surg J2020;40:1327-35

[14] Edizer M,Tayfur V,Ergür I.Arterial anatomy of the lower lip: a cadaveric study.Plast Reconstr Surg2003;111:2176-81

[15] Bertucci V,Solish N,Hicks J.Subject and partner satisfaction with lip and perioral enhancement using flexible hyaluronic acid fillers.J Cosmet Dermatol2021;20:1499-504

[16] McCracken MS,Wulc AE.Hyaluronic acid gel (Restylane) filler for facial rhytids: lessons learned from American Society of Ophthalmic Plastic and Reconstructive Surgery member treatment of 286 patients.Ophthalmic Plast Reconstr Surg2006;22:188-91

[17] Lowe NJ,Patnaik R.Adverse reactions to dermal fillers: review.Dermatol Surg2005;31:1616-25

[18] Gladstone HB.Adverse effects when injecting facial fillers.Semin Cutan Med Surg2007;26:34-9

[19] Haneke E.Adverse effects of fillers and their histopathology.Facial Plast Surg2014;30:599-614

[20] Beer K,Dover JS.A randomized, evaluator-blinded, controlled study of effectiveness and safety of small particle hyaluronic acid plus lidocaine for lip augmentation and perioral rhytides.Dermatol Surg2015;41 Suppl 1:S127-36

[21] Bergeret-Galley C,Illouz YG.The value of a new filler material in corrective and cosmetic surgery: DermaLive and DermaDeep.Aesthetic Plast Surg2001;25:249-55

[22] Wolfram D,Piza-Katzer H.Surgery for foreign body reactions due to injectable fillers.Dermatology2006;213:300-4

[23] Grunebaum LD,Dayan S,Baumann L.The risk of alar necrosis associated with dermal filler injection.Dermatol Surg2009;35 Suppl 2:1635-40

[24] Ozturk CN,Tung R,Piliang MP.Complications following injection of soft-tissue fillers.Aesthet Surg J2013;33:862-77

[25] Carruthers JDA,Rohrich RJ,Carruthers A.Blindness caused by cosmetic filler injection: a review of cause and therapy.Plast Reconstr Surg2014;134:1197-201

[26] Cohen JL,Dayan SH.Treatment of hyaluronic acid filler-induced impending necrosis with hyaluronidase: consensus recommendations.Aesthet Surg J2015;35:844-9