In this section of the course we are going to present a brief description of the anatomy of the lips. You will gain a better understanding of the different parts of the lips and where to place the product using the Hyaluron Pen.
The lips are the focal point of the lower face. It is always important to consider antiviral prophylaxis in a patient with a history of herpes simplex episodes.
The height of the lips and the proportion of the upper to lower lip should be considered. The lower lip should protrude slightly beyond the upper lip. The upper lip should be 2/3 the volume of the lower lip. Usually lip augmentation is done with a larger particle-sized filler in contrast to lip line augmentation which is done with a smaller particle-sized filler. In the case of enhancement using the Hyaluron Pen and its ability to inject a spray-type technique, a thinner consistency of Hyaluronic Acid gel is used, thus making it suitable for every part of the lip.
Philtrum Ridges-The philtrum is bordered by two ridges, also known as the infranasal depression but has no apparent function. With time these ridges deplete in volume. In some cases, practitioners will inject into the ridges creating a more youthful appearance. In the case of injecting with the Hyaluron Pen, enhancing the philtrum ridges is not recommended.
Cutaneous Upper Lip- The lip consists of the upper lip and lower lip regions. The upper and lower lip consists of two parts: skin (cutaneous) part and vermilion part (vermilion is a specific kind of skin but we do not call it skin). Injecting HA in this area will soften fine lines sometimes found in this region on mature skin. Make sure to use light massaging to ensure an even spread of product.
Cupids Bow- This is a facial feature where the double curve of the upper lip is said to resemble the bow of cupid, the Roman god of erotic love. The peaks of the bow coincide with the philtrum ridges. To enhance the cupids bow we place the Hyaluron Pen as close to the bow as possible, inside each arch as well as directly under the center.
Vermillion Border- The sharp demarcation between the lip and skin. As with the cupids bow, we place the Hyaluron Pen as close to the vermillion border as possible. Right after you inject, lightly squeeze the border to ensure the HA stays within the border, thus creating a slightly protruding and appealing border. This technique is usually only applied to upper lip.
Oral Commisure- This is the corners of the mouth where the vermillion border of the upper lip meet that of the lower lip. This area is often injected to create fuller corners. It will be left up to you and your patient if this area is to be enhanced. To enhance this area, place the Hyaluron Pen inside the corner of both the top and lower lip. NOTE: In regards to the bottom lip, be careful not to over inject product into the oral commisure, as it can create a long bottom lip,
Body of Lips- This is where the Hyaluron Pen really shines! You will achieve most of your fullness in this area, both top and bottom. Typically, the ideal lip will maintain most of its fullness directly in the middle of the bottom lip and in the two pillow areas (the arches of the cupids bow) on the upper lip. Remember to try to maintain the 2/3 volume rule for best proportion and balance of upper and bottom lip. No one likes to leave with DUCK LIPS!
To achieve consistent results with Hyaluronic Acid gel using the Hyaluron Pen, we at AAI, believe students must understand the pertinent anatomy of any area of the face they plan to work on. For the purpose of this section, we will go over the anatomy of the cheek, nose, under eye, chin, jawline and facial lines.
Those who perform injectable gels and serums into the dermis and subcutaneous layer of skin, you should have a detailed understanding of facial blood vessels and nerves, which is essential for safe and effective placement of any type of fillers. In the case of the Hyaluron Pen, because we only focus on the epidermis layer, we avoid most risks associated with needle injections, therefore in this course we will not be covering detailed information that one would require working within the lower regions of the facial anatomy. With that being said, we still want to provide our students with all they need to know when performing facial enhancements using the Hyaluron Pen.
When it comes to facial enhancements, placement of the Hyaluron Pen will be determined by the area of where you would like to enhance. The most important thing to remember when it comes to enhancements with the Hyaluron Pen, is that this is a non-invasive enhancement placed in the epidermis layer of skin, so again, we are avoiding the risk of injecting through major blood vessels. In the first image you will see the areas that can be enhanced successfully using the Hyaluron Pen. In the second graph we show the different regions of the skin layers.
We remind you that the amount of HA used will be determined by the area in which you are enhancing. You do not have to use a lot of product to get results. Subtle improvements are more natural and results should be built slowly over time.
How much HA do I use in each area of the face? This is a question that can really only be answered by you based on the client you will be working on. If you are looking for a slight enhancement such as a few fine lines, slight lip plumping, or minor hollowness filled in, then you likely will only require a small to moderate amount of Hyaluronic Acid. Client's looking to fill larger wrinkles or have a more plump lip may request much more Hyalruonic Acid. This can vary from 0.5ml-3ml approximately, however, each client should be assessed by you to determine their personalized beauty and aesthetic goals.
Injections on the face are usually done to enhance or correct facial features. With hyaluronic acid filler you can enhance the areas of the face such as cheeks, cheek bones, a flat chin, the shape of the nose and more. When it comes to performing chin, cheeks and nose enhancements using the Hyaluron Pen, we turn to Hyaluronic Acid for building the areas out. We suggest using 0.01-0.02 injections at a time not only to help push the product through, but also to build these areas out slowly. See the graphic below to get more information on injection amounts per area.
Hyaluronic Acid gels can easily be inserted over time with multiple sessions. This will allow for more natural looking results that last longer. Remember that gel and serums composed of hyaluronic acid increase one’s own collagen production. Therefore, with every hyaluronic acid enhancement, you are encouraging human collagen production leading to longer lasting results from injections. We at AAI like to refer to this as “layering." This is a safe way to receive conservative facial enhancements. It is better to add 1-3 ml of Hyaluronic Acid gel every 3-4 months during the first few appointments rather than over injecting to achieve that instant 'POP.' Once a client’s enhancement goals are met, you can then determine and develop a maintenance plan for future appointments. Hyaluronic Acid is also best when it is built upon itself. This is why those with previous injections usually have better results with HA. We recommend another session to build on your HA.
Disclaimer of Medical and Legal Liability: Aesthetics Accreditation International training courses are intended to provide the general knowledge to perform procedures but is not intended to be a substitute for medical advice, diagnosis, or treatment. Reliance on the information in this training course for procedural purposes is to be used at your own risk. If you have questions or concerns, contact a medical professional prior to treatment. AAI is not held responsible or liable for risks involved with this procedure.
AAI strongly advises each member or student to research their local legislation. It is your sole responsibility to check and clarify all rules and regulations pertaining to your country, state, city, and county if you are planning on performing our training program procedures as a professional. AAI is not held responsible to provide this information and AAI cannot guarantee this information for any person. Please check with your local health department, governing boards, and FDA regulations regarding performance of any AAI course procedure. AAI is not held responsible or liable for legal encounters regarding licensing, regulations, or other legal aspects pertaining to procedural operation.