Lips

With ageing the tissue that keep our skin looking youthful and 'plumped up' begin to break down. Loss of dermal ground substance contributes to wrinkling of the skin. Ageing is also characterized by loss of facial fat and along with alterations in skin elasticity, leads to sagging of facial tissue, evidenced by the nasolabial folds and jowls.

Fillers can help to fill out facial wrinkles, creases and folds. They can restore volume to sunken cheeks and can also add a fuller, more sensuous look to the lips.

Specific mention is made of wrinkles caused by muscular activity (mimetic wrinkles i.e. frown lines and forehead wrinkles.) Botox is more effective in treating these lines although the combination with fillers may result in their more rapid resolution.

Indications

Injectable fillers can be used at most sites, the most rewarding areas include:

Plump, pouty (without looking done!) well-defined lips, are a sign of youth. Ageing is associated with thin, wrinkled lips, poorly defined edges and lengthening of the upper lip. Off the shelf               injectables can enhance the size, shape and definition of lips and recreate a more youthful appearance.

Duration: 30 minutes
Local Anaesthetic

Indivudual fine lines can be treated by direct injection of fine fillers. In areas with multiple fine lines (smile lines around the eyes / upper lip) the whole area is treated to temporarily restore a smoother, more youthful-looking appearance.

Fillers can reduce the appearance of deep nasolabial folds (cheek folds) and marionette lines ((below the corner of the mouth)

TYPES OF FILLERS

Injectable: 'off the shelf' - performed in doctors' rooms.

These are very popular as they are quick and simple with few side effects. I only use fillers that have long track records of safety and effectiveness. I use exclusively, Hyaluronic acid fillers.

Hyaluronic acid (Restylane, Perlane, Juvederm) is a naturally occurring substance (polysaccharide), which forms much of the ground substance of the skin. It forms part of the 'gel', which bathes collagen and elastin fibres. The hyaluronic acid content of the skin decreases with age and this is partly responsible for the formation of wrinkles

The product is a clear, injectable gel formulated by purely chemical processes in the laboratory. It is non-animal derived (from the fermentation of sugar by Streptococci). The material then is alcohol precipitated, filtered and dried.

The difference between products is the size of the gel particles and their cross-linking.

Benefits

• Non-animal.
• Non-toxic.
• Non-allergenic, therefore no skin test needed.
• Biodegradable.
• Simple to use.
• Minimal 'down-time'.
• No overfilling of the area is necessary.

Side effects and potential risks

• Bruising.
• Redness.
• Irregularaties - uncommon.
• Under or over-filling - uncommon

Surgical Fillers: this involves a surgical procedure fat / dermis /

dermal-fat

Structural Fat Grafting: 'Fat Injections' - 'Autologous fat grafting'

Fat is most frequently used to fill in sagging cheeks or the naso-labial folds or to correct skin depressions or indentations and to enhance the lips.

To survive and maintain the correction live fat cells require a new blood supply at the recipient site. This may be somewhat unpredictable which is why overfilling is recommended. In addition, like all injectable fillers, the procedure may require repeating.

Being derived from your own body, there is no possibility of allergic reactions or the transmission of diseases.

Dermal Grafts

Other filling techniques include the use of dermis (the deeper layer of the skin). Dermal grafts can be harvested from old scars, the buttock, groin or similar crease, or at the time of other surgery, for example during a facelift where skin is removed. The dermis can then be threaded into the areas that require augmentation.

Dermal grafts tend to survive better than fat grafts. This may be a more suitable option of permanent lip augmentation than fat injections.