Throughout history, lips have played a significant role in defining feminine beauty. A full, well defined lip signals youth and vitality while a thin lip can signify old age or displeasure. Ancient Egyptians would color their lips with henna to draw attention to them. In more recent times, people have injected substances like paraffin and liquid silicone to enhance the lips. Luckily, much progress has been made since then in safe and effective lip rejuvenation.
Lips are one of the first places that we show our age. There are four things that happen to lips through the years. First, lips lose volume and body. You can see this in the lips of elderly ladies – they are often very thin – much thinner than the lips of teenagers.
Second, you lose your philtral columns as you age, leading to loss of the “Cupid’s Bow” appearance. Philtral columns are the two parallel lines of tissue between your nose and upper lip that give the upper lip its distinctive “M”-like shape. As these columns of tissue break down (usually in your 30s or 40s) your upper lip loses its distinctive curve and becomes flat across the top.
Thirdly, because you are losing volume in the body of your lips, and because you are losing the columns of tissue near the nose that support the upper lip, you begin to get little horizontal lines around the outside of your lips, which are commonly referred to as “smokers’ lines” although they occur in both people who smoke and people who do not. You can think of these lines very much like you would think of the wrinkles you get on the surface of a balloon as it deflates. You are losing volume both in and around the lips, and since the skin has nothing to “fill it out”, it wrinkles.
Fourth, and finally (are you depressed yet?) you also lose volume in the sides of your chin– particularly in horizontal lines below the outside edge of your lip – leading to “marionette lines”. This loss of support leads to the outside corners of the mouth turning down, giving the lips a “sad clown” or a dropping appearance.
Okay – that is the bad news. The good news is that all of these things can be corrected with dermal fillers – so let’s talk about correction, shall we?
Aging lip – Correction
It is easy to correct the loss of lip volume. Juvederm (for more on what Juvederm is and how it works, see my recent post – Juvederm, the Basics or read below) is placed in the middle of the lip – between what is called the “wet-dry border”, which is just what it sounds like, and the “vermillion border”, which is the line where the red of your lip stops and your normal colored skin begins. This has a really nice effect of “plumping” the lip and generally takes one syringe of Juvederm or less.
The key to beautiful lips is creating a natural shape and contour. Just “filling up” the lip without providing definition, can leave a person with an overblown “duck-ish” look. Rebuilding the philtral columns is also very easy to do – and gives the upper lip definition. Smokers’ lines can be corrected with Juvederm as well – using a slightly different technique. Instead of injecting between the wet-dry border and the vermillion border, you inject along the vermillion border itself. This fills in the skin just under the smokers lines and causes them to even out. This will require about half of a syringe of Juvederm in most people.
Finally, injecting Juvederm just below the corners of the mouth can give enough support to the corners of the mouth so that they turn up instead of drooping. This can also be done with about a half of a syringe in the average person.
Remember – when it comes to fillers in the lips, less is more! A lot of people put a large amount of volume into the lip – when you can get a much more natural and attractive look with less volume and more attention to contour. Generally speaking, we will not put more than one syringe of Juvederm into the lip, and will place another half a syringe in the marionette lines to provide support if needed.
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