What Is the Micro-Droplet Lip Injection Technique?

Good morning. This is a lip injection in our injection series. A beautiful patient who's had a couple of lip injections in the past, a while ago, one time Restylane, one time Juvederm. She prefers Juvederm. They're very similar products. Juvederm is a little bit softer, a little bit more hydrophilic. It gives a little bit more fullness and lasts a little longer than Restylane. But both are perfectly fine products. Restylane is FDA approved for the lips and gives a little more shape, a little more firmness. So you have to pick and choose the right product for the right patient. She already has full lips. We're just going to go a little fuller. Her preference is more of an exotic look, so we're going to do that today, and we're going to show the technique up close.

So she's had topical numbing. There's been no dental block. This is just purely topical numbing. Leave your lips open just a little bit. Perfect. We're going to go with the micro droplet technique, with the shorter needle. You may have seen the long-needle technique, but I want to give more shape, so I go with the shorter needle. It's a smaller caliber, so it's a little bit less painful.

What I like to do is go through the lips once, with either the short or the long needle, across the whole lip, and deposit some of the Juvederm. That basically gets more lidocaine into the lips, because these products have lidocaine, and it numbs them up a little bit more. Then when I go back in, it'll be more comfortable for her.

And again, there's no dental block. You don't need to block the whole face just to do the lips. With a little bit of topical and good, gentle technique, you can get this done with very little discomfort. You obviously feel it, but it's not horrifically painful. A lot of people are just scared of lip injections. Putting a needle in the lip looks painful, but it's really not that bad. It's gentle. You can see there's no jabbing. Very smooth. One side, going across, and I just smooth it out, make sure there are no lumps or bumps or anything.

Now, to give the lip more of a heart shape, a little bit more to the border, it rolls it out a little bit more and gives more lip show. The border is more painful, but she still seems to be doing okay. There are no bruises. There's a little bleeding spot, which stops. It takes a few seconds for those to stop. Basically, by the time she goes wherever she's going, most of that should be done.

Now, you saw her cringe a little bit at the top vermilion. That's the most sensitive area, especially when you get close to the central part. You can look at a patient's eyes and see how they feel, and you want to take that into account. If they need a break, give them a break. I know this hurts more, so we're just going to go a little bit slower. This is the most painful area, right there at the Cupid's bow, because there's innervation, nerves, coming from both sides.

Now, ideally, if you look at lips (leave your mouth open just a little), the central tubercle right here should be fuller, and on the lower lip, the lateral tubercles should be fuller. Some patients today want a little bit more of the modern, voluptuous look, which is slightly fuller throughout. You can see a variety of techniques, with serial threading across the wet-dry border. I did the red lip, I did the vermilion, but with all of that, I've still only used half a cc. So I'm just distributing it nicely to get a nice result. You don't want to just pump a whole bunch of it too quickly into one spot. By now it should be even more comfortable. The Juvederm has lidocaine in it, and as you inject, the lidocaine is absorbed into the lip and it gets a little bit more comfortable.

Now, a couple of facts. When younger patients come for lip injections, they want to go fuller. When older patients come, they're very afraid of going full. It's just one of those things. Lip injections always scare people, because we've all seen that fishy, ducky-looking person at the supermarket, or a cousin or a friend who had lips done poorly and ended up looking fish-lipped or duck-lipped. Just because you have full lips doesn't mean they have to look fishy. Depending on how you look, you can pull off more exotic lips and still have a really nice shape. What happens with duck lips or fish lips is they're too stiff, they're too full, and they don't have the right shape. They end up looking more like a sausage than anything else.

In older patients, lip injection is a really important part of anti-aging facial rejuvenation. If somebody comes in in their 40s, 50s or 60s and wants their smile lines filled, they're missing the point most of the time. You've got to put the rejuvenation into the cheeks and into the lips. That gives you way more bang for the buck. But again, older women tend to be really afraid of that, because we've all had friends, acquaintances, TV stars and movie stars who've had really bad lip injections, and it just scares people.

At this point, it's pretty comfortable. We're just giving a little bit more. She showed me a picture on her phone of what she likes, even though you can't usually give somebody exactly that. This is as close to it as possible. Multiple little spots. The needle's barely moving. It's a micro droplet technique, because we're trying to give shape in the right areas, not just fill them like sausages.

I have patients smile and whistle to check for symmetry, and I check in between. Now relax your lips. I'm just finishing them. You can see I've injected from a variety of directions. These are more tangential, and they're giving the vermilion more lift. Every lip injection is different. You can't do all lips exactly the same way. But you can see the direction. Look at this. It just takes that vermilion border and lifts it up. They look beautiful. When you do the micro droplet technique, results tend to last longer, because you put these drops in multiple different planes and directions, in different places, so it's not all sitting together in one zone. When I touch it, I don't feel any lumps or bumps.

Like I said, she had full lips to start with, so it's important to place it in the right places. Right now, she can put a little bit of lipstick on, go back to work, go out to dinner, and nobody can tell she had anything done. The lips look a little bit more red after injecting. They look a little bit like you have lipstick on. If you're self-conscious about the fullness, use matte lipsticks rather than shiny ones. That evening, you can go out and enjoy it. The next morning, everybody is more swollen, for a few days, and it settles down by a week. Usually, depending on your metabolism, you have to repeat it about three months later, but it tends to build up over time. So we're going to clean her up real quick and give her a mirror to see what she thinks.