How Do You Get Natural-Looking Lip Filler?

All right, so virgin lips, untouched, the perfect time to get the right shape for it. Now, I've talked about this before. If you zoom in, you'll see she has very youthful lips, and they're tight. There aren't lots of wrinkles in the lips. So to try to really stretch it and make it really, really big is not advisable. And if you're going to do that, you're going to do it in multiple stages, every few months, to get a little bit more and more and more.

Now, sometimes you'll see patients, especially of Asian descent, Middle Eastern descent, Mediterranean descent, especially older people, that have a lot of room. There are lots of wrinkles and lots of pleats in the lips, and those you can go very full very quickly. But typically Caucasian lips, you want to do it slowly, and you want to do it in stages.

You hear a lot about migration, and the issue of migration is not that the filler is actually migrating, but that it's spilling over. So if you overfill it, overstretch it, it's going to spill over, and it goes from the red lip, where you want the filler to be, over to the white lip, and it will look full and it looks migrated. So we don't want that to happen.

So we're going to start. This is Juvederm Volbella. We're only doing half a syringe. We're going to be very conservative, and you'll see the filler. So I'm injecting both antegrade and retrograde. That means the needle goes in pushing filler in, and the needle comes out threading filler out. How bad was that? Oh, not bad at all. All right, good. As you can see, she is awake. She's not anesthetized. She just has some topical numbing, and with good, gentle technique it's very tolerable. I'm rolling the lip out, exposing the wet-dry border, and injecting it.

Now, you have to examine lips. You cannot just fill the lips like a sausage. You can't just fill the whole thing the same way. If you look at her lips, you'll see she is fuller right here. She has some fullness right there. I've not injected that yet, so I don't want to inject that. So I'm looking at that saying, okay, she's not full here, she's full here. So we're going to avoid all of this, and I'm going to go to the other side. So don't enhance areas that are already full. You're going to throw off the balance. You've got to use your judgment.

Rolling the lip out. Wet-dry border. The injection is going antegrade and retrograde. That means going in, filler goes in, and out, filler goes in. You will see me inject a whole bunch of times, but look, the plunger's barely moved from 0.5. Why? Because this is true micro-droplet. You don't want to put a big clump of filler and then have to sit there and massage and massage and massage. That's not the right way of doing it. Plus, when you're doing micro-droplets, it's safer. If you happen to be in a blood vessel, you're not going to occlude it. You're not going to get a vascular occlusion by putting a tiny micro-droplet of filler. But if you put a big chunk, yes, you will.

Now I'm examining her bottom lip and top lip. I want to have balance and proportion. So what I'm going to do is go to the bottom lip very conservatively. Typically, with bottom lips you want more fullness in the lateral aspect, and with the top lip you almost want fullness in the middle, but every lip is different. Some people have a different preference. Some women love a keyhole appearance, where it's fuller here and less full in the middle, so it has to fit their face nicely. Now I'm going to do a little bit of vertical threading. With that technique you get a smoother flow right there, and again, nothing's in the white lip. So it looks nice and natural, without that migrated look. Tiny little droplets.

Now what I do is I look at them straight on. I mean, they're laying down, I look at them straight on. I love this front lip. If you bring the camera forward, you'll see it from the top. The top looks really good. I want more balance on the bottom. So we're going to lay back and finish up with the bottom. I want more vermilion show, so I'm going on the vermilion border of the bottom, because I want the bottom to be poutier. Let's balance out her top lip. What that does is it basically extends the height.

I'm checking from multiple angles, from the side, from the top, having them sit up. The top view is a really good view if your room allows you to. If you go back there with the camera, you'll see me standing up here. This is called a helicopter view, and it allows you to really look at symmetry. But some injection rooms may not allow that to happen. All right, smile really big. Good. Try to whistle. A little bit more fullness over here, then we'll be done.

Perfect. We're going to sit her up. There's no bleeding, no bruising there. That's not typical for everybody. Certainly there could be bleeding and bruising, but she looks amazing. Super natural looking. You ready? Take a look. That's what you wanted? Yep, that fits you really well.

So this was Juvederm Volbella, which is a very soft filler. I use it for lips, I use it for noses sometimes, I use it for tear troughs, and I use it for very, very fine lines, especially around the smile lines. Restylane Kysse is my next favorite. If you want quite a bit of volume, that's a great filler, but it comes in a full syringe. It doesn't come in a half syringe. So now that she's got more room, if she wants to go fuller, we'll go to Restylane Kysse at some point, but this was perfect for her. Have a good one.