Dr. Shervin Naderi demonstrates the micro-droplet technique for lip injections, focusing on patient comfort throughout the procedure. He explains each step of the injection process and how the method creates gentle, natural-looking results.
Chapters
Good morning. We're going to do another lip injection in our lip injection series. This is a beautiful patient who's had a couple of lip injections in the past. It's been a while ago. One time Restylane, one time Juvederm. She prefers Juvederm. They're both very similar products. Juvederm is a little bit softer, a little bit more hydrophilic, gives a little bit more fullness and longer lasting than Restylane. But both are perfectly fine products. Restylane is SDF group for the lips. Gives it more shape, a little bit more firmness. So you have to pick and choose for the right patient. She already has full lips. We're just going to go a little bit fuller for her. Her preference is a little bit more of an exotic look. So we're going to do that for her today. We're going to show the technique. Okay. Eyes are closed. So she's had topical numbing. There's been no dental block done. This is just purely topical numbing. I'm going to have her leave her lips open just a little bit. Perfect. Going to go with the microdroplet technique with the shorter needle. You may have seen the long needle technique. When I want to give more shape, I go with a shorter needle. It's a smaller caliber. It's a little bit less. Do you feel much? Very little bleeding. So what I like to do is go through the lips once and go with either the short or the long needle, go across the whole lip, deposit some of the Juvederm. What that does is it basically gets more lidocaine into the lips because these products have lidocaine in them. So then it numbs up a little bit more. And then when I can go back into it, it'll be more comfortable for her. Any pain? No. Feels a little pinching or how does it feel like.
Like a tiny little pinch.
Okay.
I barely feel it.
Okay. And again, there's no dental block. You don't need to really 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. I know a lot of people are just scared of lip injections. They look painful. Putting a lip. Putting a needle on the lip. But it's really not that bad. It's just gentle, gentle. You can see there's no jabbing. It's very smooth, One side going across. Kind of just smooth it out. Make sure there's no lumps or bumps or anything. Now to get a little bit more of that heart shade, I'm going a little bit more to the border. Rolls it down a little bit more, gives this more lip show, if you will. Order is more painful, but she still seems to be doing okay. There's no bruises, any little bleeding spots, which stop, takes it out a few seconds for those to stop. But 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 lip vermilion. That's the most sensitive area, especially when you get too close to the central part. You can look at a patient's eyes and see how they feel. You want to take that into account. If they need a break, give them a break. We gotta know how they're feeling. I know this hurts more, so we're just gonna go a little bit slow. This is the most painful right there at the cupid's bow because there's innervation or 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 then the lower lip, the lateral tubercle, should be fuller. With most patients today, a little bit more of that modern voluptuous look, Which is slightly fuller throughout. You can see a variety of techniques under this serial threading. I went across the wet lip, wet dry border. I did the red lip, I did the vermilion. All of that, I'm still only used half sec, so I'm just kind of distributing it nicely to get our nice result. You don't want to just pump a whole bunch of it in too quickly into one spot. By now it should be even more comfortable. Do you feel any of this now? So the Juvederm has lidocaine in it, and as you inject, the lidocaine, gets absorbed into the lip and gets a little bit more comfortable. So leave your lips open for me. A little bit more. A little bit more to the lower lip. Now, cup of fact. When younger patients come for lip injections, they want to go full. 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 always seen that fishy, ducky looking person at the supermarket or the cousin or the friend who had their lips done poorly and they ended up looking fish lip or duck lip. Just because you have full lips doesn't mean they have to look fishy or ducky, depending on how you look, you can pull off more exotic lips and still have a really nice shape to it. What happens with duck lips or fish lips? They're too stiff, they're too full, and they don't have the right look. They end up looking more like a sausage than anything else. So in older patients, lip injections are really important, part of an anti aging facial rejuvenation. If somebody comes in their 40s, 50s, 60s, and they want to get their smile lines filled, they're missing the point. Most of the time you got to put the rejuvenation into their 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 show stars and movie stars that I've had really bad lip injections and it just scares people. At this point, it's pretty comfortable. We're just kind of giving a little more shape. She'd show me a picture on her phone of lips that she likes. Even though you can't usually give somebody exactly that, this is as close to it as possible. So here we go. Multiple little spots, but the needle is barely moving. So it's a micro droplet technique because we're trying to give shape in the right areas, not just fill them like sausages. Now what I have patients do is smile a little bit. I want to check for symmetry and I want you to kind of have a whistling look. There we go. Perfect. Check this in between. Now relax your lips. Just finishing up. You can see I'm coming from a variety of directions. These are more tangential and they're giving the vermillion more lift. Every lip injection is different. It's rare to do all the lips exactly the same way, but this needles actually go almost right underneath the mucosa. But you can see the directions. What that does, it just takes that vermilion border and lifts it up. And it looks beautiful. And when you do, the microdroplet technique, results tend to last longer because you put these drops in multiple different planes and directions and places. So it's not all sitting together in one zone. When I touch it, I don't feel any lumps or bumps because it's going in with micro droplets. A little bit more. Like I said, she had full lips to start with, so it's important to place it in the right places. But right now, if she puts a little bit of lipstick on, goes back to work, goes out, goes to dinner, nobody can tell she had anything done. The lips look a little bit more red. After injection, they look a little bit more like you already have lipstick on. If you're self conscious about fullness, you don't want to put lip gloss on. You don't want to put things that are shiny or these more matte lipsticks. But that day, that evening, you can go out and enjoy it. The next morning, you're always more swollen. Everybody the next morning is more swollen. Then two or three days settles down by a week. It's perfect. And usually, depending on, you know, your metabolism, a few months later you have to repeat it, but it tends to build up with time as you go. So pretty much we're going to clean her up a little bit and we'll be done just the last few cups. So I'm looking for little areas that I can do. Perfectly symmetric. Ejection spots are going to feel a little bit bumpy for two or three days. That's it. I'm going to clean her up real quick. I'm going to give her the mirror and see what she thinks.
I love it.
Looks really good.
This is exactly what I wanted.
Looks really good. Yeah, it's just like that picture you showed me.
