Less Pain, Less Bruise, Natural Looking Lip Injection Using Restylane

Hi. We're going to do another lip injection. In our YouTube video series demonstrating lip injection techniques, you may wonder why we have so many different lip injections. That's because no two lips are exactly the same. Even the upper and lower lips on the same patient, or even the right or left side of the lip can be different. So I like to demonstrate various techniques. I've used Juvederm, Restylane, Belotero, various fillers. My partner, Dr. QLife, has videos showing implants. I used to do implants many years ago, but Dr. Culac does that in the practice now using the Permalift Surgery Cell permanent silicone lip implant. It's fantastic. There's other procedures as well. Lip lifts, lip advancements. There's many different things you can do to enhance the lips, but we're going to focus on injections today. So there's a beautiful young lady here who wants to get full of lips. She's had injections before in the past, but never by me. Now she's coming here and we're going to do a little lip injection for her. If you actually look at the lips, you can see that she has a nice shape to herself. And laterally, though, when you go on the outside, you don't see much of the red lip. So there's a difference between white lip, red lip, the cupid's bow, and filter ridges. And there's different zones to the lip. The bottom lip looks nice. The top lip in her is a little bit narrower than the or thinner than the bottom lip. Classically, you do want the top to be a little bit narrower, but more young women like them to be the same fullness or even a little bit fuller up top. As long as you don't look ducky. We don't want that. The issue becomes when you have longer white lip and less of a roll right there, when you have enough of a roll, it's very nice to inject this area. And you get really nice results. When there isn't much of a lip show or this red lip out here, injecting too much out here can actually make it look very fake and ducky, and we're not going to do that. To get that to roll up a little bit, you have to inject the vermilion border as well as the meat of the lip or the red lip itself. There's going to be limitations to what can be done. You can't make everybody's lips look exactly like Angelina Jolie's, but most people don't want those Anyway, they just want nicer, fuller lips for their faces. Just don't make them look ducky, don't make them look fake and you can get nice results. Initially, there is some swelling, there could be some bruising. Three or four days later it settles down. You could wear lipstick or makeup and cover it up. And it's a procedure you do about twice a year. We're going to demonstrate. So what I like to do is I like to grab the lip, roll it up a little bit, gentle. And I like to look at the injection entry point right here. And I ask the patient, everybody's usually nervous I'm going to enter right now. I ask them not to startle. The first injection is kind of where they feel the most. Then once I'm in, it's just a very, very gentle, slow progression. You don't want to be fast. You want to let the lidocaine start working. Start numbing up the lip ahead of yourself. Look at my speed, it's very slow. And if I want to see what it's doing, I release my finger occasionally to be able to see the effect of it. As you get closer to the central part of the lip, there's more nerve fibers there. You may feel a little bit more there. So again, I slow down, lift my finger up, see how it's doing, see what effect I'm getting. And my right thumb or the injection finger has a smooth control. I don't have to keep looking at it. I know exactly what it's doing. And you can start seeing how the right upper lip is starting to look nicer than the left upper lip. And it's starting to get filled up. I know where the tip of my needle is. This is the long needle injection technique. I use a short needle for fine tuning, but when I use the long needle, there's less injection sites, less pain and certainly less bruising. How bad was that? Not too bad. Not bad at all. Good. And you don't see any bleeding. There's no bruising. This was only with topical numbing cream, surgeon or injector. It's going to be a little, slightly different technique because I like to spread the lips with my fingers, enter again and then just slow it down. Once you enter going in the right direction, going slow. My hand that's injecting is just as important as my hand that's not injecting because the non injecting hand or finger is helping guide. You can see where the needle is. You can see where the tip is. I'm filling it. And again her central lip was fuller than the lateral lip. So I want to do less centrally on her initially. I don't want it to be a shelf. I don't want it to be ducky. Come a little bit more laterally here and see how she does. Take a look. There's a little bit more needed here. I'm not going to pull out. Go back here. You can feel where the tip of the needle is right in the zone that I need to inject right there. Deposit a little bit more and we're going to have to massage it in a couple seconds. But this gets me as much as I need without too many entry and exit points. Now I take the lips and I massage them. This does two things. It smooths it out, making sure that there's no lumps or bumps anywhere. It distributes the filler precisely and smoothly in the right plane, which is above the muscle and below the mucosa. And with my fingers I can actually feel and see how much filler I have on each side and see if I need more again. I'm going to come back and do a little bit more there later, but I'm going to let the lid again start working, going back again to the lower lip now again, the entry point is the one that probably she'll feel the most. The rest of it is a smooth progression. I'm injecting as I'm entering. It's one smooth progression. I'm also injecting as I'm pulling back. You can pull back a little quicker than you enter. Again. Not much bleeding at all. No bruises so far. On the other side. Again, you have to adjust your body depending on if you're right or left handed. Entry. Slow, slow progression. I know exactly what my injecting thumb is doing. I don't have to keep looking at the plunger and see how much I've injected. This comes with years of experience. Pulling back and then the same thing. Massage. Once I massage, I'm going to switch to a short needle and do a little fine tuning. There's a little bleeding point right here. That's the only point she's bleeding from. You just hold a little pressure and it'll stop. No major bruises there. Just like that. Just hold a little pressure and you don't have too many bruises everywhere. Okay. So I've pretty much injected. If you look at it most of the syringe, there's only 0.2 cc's left. It's very smooth. There's no bleeding, there's no bruises. I'm Going to go back and just make lips more symmetric. They never start out symmetric, but we can get them more symmetric. And you can see that I can add a little bit right here. Again, I'm very, very superficial. I don't want to create too much bleeding and bruising. Since we haven't had it so far, we'll get a little bit more bleeding. But her initial problem was the lack of lateral lip show. Now you can see, you can see the red lip really nicely laterally on both sides. Occasionally you're going to have a couple of capillaries in the way, but you're staying away from the labial artery. You're not going to get any major bruises. Just a whole little pressure and that'll stop. I tell everybody, stay off. Flaxseed, fish oil, omega 3s, aspirin, anything that makes it bleed or bruise more. And if it happens, just hold a little pressure. It'll stop. Hold some pressure, lift it off. I'm going to create a nice little cupid's right here. A little drop right there. A little drop right there will accentuate this little area right there of the philtrum. Looks really, really nice. We'll look at the lips. I'm going to have her smile. Smile for me. I'm going to have you whistle. Whistle. So what we're looking at is lip movement and how it changes. She needs a little bit of volume right there centrally, and then we're done. Done. That's it. And you can see very nice, very natural looking. She could wear lipstick, she could wear lip gloss, whatever she wants. It doesn't look ducky, it looks fuller. The bleeding, just a little bit of pressure stops and she can get back to school, back to work and enjoy the results immediately. If she wants to repeat these, typically I say it again about twice a year or we can look at implants with my partner, Dr. Chulak. Thank you.