This is a procedural demonstration (YouTube video) in which Dr. Alex Snodgrass performs lip injections and narrates technique and decision-making to achieve natural-looking results. Key points: respecting lip borders to avoid migration, layering small threads/aliquots (not too deep or superficial) to avoid lumpiness and the Tyndall effect, avoiding lateral overfilling to prevent a ‘ducky’ look, respecting tubercles and central volume to maintain facial balance, checking symmetry during animation, and using topical numbing for ~30–45 minutes prior to injection.
Questions this video answers
About 30–45 minutes.
A bluish discoloration on the skin surface secondary to superficial filler.
October 24, 2022
Chapters
Hi, I'm Dr. Alex Snodgrass, and today I'm going to do some lip injections on this beautiful patient. So today we're going to try to create some more central height. That's what would look best for her facial balance and for her specifications as well. Okay, so I'm going to have you slightly open your lips. Perfect. We're going to start here. So you can see I'm respecting the borders of the lips. That's how you avoid potential migration. You can see the filler slowly diffusing in. So I'm starting by just doing tiny little layers, threads. I'm not going too deep, but I'm not going too superficial. So you don't have any lumpiness or bumpiness or Tyndall effect, which is where you can actually see a bluish discoloration on the skin surface secondary to superficial filler. We're just continuing to layer. The patient isn't feeling too much discomfort because she's been numbing with a topical agent for 30, 45 minutes. And so you'll notice with my lip injection techniques that I really do avoid the lateral borders of the lips, because this is where you can make. You can cause the patient to be a little bit more ducky. And we're not about that look. So I'll do a few curved threads to help recapitulate the natural volume and shape of the upper lip. And then I'm just injecting like, small aliquots each time. For patients that have asymmetries, you can use like, curved and straight threads to try to recapitulate or balance out that asymmetry. She's doing perfect. So now that I've built out the central component of the upper lip, respecting the tubercles, which aren't super obvious in her, I'm going to do a fine thread right at the lateral edge to smooth out that junction. So I'm injecting a little bit harder towards the center and then slightly feathering out, so to kind of almost give a tadpole shape of filler under the skin. This will allow that junction to be nice and smooth, very natural, without risking any duckiness. The upper lip. This is one of my favorite parts of lip injections where you can see the before and after in person or in live time. It's looking great. And so far we have no bruises. Doing wonderful. So I kind of got a feel for how the filler was diffusing in her skin type and overall shape on that side. So the other half goes a little bit more Quickly, you can see the lips kind of fill as we're injecting. So another thing that I do consistently throughout the injection is watch for animation. So will you smile for me with your teeth? Perfect. So I'm checking for symmetry with and without animation to make sure that we maintain it throughout the entire time. Now for the lower lip. One, two, three. Big, big pinch. I do slightly thicker threads. So all fillers are. Most fillers are complex with lidocaine or a numbing medication, so the patient will feel a bit of burning upon injection. And I warn them of that on the lower lip, since I'm doing slightly larger threads to recapitulate the natural shape of the lower lip. And again, with the lower lip, you really want to respect the tubercles, so they're here and here. So creating a rounded shape to the lip, adding too much centrally will give that sausage look, which we're not a fan of either. So again, I'm just feathering around that shape that I just created. So at the end, I'm just still being extra cautious of all my symmetries, being aware of how much product we have left, and just moving all around to correct tiny little millimeter differences. Smile one more time for me, dear. Beautiful. And those are beautiful kissed lips. It.
