Dr. Shervin Naderi demonstrates micro-droplet filler injection to balance a thin top lip with the bottom. He uses Restylane for its shape and value, places tiny droplets slowly under topical anesthesia, and explains why minimal massage and omega-3 foods matter for healing.
Questions this video answers
"Micro-droplet Natural Top Lip Injection" (YouTube video, created/uploaded October 11, 2017).
Restylane: 0.5 cc per syringe; Juvederm Ultra: 0.4 cc per syringe.
Restylane is said to contain 0.3% lidocaine.
Normal capillary bleeding stops in about 25 seconds; hold pressure 15–20 seconds to stop a small bleeder; patients on high-omega‑3 diets may require ~45 seconds.
Chapters
Hi, good morning. I'm going to demonstrate something about beauty and balance. We have an attractive young woman here. She's here to get lip injections. When I examine her, when I evaluate her, she has beautiful bottom lip. So it's about balance. Some people like the bottom lip to be fuller, some people like the top lip to be fuller. I personally like them to be almost the same size, but it depends on the face, depends on ethnicity, depends on age, sex. A lot of things have to go into play now. A little bit of an imbalance is okay, but in her situation, the top lip definitely could use more volume.
And that's what we're going to do. I'm going to use Rest.
We could use Jupiter, we could use Volbella. But Restylane gives you the biggest bang for the buck. It's 0.5cc and it gives the best shape. Volbella is a little bit too soft in this situation. And Juvederm Ultra comes in 0.4cc. So I don't have enough material as I need. So I'm going to demonstrate that technique here with breast. So she has had topical numbing placed.
There's no dental block.
It's very tolerable.
It's not pain free, but it's very tolerable. Okay. Doing okay? Yeah, not terrible. Okay. You can put your lips together. If you penetrate really slowly, it hurts less when you jab and stab. That's when it hurts more. Just watch how slow the needle's going through. Taking my time. There's no pressure. Pressure sets off certain nerve endings. So the nerve endings that pick up sharp are different than the nerve endings that pick up pressure. You don't want to set both off. Now, if the restylane does have 0.3% lidocaine in it. So as we go through gets more and more and more comfortable. But again, you see the technique. Be gentle. When you're gentle, you get less bleeding, less swelling, less bruising. I'm watching it shape right in front of my eyes, watching the filler go. The central part of her top lip is fuller. I'm not going to do much there. You don't want to inject everything uniformly because then it's going to look like a uniform sausage.
We don't want that.
Let's switch sides. Camera angle is perfectly fine where it is. Another little Pokemon. Real gentle, tiny needle, very bearable. Ten, 15 years ago, we used to do dental blocks and numb people's entire mid face. The last probably five to seven years. I can't remember how many dental blocks I've done maybe just a handful. It's not necessary. With good topical numbing and good technique, it's very tolerable. But people come in and say, you know, they had injections. It was brutal. So much pain. Well, either no topical numbing was used or it was a jab and stab technique. Doing okay? Yes. Have you been forced to say yes? No. All right. It's a voluntary. Yes. This patient's driven from quite a far away to come here just to have this little bit of discomfort. Put lips together, more balance and do a little bit more in this zone, going in a different direction. Now, She does have a good vermilion border. I don't need to do there. My massage for lips is this. That's it. When I do this, it smooths everything out again, I have heard from patients where they've gone and injections were done and then the doctor spent quite a bit of time just wrestling the lips, massaging and massaging and massaging. That's not necessary. If you do the micro droplet, when you put tiny, tiny, tiny little droplets in different places, the beauty of that is you don't feel lumps and bumps. Another beauty is it lasts longer because the wrestling goes into different levels. Put your lips together more balanced. How you feeling? Good, Good. Smile really big. Now whistle. Very symmetric. I'll do a little bit to the top. Now switch. I want to do a little bit more pouty. Go pouty. It's a little bit more central. But again, you see, it was 0.5cc's and I don't know if anybody's keeping count of how many times I poked her with 0.5cc, but that's a true micro droplet. Very little bleeding, no bruises. Go out right afterwards. I tell my patients, don't go to lunch because your lip is numb. You gotta drool over yourself. But you can go out and she'll look normal tomorrow morning. It is more swollen.
There's a tiny little bleeder like that.
No big deal. Just hold a little pressure and it stops. These are tiny little capillaries. And that's it. Now, when you hold pressure, I've seen.
People kind of dab and dab.
Just hold pressure. You gotta hold pressure.
You hold pressure for 15, 20 seconds, it'll stop the bleeding. Now, things that make you bleed and bruise more, nuts, walnuts and almonds seeds, flaxseeds and chia seeds, tahini, sesame seeds, fish, fish oil, avocados, even vitamin D. That's fish based. All of that has a lot of omega 3s. So those patients, you'll see, you have to hold pressure for 45 seconds. Normally, bleeding time is about 25 seconds. When you poke somebody, it should stop bleeding in 25. But people that eat a very healthy diet, the Mediterranean diet, you'll see they will bleed more.
Just hold a little bit more pressure.
And that's essentially it stops bleeding. Every bleeder stops and we're done. So that's basically a micro droplet technique. Rest onto the top level. Thank you.
