Dr. Shervin Naderi injects Restylane-L into thin lips using a gradual approach over multiple treatments to avoid overfilling. He uses 0.7 cc, places some product in smile lines, and explains that initial fullness and tenderness fade within days.
Questions this video answers
Restylane-L
0.3% lidocaine
17 syringes in six months
Every 2–4 weeks
0.7 cc
Chapters
Hi. We're going to do another lip injection. I'm going to show you thin lips. A lot of people come in and say, well, how did Kylie Jenner get to the point that she got? How did she go from very thin to the really large lips that she has? And the answer is, you can't do it in one step. There's just no way. Even if I put three syringes into a lip, it's just not going to turn that way. It's just going to get stiff sausage like and duck like and it just doesn't work properly. So you think going from thin to very full. As a stepwise process, progressive algorithm, you have to do the injections every two to three or four weeks. You do the filler, it swells up, settles down, a little bit of it goes away, then you refill it again and slowly you stretch it, slowly you shape it. It's like a tissue expander. And over several months, period of time. There is a patient that I did 17 syringes in six months and now she comes in once a year. So those are some of the stories. Now most people don't want to go from Verithin to kylogen or type 4. So it's more subtle. But even when you do subtle within lips, it's a little bit more full, a little bit more stiff for the first three to four days. People a little bit self conscious for the first three or four days, but it's extremely natural. There's plenty of pictures we have that you can see on Instagram. We're on older patients, very conservative patients. A little bit of injection can be done to give you a little bit of a more youthful look, but very, very natural. Nobody can tell that anything's been done. I'm going to show you this technique, so come on up closer. We're using Restylane. Chin up a little bit. Lips open just a little bit. We're using Restylane L topical numbing has been used. No dental block, no numbing shots. But the material itself has more lidocaine in it, 0.3%. And as we go along, it numbs up more. A couple of rules of the central part hurts more. So the closer you get to the midline, the more she feels it. If you are close to that time of month, if you're close to a period, it hurts a lot more. For any type of injections, if you're within a week of it, please keep that in mind when you schedule your appointments with your doctors. Keep that in mind for some Reason it's definitely more tender and painful that time. She's doing well. Hardly any bleeding. You can kind of start seeing the shape that's taking place. Gentle injections, no stabbing, no jabbing. Don't beat up the lips. Be very gentle. Get a little bit of a stretch as you go in. If there is a little bit of a bleeder, just hold a little pressure and it stops. Remind your patient once in a while to swallow. They tend to with the numbing. Hold their saliva and they can start coughing and choking. Looks really good. Very natural. Lips together look perfectly natural. Looks really, really good. This is where we're going to end up basically in about week, week and a half. But what I'm going to do, we're going to add a little bit more because like I said, some of this is going to settle down. So I don't want to be turning around in a week and a half and not seeing any results. Lips open just a little bit. So we're going to go a little bit fuller just for three or four days. Just so that in the long run we have something more to show for it. For people that are afraid of the fullness, if they love it at that moment, three days later, they turn around and say, I don't see anything. Why did I even do this? But regardless, even if they're self conscious about the fullness, it's because usually the lips are numb. When the lips are numb, if you go to the dentist and you get dental work and your lips are numb, they feel large, they feel big. It's a feeling. It's not a look, it's a feeling. And it settles down quite a bit. Now you can see. Perfectly natural. If you didn't know her, you think that these were the lips she was born with. Smile for me. Really big. I want to see teeth. Good. We're checking for symmetry and I do a couple little massages just to make sure there's no lumps or bumps. With this technique, there's not a lot of massaging necessary. Lips open just a bit. Good. These little bleeders that bleed out, they don't bruise. Bruising is the ones that kind of stay and bleed underneath the mucosa, underneath the skin. This is going to bleed right out. There'll be no bruises, but just a little bit of pressure to stop it. Now pressure works when you actually hold pressure. The other thing I tell patients is don't clench your hands because what that does is it makes your blood pressure go up, you bleed more. So you want to be in Kind of a yoga Zen state. Doing okay? Yes. Good. There's a long list of food supplements, herbs, seeds, nuts, fish that I tell patients to avoid prior to injections for two weeks. That is all this patient eats. So she does tend to bleed a little bit more. But again, no major bruises. If you avoid the nuts and seeds and fish and omega 3s and avocados, you bleed much less. Okay, clips together. Let me see a big smile. Whistle as if you're trying to whistle. Okay, got. So basically we're just checking for symmetry. Lips together, holding a little bit of pressure, then we're done. Now, I used 0.7 cc's. So just because you open a 1 cc syringe doesn't mean you have to use a full cc. What I'm going to do is I'm not going to waste it. This stuff is expensive. So I'm going to basically talk to her about putting it into the smile lines. She has a thinner face, so she's formed some smile lines there. And it's going to be quick and easy. This is just something that we're going to do and it'll help her out. Lips look perfect. We're not going to go any fuller. Let me just double check. I like the symmetry. Looks really, really good. So some of these smile lines here, you'll feel this a little bit. Bear with me. Two pokes on each side. One, two. These always hurt a little bit more because even if you put numbing, which don't numb well, the skin in this area is thicker, so they don't numb well. One, but anybody can take two pokes. Two. Done. Perfect. We are done. That's it. She can put some lipstick, she can go up, enjoy the lips. And that's pretty much it. Thank you.
