A Simple Surgical Remedy for Iatrogenic Excessively Thick Lips

Botti, Giovanni; Botti, Chiara; Cella, A.

doi:10.1097/01.prs.0000026498.97540.96

“…Botti et al, 15 in 2002, described their experience in iatrogenic excessively thick lips surgical reduction in 24 patients. In the paper it was described a ''double arch'' approach for the upper lip, represented by a curvilinear ink mark traced down to the mucosal lining of the internal side of the lip in the shape of 2 lozenges coming tighter to form a bow, providing the pattern to be followed by the incision.…”

Section: Results Of Individual Studiesmentioning

confidence: 99%

“…The review process identified a total of 3 studies: Botti et al 15 (2002); Kastner et al 16 (2018); Rauso et al 17 (2019). Seventy-three patients were evaluated; 72 upper and 39 lower lips were operated on.…”

Section: Resultsmentioning

confidence: 99%

“…After a careful evaluation of all the existing medical literature, only 3 papers were considered suitable for the review because not many physicians are prone to treat these clinical conditions 15–17 …”

Section: Discussionmentioning

confidence: 99%

“…The first ones introducing the idea to extensively treat lip previously injected with permanent filler were Botti et al, 15 in 2002, who presented an easy surgical technique to ameliorate iatrogenic thick lips performed in 24 upper lips.…”

Section: Discussionmentioning

confidence: 99%

“…36 After a careful evaluation of all the existing medical literature, only 3 papers were considered suitable for the review because not many physicians are prone to treat these clinical conditions. [15][16][17] The first ones introducing the idea to extensively treat lip previously injected with permanent filler were Botti et al, 15 in 2002, who presented an easy surgical technique to ameliorate iatrogenic thick lips performed in 24 upper lips.…”

Section: Summary Of Evidencementioning

confidence: 99%

See 3 more Smart Citations

Surgical Lip Remodeling Following Permanent Filler Injection: A Scoping Review

Rauso

¹

,

Fragola

²

,

Fasano

³

et al. 2021

Journal of Craniofacial Surgery

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Over the years, several techniques have been introduced to obtain permanent lip enhancement, such as the use of silicone lip implants or the off-label use of permanent fillers. Although some reports indicate that permanent lip filler is safe, many others describe early-and late-onset complications. The main issue with permanent lip fillers is the lack of a standard technique to correct undesirable results. The aim of this scoping review was to list and evaluate the surgical pathways described in literature to correct lip deformity resulted from the injection of permanent fillers. The methods and the inclusion criteria of this work were specified in advance and documented in a protocol, according to the PRISMA 2009 checklist. The research was carried out on electronic databases PubMed, Cochrane Library, and Scopus databases identifying articles from March 1991 to December 2020 and conducted up to December 23rd, 2020. Articles language was limited to English. The selection process identified 3 retrospective studies eligible for inclusion. 73 patients and a total of 111 lips (72 upper and 39 lower) were considered. Two early complications were identified, 1 suture dehiscence and 1 total lip mucosa necrosis. Surgical lip remodeling following permanent filler injection seems to be an effective approach although the surgical pathway needs to be customized per each patient. Complication rate seems to be coherent to lip surgery performed with reconstructive purposes. To confirm these data case-control studies with much wider cohorts are needed to reach statistical significance.

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Histological, Clinical Assessment, and Treatment of a Complication after 16 Years of a Permanent Filler in the Upper Lip: A Case Report

Fiuza,

Marques,

Padin

et al. 2024

Preprint

1

0

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There is a considerable increase in the use of substances and medical procedures aimed at changing the esthetics of the face, particularly the appearance of the lips. Permanent fillers such as polydimethylsiloxane, also called liquid silicone, are widely used, but their application for facial esthetics is currently obsolete. However, the long-term complications remain a reality, as they can occur decades after the application. Thus, the goal of this case report was to present a complication after 16 years of treatment using liquid silicone. This case report involved a 52-year-old male with a complication of bilateral permanent filler in the upper lip performed 16 years ago, its surgical removal, and histological analysis. Histologically, it was possible to identify a chronic inflammatory, lymphoplasmacytic, and granulomatous reaction, with foreign body giant cells’ reaction, in relation to non-polarizable exogenous material due to the reaction to silicone. The most common complications are granulomas' appearance and material displacement. The case report shows these granulomas are characterized as chronic low-caliber inflammation around the silicone. They have an unknown etiology but are probably multifactorial, from continuous trauma, friction or irritation, iatrogenic factors, infection, immunological mechanisms, and genetic and molecular variations, and can be highly related to the impurity of the injected material.

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Histological, Clinical Assessment, and Treatment of a Permanent Filler Complication in the Upper Lip: A Case Report with 16-Year Follow-Up

Fiuza,

Marques,

Padin

et al. 2024

Cosmetics

1

0

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There is a considerable increase in the use of substances and medical procedures aimed at changing the esthetics of the face, particularly the appearance of the lips. Permanent fillers such as polydimethylsiloxane, also called liquid silicone, are widely used, but their application for facial esthetics is currently obsolete. Silicone belongs to this polymer family; its viscosity is determined by its degree of polymerization. Liquid injectable silicone is odorless, colorless, non-volatile, and oily to the touch. The substance is not altered by storage at room temperature and is not carcinogenic or teratogenic. However, the long-term complications remain a reality, as they can occur decades after the application. Thus, the goal of this case report was to present a complication after 16 years of treatment using liquid silicone. This case report involved a 52-year-old male with a complication of bilateral permanent filler in the upper lip performed 16 years ago, its surgical removal, and histological analysis. The patient had the first appointment at the University Dental Clinic—Universidade Católica Portuguesa (Viseu, Portugal) in April 2022, dissatisfied with his upper lip’s esthetic appearance and shape. He was not a smoker or diabetic but had hypertension and hypercholesterolemia and was medicated with Losartan, Hydrochlorothiazide, and Pitavastatin. No relevant findings were observed in the extraoral examination; he had bruxism and a good periodontal condition. The patient had an asymptomatic bilateral mass, hard to palpation, located on the upper lip due to permanent lip filling performed to increase its volume in 2006 associated with non-related generalized granules of Fordyce. The treatment options presented just observation or complete material removal in two surgical steps, which was the patient’s choice. Then, the first surgical procedure was performed under local anesthesia on the right side of the lip, one carpule of Lidocaine 2% with adrenaline 1:100,000, with a chalazion clamp, a diode laser for hemorrhagic control, and a simple suture. In this procedure, three fragments were biopsied: a cuboid measuring 1 × 1 × 0.8 cm and an irregular one consisting of two fragments that at one end of the piece were in continuity with each other, one measuring 1.6 × 0.5 × 0.4 cm and the other 2.5 × 0.6 × 0.5 cm. A similar macroscopic appearance in all the material, white in color, irregular surface, elastic, white section surface, or slightly fasciculate. The patient was medicated with Tylenol 500 mg thrice a day for two days. With 20-day intervals, the sutures from the first surgery were removed, as well as the foreign body from the upper lip on the left side, following the same surgical technique and medication. Histologically, it was possible to identify a chronic inflammatory, lymphoplasmacytic, and granulomatous reaction, with foreign body giant cells’ reaction, in relation to non-polarizable exogenous material due to the reaction to silicone. The most common complications are granulomas’ appearance and material displacement. The case report shows these granulomas are characterized as chronic low-caliber inflammation around the silicone. They have an unknown etiology but are probably multifactorial, from continuous trauma, friction or irritation, iatrogenic factors, infection, immunological mechanisms, and genetic and molecular variations, and can be highly related to the impurity of the injected material. This case brings the opportunity for health professionals to increase awareness of the long-term adverse effects of the silicone material used to fill the lip in order to make its application more predictable and conscious.

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A Simple Surgical Remedy for Iatrogenic Excessively Thick Lips

Cited by 3 publications

References 16 publications

Surgical Lip Remodeling Following Permanent Filler Injection: A Scoping Review

Surgical Lip Remodeling Following Permanent Filler Injection: A Scoping Review

Histological, Clinical Assessment, and Treatment of a Complication after 16 Years of a Permanent Filler in the Upper Lip: A Case Report

Histological, Clinical Assessment, and Treatment of a Permanent Filler Complication in the Upper Lip: A Case Report with 16-Year Follow-Up

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