Lip Lifting Efficacy of Hyaluronic Acid Filler Injections: A Quantitative Assessment Using 3-Dimensional Photography

Abstract

The study aimed to compare the volume enhancement and the lifting capacity of two different hyaluronic acid gels for lip injection. Thirty-six Korean female patients were randomized into two groups according to the cross-linking degree of the hyaluronic acid filler injected. Using a fixed injection protocol, patients were injected with 1 mL of hyaluronic acid filler in the lips and followed up at four and 12 weeks after injection. Lip volume, lip projection, and columella–labial angle were measured using a 3-dimensional imaging system at each time point. Follow-up values were compared with baseline. Compared with pre-treatment values, there was a statistically significant increase in mean lip volume and lip projection at four and 12 weeks after injection, with no significant differences between the two groups. Lips injected with hyaluronic acid filler of intermediate cross-link density resulted in more acute angles than lips injected with lightly cross-linked hyaluronic acid. The difference was statistically significant at each follow-up time point. No serious complications were observed throughout the study period. Our results imply that in patients who want a prominent upper lip lift, lip injections using hyaluronic acid fillers with intermediate cross-linking density can be a good option due to their lift capacity. The degree of cross-linking may not be a significant determinant of simple lip volume augmentation when other variables are constant.

Different Techniques and Quantitative Measurements in Upper lip lift: A Systematic Review

“…Through skin excision and advancement of the soft tissue complex, the surgical procedure can effectively shorten the distance between the nasal base and the vermilion border of the upper lip, thereby improving the philtrum to upper vermilion proportions [ 55 ]. Nonsurgical procedures, such as lip fillers, generally improve the ratio of the philtrum to the vermilion by restoring volume to the lip [ 25 ].…”

“…Various techniques to lift the upper lip have been described in the literature, which may consist of injecting fillers [ 25 ] and lip lift surgical techniques [ 26 ], such as simple subnasal skin excision, subnostril skin excision, or even vermilion advancement [ 27 , 28 ]. Filler materials were first used to restore lip architecture and volume loss in the 1990s [ 29 , 30 ], whereas surgical interventions to lift upper lips began in the early 1970s, with a large series of cases reported ten years later [ 20 , 31 ].…”

“…Different excisions and more methods with fewer scars have gained interest from then on [ 32 ]. Typically, some studies believe that injectable fillers do not produce long-term results due to a lack of permanent fillers [ 33 ] while others think fillers injected into the upper lip can produce clinical effects equivalent to surgical lip lift operations [ 25 , 34 ]. However, it remains unclear whether they have the same effects, and there is a lack of precise measurement evidence.…”

An Integrated Approach to Treatment of Edentulous Patients With Perioral Wrinkles of the Skin

“…Inclusion criteria: healthy women aged 45-65; the patient's desire and ability to take part in the study and follow the doctor's prescriptions aimed at achieving the result of therapy and adherence to the protocol requirements; the presence of scales nazolabial, lower and upper lips, marionette lines wrinkles of mild and moderate degrees according to the Merz Aesthetics Scale (MAS in the validated 5-point, where 0=no wrinkles, 1=mild wrinkles, 2=moderate wrinkles, 3=severe wrinkles, and 4=very severe wrinkles) 21,22 .…”

“…HA evenly fills the gaps between collagen fibers located in the spaces between cells, intensively moisturizes the skin, at the same time stimulating the synthesis of collagen (one of the most important proteins affecting elasticity), slowing down its breakdown, as a result, the skin begins to actively produce its own hyaluronic acid -thereby forming new skin fibers 19,20 . Plasmotherapy, in turn, stimulates the synthesis of main fibroblast cells, triggering the production of hyaluronic acid and inducing deep regenerative and restorative processes in all layers of the skin 21 . It is important to emphasize that hyaluronic injections give a result with a natural effect -thanks to the injection, expression lines, deep wrinkles and folds are reduced and evened out, so the face looks younger and fresher.…”