Novel assessment of lip redness and microcirculation using optical coherence tomography after dermal filler injection

Abstract

ObjectivesLip filler injections are one of the most popular procedures in esthetic dermatology. In this study, we used three‐dimensional colorimetric photography to assess lip color and optical coherence tomography‐angiography (OCT‐A), a noninvasive alternative to histopathology, to evaluate microcirculation after hyaluronic acid (HA) injection. The pain of the injection procedure was also assessed.MethodsAn average of 0.85cc of the total volume of HA with lidocaine was injected into the upper and lower lip of eighteen young (<30yo) and nine postmenopausal healthy women. OCT‐A, two‐dimensional, and three‐dimensional images were acquired immediately before (visit 1) and 15 days after injection (visit 2). Custom‐made software was used to analyze the imaging data to detect vessel morphology and redness changes. The Wong‐Baker FACES pain rating scale (0–10) was used to score the subject procedural pain.ResultsFor young and old subjects, three‐dimensional lip volume was greater than the injected volume. OCT‐A images of the lips showed higher vessel density and thickness, reaching statistical significance in the younger cohort. The overall trend of increased redness assessed by three‐dimensional colorimetric imaging and increased vascularity evaluated by OCT‐A imaging were similar. However, the correlation was not statistically significant for standard two‐dimensional digital photography. The average pain score after the first needle insertion and overall procedure were 2.9 and 3.5, respectively.ConclusionsThe results suggest an increased microvasculature network observed in OCT‐A images in young females. The increased blood vessel density and thickness observed by OCT‐A after HA lip filler injection is associated with increased lip redness and volume as assessed by colorimetric three‐dimensional photography; however, more research is needed to confirm these findings. This study presents OCT‐A as a novel noninvasive tool to investigate changes in lip microvascularity after HA filler injection and indicates that HA filler procedures may affect lip vascularity.