Abstract

Objectives: The objectives of this study were to investigate the role of dynamic activity of the orbicularis oris muscle (OOr) mucosa insertion in filler redistribution, which contributes to unnatural results after lip enhancement procedures. The study results provide a clear understanding of surface lip anatomy based on dynamic ultrasound (US) assessment and can improve the techniques of lip augmentation procedures to reduce the risk of filler displacement. Introduction: The issue of unnatural results following lip filler augmentation procedures remains prevalent. This study is based on dynamic US assessment of OOr as a primary factor influencing filler redistribution from the vermilion to the skin part of the lip. Materials / method: The perioral area of 30 patients were assessed before and from 2 to 6 weeks after lip injection procedures (lip augmentation with hyaluronic acid (HA), filler removing with hyaluronidase) using US devises (15Mhz, 20MHz) and visual analysis with photos and videos of the surface anatomy of the lips. Results: The marginal part of OOr was identified in every assessed patient. Dynamic US assessment revealed the location of the terminal mucosal insertion into the dry mucosa of the lips, corresponding to subcontour transverse wrinkle of vermilion body. HA filler injection outside the OOr mucosa insertion contributed to filler redistribution into the skin part of the lips, as confirmed in dynamic US examinations. Injections of HA filler along the OOr mucosa insertion and beneath it into the vermilion body is resulted in proper filler placement after full recovery, yielding a more natural result. Conclusion: The author’s findings could be valuable for understanding the dynamic anatomy of the lips and improving lip augmentation techniques to reduce the risk of filler redistribution due to the contraction of OOr.