Доктор Juliana CHIEPPE
Дерматолог
Treating the protruded lower lip in different ethnicities
Objectives: Literature on reducing a protruded lower lip is scarce. Injectors tend to focus on lip augmentation and neglect treating the protruded lower lip, itself.
In such cases, structural support provided by the chin and mandible are important to ensure a youthful looking lower lip and prevent overfilling.
This oral presentation will explain why filling the upper lip is not always an effective manner to improve balance and proportion between the lips. As well, it will demonstrate a method to treat a protruded lower lip by injecting the chin - whether or not associated with upper lip augmentation.
Introduction: It is frequently assumed the best treatment for lower lip protrusion is upper lip augmentation; however, this is not always correct.
This presentation shows treatment options for patients of different ethnicities and demonstrates that chin augmentation, in many cases, can offer superior support and outcomes for better lip proportion.
Note that in patients of African descent, more protrusion is accepted. Yet, not to the point that the lip submucosa is showing.
Injection of the chin with hyaluronic acid (HA) fillers can provide support to, and invert, the lower lip.
Materials / method: Three patients received similar treatments for protruded lower lip correction with chin support (Patient 1: 39yo African descent; Patient 2: 32yo mixed race; Patient 3: 22yo Caucasian).
Using a fanning technique in the subcutaneous plane in the labiomental sulcus, patients received between 0.5-0.7 mL of HA on each side using a 25G blunt-tip cannula. The chin apex, the lower prejowl and the lower anterior chin area were injected with 25 mg/ mL of HA using an anterograde linear injection to advance the jaw.
The Caucasian patient had the upper lip filled.
Results: In these three cases, chin support greatly contributed to the reduction of the protruded lower lip. The lip submucosa is no longer apparent and there is better proportion between the upper and lower lips.
Post-treatment, with support in the soft tissue of the chin and lips, the direction of movement while pursing the lips is horizontal. The reduction in the protrusion of the lower lip (due to increased chin support) and the improvement in the jawline definition are both clearly evident. The refinement of these specific areas greatly enhances the overall contour and balance of the face.
Conclusion: The treatment of a protruded lower lip involves not only selecting an appropriate filler and precise injection technique, but also knowledge of anatomy, facial proportions, and ethnic differences.
The use of HA fillers for chin augmentation to support the lower lip in cases of protrusion is supported by studies. Yet, it is not performed by many practitioners, as injecting the upper lip is easier and less costly.
By identifying and understanding the importance of chin support, injectors can treat a protruded lower lip more effectively and avoid an unnatural result by overfilling the upper lip.