Perioral Filler – Addressing Wrinkles Around the Mouth

Hyaluronic acid dermal fillers, in particular, are used for their ability to rejuvenate by adding volume and hydration, thereby reducing conspicuous lines and improving structural support.

Best Practices for Perioral Filler Injections

Perioral filler injections demand a refined technique and an artistic approach to restore and enhance the lip and mouth area while ensuring a natural outcome that complements the entire face.

Assessing the Lips in the Context of the Whole Face

Considering Proportions with Nose, Cheeks, Teeth, and Mandible: The most favorable outcomes in perioral filler injections are achieved when the lips are considered within the context of surrounding facial structures. Establishing harmony between the lips and adjacent features such as the nose, cheeks, teeth, and mandible ensures that enhancements enhance the individual’s natural beauty. For instance, a well-defined lip should not overpower the cheeks, and the fullness of the lower lip should be in balance with the prominence of the chin. Precision in assessing these proportions pre-treatment can influence the selection of filler type, injection sites, and the volume of product used.

Evaluating from Multiple Angles: Successful perioral filler injections rely on a 360-degree evaluation of the lips – an assessment that transcends a frontal view. Practitioners examine the lips from multiple angles, ensuring that the filler distribution supports a three-dimensional augmentation. This thorough evaluation helps to avoid asymmetry and irregular contours that might not be apparent from a singular perspective. The dynamic nature of the lips, including how they function and appear as the person speaks and expresses emotion, is also a critical factor in the evaluative process.

Avoiding Unnatural Projection and Overfilling

Lateral Lips and Oral Commissures: Careful attention to the lateral aspects of the lips and the oral commissures is very important in maintaining a natural lip contour. Overfilling these areas or incorrect placement of the product can result in an exaggerated, stretched appearance that distorts the mouth’s natural expression. The goal should be to support the structure and softness of the lips without altering the defining edges that contribute to an individual’s unique smile. Sticking to these considerations helps avert the stereotypical “overdone” look and ensures an attractive, understated enhancement.

Cupid’s Bow and Vermilion Border: The Cupid’s bow and vermilion border are landmarks that define the upper lip’s shape and form. Preserving these features with precision during filler injections helps to uphold a natural and attractive lip architecture. Emphasizing the Cupid’s bow subtly can add to the lip’s aesthetic appeal without veering into the realm of artificiality. Equally important is the judicious enhancement of the vermilion border to avoid the undesirable ‘duck-lip’ appearance, instead opting for soft, gradual transitions that speak to the lip’s innate shape.

Pain Management Techniques

Topical Anesthesia: The use of topical anesthetic creams prior to perioral filler injections significantly reduces patient discomfort, making the process more tolerable. These creams typically contain lidocaine or benzocaine, which numb the skin’s surface and lower layers. An adequate application time, usually 20-30 minutes before the procedure, is crucial to achieving optimal numbing. In high-sensitivity areas, such as the lip border or philtrum, a properly applied topical anesthesia can greatly enhance patient comfort without affecting the outcome of the filler injection.

Nerve Blocks for Sensitive Patients: For patients with lower pain thresholds or undergoing more extensive injections, dental nerve blocks provide profound anesthesia. Similar to anesthetic techniques used in dental procedures, nerve blocks can effectively numb a larger section of the lips and perioral region. This technique is particularly useful when treating deep or widespread areas as it ensures minimal discomfort throughout the procedure. Clinicians may choose nerve blocks when performing treatments that require multiple injections or where accurate filler placement is essential, and patient movement must be limited.

Minimizing Risks and Complications

Bruising and Swelling: Bruising and swelling are common side effects of filler injections, but their impact can be mitigated with careful technique and pre-procedural planning. Using fine needles, gentle insertion techniques, and ice packs immediately post-injection helps reduce the risk. Clinicians often advise patients to avoid blood-thinning medications and supplements that could make bruising worse. Staying elevated and applying cold compresses off-and-on after the treatment can also minimize swelling, allowing the treated area to heal and stabilizing the filler quicker.

Intravascular Injection: One of the most severe complications in filler injections is the accidental intravascular injection, which can lead to skin necrosis or, in worst cases, systemic embolic events. Practitioners should employ aspiration technique, where the syringe plunger is pulled back to check for blood return before injecting. Using cannulas in high-risk areas can also decrease the chances of intravascular injection, as the blunt tips tend to navigate around rather than pierce blood vessels.

Nodule Formation: Nodule formation post-filler injections can be distressing for patients and is often avoidable with proper injection depth, the correct choice of filler product, and technique. To prevent nodules, practitioners should thoroughly understand the anatomical planes of injection and use fillers with appropriate consistency for the target area. Massaging the area gently post-injection ensures even distribution of the product. If nodules develop, they can sometimes be managed with massage, heat, or in some cases, an injection of hyaluronidase to dissolve hyaluronic acid-based fillers.

Aftercare and Maintenance

Proper aftercare following perioral filler treatments is essential for maximizing results and minimizing potential complications, contributing to the treatment’s overall success and longevity.

Immediate Post-Treatment Care

Avoiding Alcohol and Blood Thinners: After receiving perioral fillers, patients are advised to avoid alcohol and medications or supplements with blood-thinning effects for at least 24 to 48 hours. Alcohol can increase the risk of swelling and bruising at the injection sites, complicating the recovery process. Similarly, blood-thinning agents like aspirin, ibuprofen, and certain herbal supplements can make bleeding worse and delay healing. By following these guidelines, patients can help ensure a smoother recovery and better aesthetic outcomes.

Managing Swelling and Bruising: To manage common post-treatment symptoms like swelling and bruising, patients should apply ice packs to the affected areas, taking care not to put direct pressure on the injection sites. Keeping the head elevated, especially when sleeping for the first few nights, can further help reduce swelling. If bruising does occur, topical treatments such as Arnica may be recommended to accelerate the fading process. Strenuous activity should be avoided immediately after treatment to minimize swelling and bruising.

Long-Term Maintenance

Touch-Up Treatments: Over time, perioral fillers will naturally degrade in the body, leading to a gradual diminishment of the treatment’s effects. Touch-up treatments are a standard part of maintaining the rejuvenated appearance. Depending on the type of filler used and individual factors such as metabolism and lifestyle, scheduling touch-ups every 6 to 12 months can help maintain consistency in the desired aesthetic result.

Skincare Regimen for Optimal Results: A well-crafted skincare regimen post-filler injections can enhance and prolong the treatment’s benefits. Patients are encouraged to use gentle, non-irritating cleansers, hydrating serums rich in hyaluronic acid, and broad-spectrum sunscreens to protect the treated areas from photoaging. Regular use of medical-grade topical products, like retinoids and antioxidants, can also support skin health, providing a favorable environment for the sustained effect of perioral fillers.