Love my journal. This is the yearly Best Papers Awards issue October 2022. Plastic and Reconstructive Surgery Journal.
This was an article of “Safe and Effective Lip Augmentation Method: The Step by Step Phi Technique.”
I, along with almost all of my colleagues, do dermal filler injections. But there is always a way to improve technique, and it is good to have scientific principals guiding us. I won’t bore you with the exact details of their technique, but I will comment on some pearls of information they shared which I found interesting.
- In 2018, 2.6 million injections were done into the lips.
- The vast majority of severe complications were due to “unauthorized non medic injectors.”
- They do not inject more than 1- 1.5cc of filler in one session. They discuss that lips have limited expansion properties, and do a series spaced 15-30 days apart for those who want fuller lips.
- They apply the golden ratio 1.618 (This is the PHI) to identify the points for injection
- Most lips are asymmetrical
- Safety: don’t treat posterior to the wet dry border, be careful around the midline, it is safer to puncture the lips from the vermillion border, and don’t inject deeper than 2.5mm at any point. If the patient has blanching or extreme pain, use hyaluronidase immediately, massage, warm, compresses, and aspirin.
My thoughts?
They stated the majority of their 833 patients did 3 sessions spaced one month apart to get the desired result. The range was 1-12 cc of volume (12?!!) with an average of 3cc. 623 of them came back yearly for touch ups. and “92% of them marked the results as exceptional.”
It was interesting. They had a chart of different lip ratios for patients to consider. A natural lip will have a fuller lower lip than upper lip. I see many starlets today doing an even ratio (where upper and lower lip are equal in volume) or even making the upper lip larger (not natural).
I can’t imagine having women come back monthly for more filler. But I don’t think this is my patient base. I like a really natural look, and my patients don’t look “done.” I have many patients who do less than a syringe of filler in the lip (we can always find places to inject the rest of the syringe).
But I appreciate the science and thought process they are bringing to this. For those with super thin lips, I do think their idea of “building up” to a fuller lip is the right one.