Lipstick Lines (Smoker’s lines): A Quick Guide for Practitioners

Lipstick or ‘smoker’s’ lines can be tricky to treat. They are relatively difficult to access because the nose gets in the way, and it’s difficult to get yourself and the patient into a comfortable position so that you can concentrate on the treatment itself AND when you’re finished, initially, the lines may look worse than when you started! So how do you do it? Lipstick line filler gives ok results if done well. It’s tricky. I recommend using strong anaesthetic gel as it’s a tender area. It can also bruise; remember that each time you insert the needle, you cause more trauma. If the lines are below the nose, approach from below if the lines are lateral to the nose, approach from above. Use a max of 0.4 ml for top lip lipstick lines. If you try a treating a line twice and it still hasn’t lifted, it’s probably better to leave it rather than risk giving them a thickened top lip. Avoid injecting into the lip (i.e. Below the vermilion border), to save on causing unnecessary swelling. Mould the area afterwards to limit the lumps that you leave behind. Be aware, and advise the patient before you start, that initially the lines may look WORSE as they will be highlighted by pink / redness, from the injections themselves. Reassure the patient that on covering with their regular makeup regimen the following day, the true effect of treatment will be seen. I use Dermal Revolution (DERM) now for lipstick lines, but again, remember that no-matter what product you use, apply a strong anaesthetic gel liberally before...
LIPS LIPS LIPS: Achieving The Luscious Yet Natural Result

LIPS LIPS LIPS: Achieving The Luscious Yet Natural Result

  Hey I’m Ruth, I work within the Dermal Revolution team. Nearly everything Valentines themed, will have a luscious lip stain stamped on it right? Limited editions lipstick shades come out JUST for Valentines Day, and we are bombarded with LIPS LIPS LIPS. So what about achieving luscious lips with filler – minus that UNNATURAL result? One of the most common phrases I hear in the waiting room is this – “Oh I’m not into lip fillers” I never understand it because these clients are usually going ahead with a few areas of botox and one other filler area, they are seemingly educated in the treatments. I ask them why and they say “I don’t want to look unnatural” – makes sense I guess when we only have to switch on our laptop or phone and a picture of a Kardashian pops up. Those girls are everywhere and their lips are not ‘subtle’ or ‘natural’ looking. So maybe it’s time to set the record straight about Lip Fillers- IT CAN BE DONE SUBTLY. With a little bit of product you can enhance the natural shape you already have, just so you can enjoy your lipstick to its full potential or to restore an asymmetry that annoys you. In actual fact the most beautiful Lip enhancements I’ve seen Dr Michael Aicken do have been on 55-60yr olds where there has been a thinning of the lips and a flattening out over time. No more than 0.5-1ml of filler has been administered restoring the lips back to a shape they once had and creating a ‘cupid’s bow’ again (which is usually...

Dermal Filler Doses – Article in Aesthetics by Dr Michael Aicken

Dr Michael Aicken, founder and course director of Visage Academy has this month written a detailed article published in Aesthetics Journal. This article touches on what doses of Dermal Filler should ideally be used in different situations.  We have made this article free for our Visage Academy blog readers and can be viewed below with the permission of Aesthetics Journal who we recommend strongly for your CPD requirements.  ...

How Much Filler Should I Use?

With Botox there are standard doses that most practitioners use as their starting point. Adding more as a ‘top-up’ if required and taking note of the full dose needed for a given result so that it can be reapplied later, Botox doses are relatively straightforward. But with filler we don’t tend to have these ‘standard’ doses. On our training courses I often explain that Botox administration is a scientific method whereas dermal filler treatments are much more of an artform. So how do I answer this common question, ‘how much filler should I use?’ Firstly, there is a facetious answer. Teachers and lecturers i’d venture, will always have this answer in mind, and will dream of bursting out with the answer that makes their student look or feel stupid for asking. The vanity from within me, wants me to guffaw, ‘how long is a piece of string’ then drop the proverbial mic to the applause of the other students. I also keep wanting to ask in retort, ‘how deep are the lines?’ Of course, the answer to both is tricky and not unilateral- exactly my point. But wait, i’m supposed to know the answer to this- that’s why people pay me to teach them! Of course, the questioner is asking a specific question about a poorly-defined hypothetical scenario, but in this reply, you can see that knowing how deep the lines are doesn’t really even help decide on the volume you should use. A better question might be – ‘what volume has been lost’. For an accurate answer you are likely to need to use expensive 3D imaging in...

When Not To Treat

“Good surgeons know how to operate, better ones when to operate, and the best when not to operate.” (Anon) This is a rough guide for those involved in the treatment of patients with Botulinum Toxin type A & Hyaluronic Acid. Here we’ll use the medical history form from the Flourish Cosmetic App as a reference – this can be viewed here. You may find it useful to open this now in a new window. This medical history form incorporates the questions taken from the medical history and consent forms disseminated by all of the leading Botulinum Toxin and Hyaluronic Acid manufacturers. It seeks to be comprehensive. The Flourish Cosmetic App is currently co-owned by Visage Aesthetics UK (the same company that owns this website). Introduction Basically, there aren’t many conditions that we need to absolutely avoid when using Botox and Fillers, which is why, if you took a punt and treated everyone without question, you’d probably get away with it. But i’ll go through the Flourish medical history form so that you can see the kinds of things I pick up on when I review this with a patient, either before I treat them myself or whenever I consult with them and decide to go ahead and issue prescriptions for them to their own practitioner. Are you attending or receiving treatment from a doctor or specialist? This one should catch most things and many of the later questions are just double-checking the answers. For example, many people who have chronic illness can forget to mention it when you ask them about medical problems. That’s why Doctors often ask this same question in...

Lumps

I got asked about this today and i’ve realised on reflection, I probably get asked about lumps more than anything else related to Botox or Fillers. Usually it’s lips, but this time around it was relating to nasolabial fillers. Here’s my short, simple advice on lumps. Check you aren’t leaving visible lumps post procedure before the patient leaves. If you have chosen to leave lumps / a mass of filler anywhere that you can feel with your fingers (and if you are replacing volume this is often the standard method) it’s important to explain to the patient that this is your intention and that this is normal but that they shouldn’t see the ‘lumps’. Then I also give out an aftercare sheet (and if you’re using Flourish they will have ticked a box to say that they have downloaded and read the aftercare sheet) explaining again about lumps and what to do about them if they are present. I definitely don’t recommend telling patients to massage their filler as this undoes the good work you’ve done- but lots of clinics do recommend this, strangely. So, you have a lump, despite your best efforts to avoid one – what are your options? Everyone wants to jump in with hyalase (hyaluronidase). It is possible to do this. You can buy individual vials from HealthXChange (last time I checked) for around £14, and make these up with normal saline (here’s a protocol for that). Beware that if you do use hyalase, you may well end up with a loss of volume as the hyalase will indescriminately dissolve hyaluronidase; whether it is the filler that...