Lip augmentation procedures are among the most popular cosmetic procedures practitioners can perform. Patients usually come with age-related concerns, such as thinning lips, wrinkles above the upper lip (also known as “smoker’s lines”), flattening of the Cupid’s bow, and the loss of lip volume. This area can be challenging to treat, as it is a highly mobile area, so any non-permanent filler will typically have a decreased duration of action in this area compared with other areas of the face.

Usually, the approach used for lip enhancement involves invasive surgery and the use of synthetic materials as filler. The effects of these procedures are often long-lasting, with corrections often remaining for up to five years. However, such procedures are expensive, involve surgery, and are associated with severe complications, including scarring and asymmetry. Implants such as polytetrafluoroethylene fillers are another available option, but these have their own disadvantages. The permanence of such fillers can also be a major drawback if the desired results are not achieved, as removing the fillers is extremely difficult and, in some cases, impossible. Given all this, the best device for lip augmentation procedures are therefore a soft tissue volumizing agent which can be implanted in a non-invasive manner and offers semi-permanent results.

Can Radiesse be used for lip augmentation?

The use of calcium hydroxylapatite dermal filler (marketed as Radiesse) in the lips has been a matter of debate, as some practitioners discourage the practice due to a reported high risk of nodularity. This could be attributed to the fact that lip nodules can be a result of product crowding, which is a consequence of the injector technique. The following steps can help minimize the risk of nodule formation:

• sufficiently deep product placement
• avoidance of overcorrection
• treating nodules and granulomas with triamcinolone either through the administration of local injections or, in persistent cases, through a small incision.

Lip augmentation procedure with Radiesse

Before treating the lips, anesthesia, is highly recommended given the sensitivity of this facial region. Radiesse can be administered with a 27 or 25-gauge, one-inch needle to minimize the number of punctures. Radiesse should ideally be injected into the plane between the orbicularis oris muscle and the mucosal border into two punctures for each side.

If more volume is required for lip fullness in addition to vermillion enhancement, a second line can be injected but should be deeper than the first. If treating the philtrum columns, a separate 27-gauge needle is required.

When treating smoker’s lines, physicians should avoid correction by direct filling, as this could result in bumps and unevenness. The linear threading technique is suitable for treating fine perioral lines.

Conclusion

Radiesse is an effective soft-tissue filler that is suitable for a variety of clinical applications. When it comes to lip augmentation, the increased risk of nodularity with Radiesse treatment must be taken into account and weighed against its many advantages, including the longevity of results.