Adma Silva de Lima*

Dermatologist, Private Clinic - Brusque, Santa Catarina, Brazil

*Corresponding Author: Adma Silva de Lima, Dermatologist, Private Clinic - Brusque, Santa Catarina, Brazil.

Received: July 25, 2023; Published: August 09, 2023

Abstract

Introduction: Lip filling is one of the main procedures looked after on an medical injector’s office, with a steadily increase over the years. Social media has had an impact on it, with patients seeking to look better in photographs and in online and offline in general. Patients often reach our clinics with ideas about how they would like their lips to be; either more volume, better shape, better contoured. We must then understand where we must treat the lips in order to achieve these results of better shape, volume and/or projection. In spite of that, studies about the deposition of the filler in different planes during injection, either with cannula or needle and its effects on the tissues are scarce.

Materials and Methods: A male cadaver was injected in 4 parts of its lips with different instruments as it follows: left superior with a 30 G needle; right superior with a 25G cannula entering on the vermillion border on the cupid’s bow; left inferior with a 27G needle and right inferior with a 22 G cannula coming from the corner of the mouth. All the injections were directed towards the superficial subcutaneous layer (SSL), which is a thin layer between the submucosa and the orbicular oculi muscle and is the safest layer to inject since the labial arteries are usually located either in the deep subcutaneous layer or the intramuscular layer.

Results: On the left superior vermillion, with a superficial injection with a 30 G needle, using a small amount of product in each injection, we were able to achieve the correct layer and the product was all displaced there (Figure 1 - A). With a 25 G cannula, the product deposits remained between the superficial fat compartment and the superior part of orbicular oris muscle (Figure 1 - B). With the 27 G needle, which is a thicker needle, the product behave just as with cannula (Figure 1 - C). With a 22 G cannula coming from the corner of the mouth, injections were both located only superficially or in the superficial and intramuscular layers; nevertheless in the superficial injections the deposition of product produced a linear streak on the vermillion and did not integrated right away and the layer was more difficult to achieve (Figure 1 - D).

Discussion and Conclusion: Both needle and cannula might be used for filling lips. Nevertheless, the superficial subcutaneous layer is easier to achieve and maintain using a 30 G needle. With a cannula, as well as with larger needles, the correct plane might be harder to be found and there is a tendency to the product to be deposited both on the subcutaneous tissue and on the superficial fibers of the orbicular oris muscle at the same time.

 Keywords: Needle; Lip Filling; Anatomy

References

1. PLASTIC SURGERY STATISTICS REPORT. ASPS National Clearinghouse of Plastic Surgery Procedural Statistics.
2. van Loghem JAJ., et al. “Cannula Versus Sharp Needle for Placement of Soft Tissue Fillers: An Observational Cadaver Study”. Aesthetic Surgery Journal1 (2017): 73-88.
3. Blandford AD., et al. “Microanatomical Location of Hyaluronic Acid Gel Following Injection of the Upper Lip Vermillion Border: Comparison of Needle and Microcannula Injection Technique”. Ophthalmic Plastic and Reconstructive Surgery3 (2018): 296-299.
4. de Lima AS and Gubert M. “The Lips Shapes: A New Approach to Sculpt Beautiful Lips”. Journal of Clinical and Experimental Dermatology Research 14 (2023): 639.
5. Vent J., et al. “Do you know where your fillers go? An ultrastructural investigation of the lips”. Clinical, Cosmetic and Investigational Dermatology 7 (2014): 191-199.
6. Ghannam S., et al. “Treating the Lips and Its Anatomical Correlate in Respect to Vascular Compromise”. Facial Plastic Surgery2 (2019): 193-203.

Citation

Citation: Adma Silva de Lima. “Understanding the Anatomy of the Lips and its Relationship with Needle and Cannula Filling Procedures”.Acta Scientific Medical Sciences 7.9 (2023): 54-57.

Copyright

Copyright: © 2023 Adma Silva de Lima. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.