Unit 13: Lip Rejuvenation


When treating the perioral region, be aware of the position of blood vessels especially the superior labial artery. Swelling and bruising are common, more so than in other areas.


The repeated mechanical movement of the orbicularis oris muscle causes wrinkles to form around the mouth (e.g. smokers lines). Loss in bone density and gum atrophy also adds to the problem. Fine lines in the area are often accompanied by a loss of definition of the philtrum and vermillion border. The vermillion border is the demarcation between the lips and the surrounding skin. The cupids bow is the central part of the upper lip with two peaks forming the philtrum. The cupids bow contributes to the natural shape of the lip and is typically enhanced as part of the dermal filler lip augmentation.

The lip can be divided into dry and wet mucosa. When the mouth is closed, the dry mucosa is exposed to air and the wet mucosa remains inside the mouth. The junction between these two portions of the lip is called the wet-dry border. Lip shape and volume varies greatly. In general, the lower lip is fuller than the upper lip.

Common Site-Specific Side Effects

Brusing, swelling and pain.

Injection Techniques

Serial puncture (smokers lines)

Linear threading


Volumes vary between clients.

Treatment Specific Side Effects

  • Under correction
  • Overcorrection
  • Asymmetry
  • Lumpiness of filler
  • Herpes simplex outbreak
  • Telangiectasia
  • Infection
  • Granulomas
  • Arterial compromise

Vermillion Border Enhancement:

The treatment consists of linear thread injections for the upper and lower lip borders. Injections are place in the superficial dermis of the vermillion border.

Lip Volume Enhancement:

This treatment is suitable for those with a loss of volume in their lips or for the purpose of cosmetic enhancement. The technique used in lip volume enhancement is retrograde linear injections. Dermal filler is injected approximately 2mm deep in the mucosa, at or just superior to the wet–dry border.

Cautions and Observations:

Watch filler volume closely during treatment and ensure equal volumes of filler are injected into both sides of the lips (except when lip asymmetry is being corrected).

Lip oedema occurs quickly. At the end of the treatment, the side injected first may appear larger due to oedema.

Care must be taken to avoid the labial arteries as this can cause vascular occlusion and necrosis.

Remember to use your flashback techniques.

Side Effects of Lip Filler:
Herpes Simplex