Lip augmentation plays a very important role in minimally invasive aesthetic therapy [1,2]. Although the most frequently described techniques are simple procedures, unsatisfactory results are regularly achieved. The lips have an unnatural appearance after the treatment. The reason for this is that the anatomical conditions are not taken into account [3,4]. In some cases, aesthetic improvement is not synonymous with pure volume enlargement, since an improvement in definition or proportion can be equally effective and natural. During lip augmentation, the dentist should concentrate on the overall aesthetic impression of the lips and face and not only on the pure administration of volume [5]. Therefore, an anatomical-based, step-by-step approach should form the basis of the treatment, taking into account the individual aesthetic needs of the patient [6,7]. The patient analysis is therefore multifactorial and includes asymmetries, facial aging, the aesthetic subunits of the lips and, above all, the lip proportions. Another often underestimated criterion in lip analysis is the attractiveness of the patient’s smile.

With the ZFill products from Zimmer MedizinSysteme, the dentist has access to the latest cross-linked hyaluronic acid products for perfect lip augmentation with a long shelf life. On the one hand, these hyaluronic acids initiate biological processes for tissue regeneration and, on the other hand, have a high moisture-binding capacity. Due to the easy modeling and the excellent tissue integration we decided to use the preparation ZFill contour² from Zimmer MedizinSysteme.

A 30-year-old woman without previous illnesses presented herself in our practice for the aesthetic treatment of her lips. After a thorough anamnesis and asking about the patient’s expectations and wishes, the anatomical conditions were first analysed. The patient’s upper and lower lips were very narrow and low in volume (disproportion of the upper lip volume in relation to the lower lip). In addition, a flattening of the cupid arch was visible. The aim of the augmentation was on the one hand to improve the lip volume with a natural appearance without overcorrection and on the other hand to improve the lip projection. In particular, the natural ratio of upper to lower lip should remain 1:1.6 (Fig. 1).

ZFill contour² was first applied in lip red with the retrograde injection technique for volume augmentation and then modelled. After the desired volume was reached, the punctiform vertical injection along the lip white was performed in a second step to improve the projection and the lip profile. After augmentation of the upper lip, this procedure is also performed in the area of the lower lip. The retrograde injection in the corners of the mouth makes it very easy to raise the angle of the wound. Finally, the philtrum and the cupid arch are augmented to create a harmonious image. Thus, the missing lip volume was augmented and the lip profile and projection were improved. By orienting the treatment to the anatomical and functional conditions of the lips, a harmonious functional result with a natural appearance was achieved. (Fig. 2 – Standardized procedure for lip augmentation by Prof. Dr. J. Faulhaber and Dr. D. S. Müller)

Fig. 1: The natural ratio of upper to lower lip should remain 1:1.6.

In the future more and more patients will turn to aesthetic dermatology. The overall average age of patients will decrease. We also observe that the trend is towards low-grade invasive procedures. Here, ZFill products are excellent volume and lifting products that can replace lost volumes with an excellent lifting effect and aesthetically tighten decreasing contours in a very appealing way. In the lip area, in addition to ZFill contour², ZFill deep² can also be used very safely and with an excellent volume effect even with pronounced volume losses.

Address of Correspondence:
Prof. Dr. med. Jörg Faulhaber
Dermatologische Gemeinschaftspraxis
Dr. Weller, Prof. Dr. Faulhaber & Kollegen
Kalter Markt 27
DE-73525 Schwäbisch Gmünd
info@hautarzt-gmuend.de

Universitätsmedizin Mannheim
Ruprecht-Karls-Universität Heidelberg

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