Lip Augementation

Lip augmentation using fillers is increasingly more common and is one of the most sought after filler treatments. With celebrity endorsement and many media fuelled horror stories, it is paramount that aesthetic practitioners develop their skill and knowledge in this procedure

The Perfect Lip 
Lips are the central hallmark of the lower face and when they are full and well-defined, they impart youth, health, attractiveness and sexuality. Wider, fuller curved lips with a high vermilion and a short upper white lip are all signs of female attractiveness . One of our greatest challenges is to achieve natural results after lip augmentation

Treatment Strategy
– Lip augmentation consists of the reshaping and/or enlargement of the visible portion of the lip, the vermilion. Alteration of the shape of the Cupid’s bow and of the relationship between the vermilion and the skin underlying the nasal columella also falls within the category of lip augmentation.
It is also important to consider the relationship between lip height and incisor shown in the anatomic analysis, to evaluate possible maxillary hypoplasia and protrusion, and to consider the patient’s occlusion status.

Assessment and technique
To achieve natural results it’s important to understand patient’s anatomy, and just as important to assess the lips before , so as to be able to appreciate what is and isn’t possible.
Fashion Styles of Lip fillers
1. Caucasian Style  : like Kylie Jenner,Kim-Kardashian,Angellina Jolie,Julia Robers,Scarlett Johansan . The characteristic types are full lips  or Heavy lower lip .

2. Asian Style like Jeon Ji Hyun,Kim Tae Hee,Yoon Eun Hye ,Lee Ji Eun(IU), Song Hye Kyo .The characteristic types Heavy lower lip,Bow Shaped lips ,Wide lips
How much face and lip fillers cost
–  The cost of dermal fillers is 15,000-20,000 bahts /CC of Restylane of Juvederm , depending on things like the type of product and number of syringes used, and the complexity of the area being treated

Side effects are typically mild and include temporary bruising, swelling or redness at the injection site. Serious complications are extremely rare when treatment is performed by a qualified provide

How long last for lip fillers? Hyaluronic acid fillers, such as Juvéderm and Restylane products, are a popular non-surgical option, offering temporary lip enhancement at an affordable cost. When administered by an experienced provider. Lip filler can last 8 to 12 months d and achieve soft, natural-looking results. Depending on the product, fillers can boost lip volume, enhance lip shape, and smooth vertical lip lines (peri-oral rhytids).
Benefits of dermal lip fillers
– A skilled cosmetic dermatologist can adjust the amount of filler used to achieve results with precision
– Little to no downtime is needed
– Improvements are usually noticeable immediately after treatment
– Results are final within 2 weeks
– Side effects are typically mild and include temporary bruising, swelling or redness at the injection site. Serious complications are extremely rare when treatment is performed by a qualified provider

Considerations

• Treatments must be repeated periodically to maintain results
• Beautiful, natural results require a provider with immense skill and experience
• The affected area may be a bit red, sore and swollen. Any swelling or bruising should settle down in a few days.
• This includes not wearing make-up immediately after the procedure and avoiding alcohol, coffee and the sun.

What is the V-Beam laser

This is a laser treatment that uses a built-in cooling cryogenic spray mist onto the skin to help decrease the mild discomfort associated with the treatment, and decrease the possibility of blister or scab formation.
This laser produces an intense but gentle burst of light that selectively destroys the blood vessels of spider veins, or other vascular lesions, without damaging the surrounding tissues, leaving them intact and allowing normal pigmentation to occur.
This treatment can improve the look and feel of most scars and stretch marks by stimulating collagen production in the deeper layers of the skin.
This is an USA-FDA accredited treatment procedure. This has a remarkable level of safety and effectiveness.

What are the indications for the V-Beam laser treatment?

1. Acne redness
2. Rosacea
3. Redness on face (telangiectasia)
4. Red birth marks (hemangiomas, Port-wine stains)
5. Angiomas
6. Red stretch marks
6. Keloid scars
How many treatments are recommended to achieve optimum results?
-For acne redness, multiple treatments every 2 weeks is the recommendation while other treatments may be given every 4-6 weeks.
– For angiomas, 1-2 treatments is the recommendation.
– For keloid, acne redness, and birth marks, 4-8 treatments is the recommendation.
Contraindications of this procedure:
1.Darkly pigmented patients, as skin pigment will make laser less effective in decreasing blood vessels of vascular lesions
2. Lesions with blood vessel depth of more than 1.5mm

The Procedure:

This is a simple 5-20 minute procedure.

1. The face is properly cleansed.
2. The dermatologist will assess the patient’s pain tolerance and if required, he may apply some numbing cream to the area 40 minutes before the laser treatment is started.
3. The dermatologist directs the V-Beam laser towards the area in the patient’s face, where the lesion is located, keeping it still for several minutes.
4. After the procedure a slight redness may be noted so a mild moisturizing cream will be applied to the skin.
5. The patient is allowed to go home with special instructions.
   Instructions for the patient after going through the V-Beam treatment procedure:
   There may be a transient redness or a slight bruise noted on the treated area for about 2-4 hours or 1-7 days, depending on the treated area. There may also be a very mild pain likened to the sting of sunburn. The treated area is very delicate and should be handled with care.

Plexr is definitely one of our most interesting developments, a real revolutionary and patented innovation in the field of aesthetic medicine and surgery.

PLEXR represents a new and exciting frontier in surgery: it offers both the doctor and the patient an alternative approach to procedures that were, until now, highly invasive due to pre- and post-operative complications such as anesthesia, surgical resection, sutures and post-operative recovery in hospital.

This completely wireless device is extremely handy, ergonomic and well-performing, created from the need to operate on conditions where it is difficult to use other instruments such as a laser or a radio-frequency scalpel.

Plexer uses the fourth state of matter: Plasma. Tissues treated “Sublimate” avoiding spreading unwanted heat to surrounding areas. The principle is to ionise gases in the air to create a small electrical arc, similar to a tiny lightning bolt, with which dermal and epidermal areas affected by aesthetic problems may be treated, without spreading unwanted heat to surrounding areas.

Key uses:

• Eyebag/Eyelid Correction
• Acne – active spots AND scarring
• Stretch marks, scars
• Lines & Wrinkles eg smoker’s lines
• Skin Lesions eg warts, xanthelasma, moles (flat or raised), age spots

Advantages Vs Surgery:

• No injectable anaesthetic required
• No cutting of skin
• No stitches required
• Very low risk procedure (NO risk of blindness as there is with surgery)
• Minimal side effects and far less downtime
• Quick & easy procedure
• Most patients can return to work the same day
• No thinning of the skin

The Exilis® Elite is a non-invasive face and body contouring device designed to tighten skin while reducing fat and signs of fine lines and wrinkles.
It uses a combination of monopolar radio frequency (RF) energy, ultrasound to stimulate fat lipolysis (the breakdown of fat cells) and collagen remodelling (for skin tightening), alongside skin cooking, helping to contour the body and face.
How does it work?
The Exilis Elite uses a combination of radiofrequency energy (3.4Mhz up to 120 Watts), ultrasound and skin cooling to deliver controlled heating to target deep tissue, addressing deeper wrinkles, sagging skin and jowls, as well as the superficial skin layer, treating finer lines.
License status
The Exilis Elite was granted European CE Mark certification in 2011.It has also been approved by the U.S. FDA (Food & Drug Administration) and cleared for the non-invasive treatment of dermatologic wrinkles and rhytids
What is it used to treat?
The Exilis Elite is used to treat everything from superficial, fine lines to deep wrinkles within the deep tissue on the face, neck and body. Skin becomes smoother and lines are reduced, while the body and face are reshaped and recontoured.
– Fat deposits in hard-to-reach areas can be reduced, all with long-lasting results provided that you continue to maintain a healthy diet and lifestyle.
It is suitable for those with stubborn, mild to moderate fat deposits, and can postpone or even eliminate the need for more invasive treatments, like liposuction, in the future.It is not a weight loss solution.
Exilis Elite is used to treat love handles, bingo wings (flabby arms), saddle bags on hips and thighs, post-baby tummies, turkey necks and jowling in the face

About Exilis Elite Body Contouring & Tightening Technology
The new Exilis Elite offers improvement with the delivery of cooling and heating that dramatically improve results. Key benefits of the Exilis Elite is that the RF energy is able to penetrate up to 4cm deep into the fat and deliver to the fat a temperature greater than 44.2 Celsius. Why is that important? Clinical research has proven that not only can you cause a fat cell to lose its lipids through heating, but if you maintain a temperature of 44.2C for 4-5 minutes, fat cell destruction can occur as well.
How long does it last?
According to clinical data, Exilis Elite results are generally permanent, provided that you maintain your weight following the treatment. Its use to treat cellulite is not-permanent, however, as this can easily reoccur over time.
A European study demonstrated significant circumferential reduction in all 58 trial volunteers after 4-5 treatments. Another study demonstrated longevity of results up to at least 18 months.
The longevity of the results will depend on your genetic predisposition to ageing and your lifestyle; you may need top-up treatments to maintain the results

Side effects & risks

Side effects are generally minimal. You may notice some pinkness or redness to the skin immediately following the treatment but this typically subsides within 15-30 minutes. Skin may be slightly tender to the touch for a little time afterwards, but this is not always the case. Very rare risks reported include numbness, swelling (oedema), blistering, scarring, allergic reactions and nausea.

About Ulthera
Ulthera, Inc. is a global medical device company focused on developing and commercializing technologies for aesthetic and medical applications using its therapeutic ultrasound platform technology.
The Ulthera® System is the first and only energy-based device to receive U.S. FDA clearance for a non-invasive aesthetic lift indication. It is used in a procedure known as Ultherapy®, which is an FDA-cleared treatment to lift skin above the eyebrow, on the neck , under the chin ,on the upper chest,etc
How is Ultherapy different from other cosmetic procedures
Ultherapy targets deep tissue below the skin, an area typically reached with cosmetic surgery. Ultherapy also provides ultrasound imaging, which allows  doctors to actually see the layers of tissue that are targeted during the treatment, and thus ensure the energy is delivered where it will be most effective.
Who is a good candidate for Ultherapy?
Someone with skin that has “relaxed” to the point of looking less firm. A lowered eyebrow line or sagging skin on the neck or the jowls, is often the first sign of “maturing” skin. Typically, those in their thirties and older who have mild to moderate skin laxity are candidates. Ultherapy is also a good option for people who want to “stay ahead of the game” as well as those looking to prolong the effects of cosmetic surgery.
What results can be expected?
Ultherapy addresses mild to moderate loose or sagging skin by reconditioning and renewing the collagen underlying the skin. Ultherapy can lift the brow, which in turn reduces excess skin on the lids, opens up the eyes, and gives a more refreshed look overall. It can also improve the appearance of loose skin in the jowls or neck.

How does Ultherapy work?
Before we can delve into why Ultherapy works so well, we’ll need a quick anatomy lesson. The skin is composed of layers, not unlike an onion. Peel away the top epidermal layer, and you’ll find the dermal layer – beneath it is a layer of subcutaneous fat. Between the bones and the fat is the SMAS – the Superficial Muscular Aponeurotic System – gliding membrane consisting of connective tissue (a tissue rich in collagen) and muscle. The SMAS, through many extensions, attaches to the layers piled on top of it: the subcutaneous and the epidermal-dermal layer.
It’s no wonder the SMAS is nicknamed the “face’s foundation.” Ulthera uses this structure, heating it with sound waves and thus tightening and lifting the face through all its layers to create a youthful, more natural-looking appearance. Among the youth-inducing results are lifted jowls, tightened muscles, and the improvement of sagging skin. Ultherapy delivers focused ultrasound energy below the surface of the skin to stimulate the body’s creation of new collagen. As a result, skin will lift and tone over a period of several weeks.
The Technology Behind Ulthera
What distinguishes Ulthera from lasers is the precision built into Ulthera – the DeepSEE technology. This technology not only heats the underlying skin, but also allows doctors to see which areas they’re targeting and treat these areas with precision. In a sense, DeepSEE allows doctors to rehearse before actually treating areas.
An initial ultrasound is used to find problem areas, which the doctor then narrows down to specific regions. The doctor then directs the sound waves to the deepest layers of the skin. One great advantage of DeepSEE technology is that not only are problem spots treated, but also the depth of the sound waves is also controlled, usually to 3 to 4 millimeters to target the SMAS.Before we can understand how the sound waves pass through the skin, we’ll need a brief physics lesson. Sound waves can only travel through a medium, such a solid, liquid, or gas. In order to maximize the sound waves absorbed into the skin and minimize reflection, a gel is used before the waves are fired into the skin. Sound waves then travel through the gel-slathered skin, vibrating until they reach areas of high-collagen concentrations (such as the SMAS) where they are absorbed and warm up the soft tissue, provoking an inflammatory response that sets off a healing response that in turn starts up collagen production

What does collagen do?
Collagen is a natural protein that gives skin its youthfulness and bounce by keeping it firmed and toned. As we age, collagen loses its strength, elasticity and the ability to stand up to the effects of gravity that pull the skin downward. Ultherapy jump starts a repair process that strengthens your existing collagen and produces fresh, new collagen.
Is Ultherapy uncomfortable or painful?
It really varies from patient to patient. Some patients tolerate the procedure well while other patients experience significant discomfort or pain while the energy is being delivered. This pain and discomfort are temporary and a signal that the collagen-building process has been initiated. We have extensive experience with pain management for Ultherapy and are able to offer the highest possible level of patient comfort during the procedure. The doctors will adjust the procedure based on each patient’s response and comfort threshold and will provide numbing injections as well as oral medications as needed for patient comfort. There is no pain after the procedure and patients usually tell us that any discomfort was well worth it given the benefits to come.
How long does it take to recover?
Typically there is no downtime, and patients can return to their normal activities after treatment.
How long does it take to see results?
Patients may see some initial effect but most lifting and toning will take place over 2-3 months, as tired collagen is replaced with new, more elastic collagen. As this collagen-building process continues, further improvements can appear up to 6 months following a procedure

How long do the results last?
Patients treated with Ultherapy still have fresh young collagen a year after the procedure, but skin continues to age. Future touch-up treatments can help keep pace with the aging process, and the appropriate frequency varies for each patient.
Can Ultherapy replace a facelift?
Ultherapy is an “uplift” not a “face lift.” While it is not a replacement for surgery, it is a viable option for those not ready for a face lift or those looking to prolong the effects of cosmetic surgery.
What about treating regions other than the face?
Recent clinical research shows that Ultherapy can be effective in tightening sagging skin on the body, particularly on the chest, abdomen, under the arms and around the knees. If you are interested in areas other than the face, please schedule a consultation with  doctors to see if Ultherapy would be a good approach to tighten and smooth your trouble spots.
How does Ultherapy compare to lasers?
Lasers typically address issues in the superficial layers of the skin (e.g. fine lines, wrinkles, pigment changes). Ultherapy addresses the deep skin layer to lift and lend support to the skin. The two technologies address different areas and thus can be used together when a combined approach is desired.
Are there any side effects?
There may be slight redness for a few hours following the treatment, and it is not uncommon to experience slight swelling, tingling or tenderness to touch for a few weeks. These side effects are typically mild and temporary. It is also possible to experience certain post-procedural effects such as bruising and small areas of numbness, but these are less common and will typically dissipate over the two weeks following treatment.
How much does it cost?
Ultherapy typically costs between $ 800 and $3,000 depending on the extent of treatment. You will receive a precise estimate after your consultation with the doctors.
 Is Ultherapy safe?
Ultherapy has been cleared by the FDA after demonstrating safety in clinical studies, and tens of thousands of treatments have been performed worldwide without any significant adverse events.
How many treatments are needed?
The majority of patients only need one treatment, while those with a fair amount of laxity may need more than one treatment. Annual touch-up treatments can help slow down the rate of skin aging.
Who is a good candidate for Ultherapy?
There is a broad range of people who can benefit from Ultherapy, but typically those in their thirties and older are candidates. While this is not a replacement for surgery, there are many people who want some lifting, in order to look more refreshed and toned but are not ready for surgery (mentally, financially, or logistically). And then there are younger people who want to “stay ahead of the game” as well as those looking to prolong the effect of surgery.