Lip augmentation is a cosmetic procedure that can create fuller, plumper lips.
These days, injectable dermal filler is the most commonly used method of lip augmentation.
There are many types of dermal fillers that can be injected into the lips and around the mouth. But the most common fillers today are products containing substances similar to hyaluronic acid. Hyaluronic acid is a natural substance found in the body. Helps increase lip volume.
These types of dermal fillers are sometimes called "hyaluronic acid fillers."
- Collagen, once the most common dermal filler, is used less and less today. The new options are safer and the effects last longer.
- Fat injections and implants are another way to plump your lips. But they are not used as often today because results vary and there is a greater risk of side effects.
Using fillers with hyaluronic acid
Hyaluronic acid fillers can improve the appearance of your lips by adding:
- form
- compound
- volume
The effect usually lasts about six months. After this, you need to give more injections so that your lips do not change.
There are several hyaluronic acid fillers on the market. Among them are the following products:
- Restylane, Restylane-L, Restylane Silk
- Juvederm Ultra, Juvederm Ultra Plus, Juvederm Volbella XC
- Belotero Balance
- HylaForm
- Elevess
- Prevelle Silk
All of these products are administered the same way and produce the same results. And some contain lidocaine, a local anesthetic.
Hyaluronic acid (HA) fillers are currently one of the most commonly performed minimally invasive cosmetic procedures. Unfortunately, sometimes (although quite rarely) these procedures are associated with complications. Some of the most dangerous are ischemia and skin necrosis - and the sooner treatment is started, the greater the chance of preventing serious consequences. However, “ischemia is not all that it seems” - scientists from Brazil described a case of herpes after an injection, which was very similar to the symptoms of ischemia.
In an article published in The Journal of Clinical and Aesthetic Dermatology, the authors report on a 65-year-old female patient with significant fat loss in the malar region. She underwent contouring using 2 ml of HA per session: one point injection in the anterior zygomatic region (0.3 ml/side) and another in the fossa canina (“canine fossa”) area (0.2 ml/side) with using a 27G needle, 0.5 inch needle, in the supraperiosteal plane with negative aspiration at all points. The anterior zygomatic region was treated with retroinjection using a 25-gauge blunt-tipped cannula, 1.5-inch needle (0.4 ml on the right and 0.6 ml on the left using a fan technique). There were no side effects in the immediate postoperative period.
However, two days after the procedure, the patient began to experience mild pain in the malar region on both sides and in the right side of the nasolabial fold, which decreased with the use of over-the-counter analgesics. On the fourth day, there was an increase in pain in the area of the zygomatic bone; the patient also complained of a headache in the temporal region and pain in the shoulder, worse on the right.
On physical examination, vesicles and erythema were found in the nasolabial fold and supralabial area on the right. Specialists promptly performed an ultrasound examination with Dopplerography to determine the patency of the vessels. Normal blood flow in the angular artery and adequate location of the filler in the supraperiosteal region were revealed, which indicated the absence of ischemic origin of the symptoms and confirmed the diagnosis of herpes zoster. Vanciclovir was recommended, and the symptoms were relieved.
Reactivation of herpes after filler injections is a rare complication that can be caused by direct injury to the axon from the needle or inflammatory reactions in response to mechanical manipulation and foreign body injection. Symptoms appear 24-48 hours after the procedure. The nature of reactivation depends on the type of virus and most often occurs along the branches and ganglia of the trigeminal nerve, most often affecting the ophthalmic branch. In the described case, the maxillary branch of the nerve was affected.
The authors note that this is the first case of herpes zoster occurring after injection of HA filler. In a review of the literature, they were able to find only one case of herpes zoster reactivation after injection of fillers, but this was a product based on calcium hydroxyapatite.
This complication may clinically resemble ischemia, therefore, in any case of the appearance of erythema and blisters after injection, it is recommended to perform an ultrasound examination with Doppler sonography to exclude vascular occlusion and identify the location of the filler.
For our part, we will say that it is worth knowing about such a complication, but if you do not have an ultrasound machine at hand, it is always better to assume the worst - unfortunately, much more ischemic complications have been recorded.
Source:
Kim JSTW, Dos Santos Guadanhim LR, De Barros Nunes GJ, Dias Da Rocha MA, Munia MA, Yarak S. Herpes Zoster as a Differential Diagnosis for Ischemia after Facial Hyaluronic Acid Filler. J Clin Aesthet Dermatol 2020; 13(12): 29–31.
Benefits of Hyaluronic Acid Fillers
Once injected, the gel in the filler supports and shapes the lip tissue.
The benefits of using hyaluronic acid fillers include:
- Control of lip volume. The amount of substance injected can be controlled so that the doctor can better control the volume of the lips.
- Gradual pace of treatment. The injections can be given gradually over different appointments until the desired results are achieved.
- Irregularities are easily dissolved. Any lumps or lumps created by moving your lips will easily dissolve.
- Less bruising. There may be less bruising and swelling compared to other dermal fillers.
- Quite stable results. The results are quite long lasting, but not permanent.
- An allergic reaction is unlikely. Because hyaluronic acid fillers are made from substances similar to those found in the body, they are unlikely to cause an allergic reaction. But if you are allergic to lidocaine, tell your doctor before treatment.
Does the risk of herpes depend on the brand and composition of lip filler?
The arguments found on Internet forums that some fillers are more likely than others to cause an exacerbation of herpes are absolutely incorrect. Herpetic rashes can be caused by any composition, since in this case the provoking factor is the condition of the body.
Why then does herpes not occur after every increase? It’s just that the immune system reacts differently each time. His reaction depends on the woman’s health, time of year, and stress. The reason for success and failure lies precisely in this.
Therefore, if you are prone to herpetic rashes, you need to start taking antiviral drugs prescribed by the doctor at the Aesthetic Medicine Center in advance. This will allow you to avoid the manifestations of herpes, regardless of the weather, the state of the nervous system and other factors. It is competent prevention that is responsible for the minimal number of such complications in patients who contact our Center.
Side effects and risks
The side effects of hyaluronic acid fillers are temporary and should only last a few days. These may include:
- bleeding from injection sites;
- swelling and bruising;
- redness and soreness at the injection site;
- reactivation of cold sores or blisters (herpes simplex) on or around the lips.
More serious side effects or risks may include:
- severe and prolonged swelling or bruising lasting one week to 10 days;
- lip asymmetry (parts of the lips of different sizes);
- lumps and unevenness on the lips;
- infection;
- injection into a blood vessel causing tissue loss
- ulceration, scarring, or hardening of the lip;
- an allergic reaction that causes redness, swelling, or itching around the lips.
If you develop a fever or severe swelling, you should call your doctor immediately.
Fibrosis and compaction - complications after lip contouring
In the first days after the injection of fillers, lumps may appear at the injection site, this is due to the fact that the substance has not yet had time to distribute evenly. Sometimes it happens that a hematoma (bruise) appears due to damage to a vessel. Within a week, it usually resolves, but if the cause of the lump is fibrosis, then the situation is much more complicated and requires your close attention.
Why does fibrosis occur?
The distribution of fillers in the lip occurs gradually, and the effect can last up to 12 months. Immediately after administration of the drug and during the first week, balls are felt under the skin, which dissolve on their own. Clots are nothing more than drops of filler, which is quite natural. Fibrosis is an unpleasant complication when connective tissue grows with the appearance of scar changes.
One of the obvious reasons for the formation of fibrosis is the rejection of a foreign substance by the body . In this case, a well-chosen injection solution can solve this issue. But only a professional cosmetologist can determine the dosage and prescribe the necessary drug that will not aggravate the situation. The doctor will also tell you what care is suitable after lip contouring in your case.
Unobvious reasons for the formation of fibrosis include:
- inexperience of the cosmetologist;
- violation of sanitary norms and rules;
- mechanical damage to the walls of blood vessels;
- counterfeit or low-quality filler;
- violation of the technology and technique of drug administration;
- incorrectly selected dose of the administered substance.
Rehabilitation after lip contouring
Fibrous changes after filler injection can occur anywhere on the face, but a particularly favorite area for localization of compactions is the upper lip. This is due to the fact that the skin here is extremely sensitive, delicate and thin. Swelling may not even arise from the filler, but simply from trauma to the skin with a needle.
Seals on the lips cannot be corrected with makeup. Fibrosis is noticeable to the naked eye, and you won’t be able to hide lumps with lipstick and gloss; rather, on the contrary, you only focus attention on this area. It is possible to get rid of fibrosis in one of two ways: surgical or conservative. In the first case, surgical intervention will be required, and in the second, an external agent with collagenase enzymes. The operation is an extreme measure, which is usually used to extract biogel; most often, gentle methods can be used.
Is lip augmentation right for you?
To answer this question, you must first ask yourself why you want to change your lips. You should not undergo this procedure unless you really want to change your appearance.
If you're considering lip augmentation to make someone happy or to try to create the perfect look, think twice.
It is also important to have realistic expectations about the outcome. Extended lips can make your lips look plump and full, but you'll still be yourself when you step out of the doctor's office.
Before undergoing lip augmentation surgery, you must be healthy and not smoke. You may not be a candidate for lip augmentation if you have:
- active infection, such as oral herpes;
- diabetes;
- lupus;
- problems with blood clotting.
Why is the herpes virus activated after lip augmentation?
The culprit of herpes infection after lip augmentation is most often the injection method. It damages the epidermis and introduces infection into the body. Here the virus begins to multiply and launches its DNA into the nuclei of nerve cells. Therefore, it will not be possible to completely “dispose” of herpes.
Cases of infection in salons where surgery was performed are quite common. But it happens that the patient is sick with the virus even before the operation. Therefore, herpes after lip augmentation with hyaluronic acid begins to manifest itself in full.
The herpes virus is activated after the procedure for several reasons:
- protective covering injuries;
- epidermal injuries;
- weakened immunity;
- allergic reaction.
It is worth noting that a complete cure for herpes is impossible.
What you should tell your doctor before lip augmentation
Your doctor can discuss the pros and cons of your lip augmentation options with you and help you decide which method or product is best for you. But you should also tell him all the information about yourself:
- if you have ever had herpes in the past;
- known allergies or allergies to lidocaine;
- about any medications you take, including prescription and over-the-counter medications;
- as well as herbal supplements.
The most important thing is to find a doctor who is qualified and experienced in administering injections and who you trust.
Don't go to just anyone. Lip augmentation poses a real risk, especially if the person doing the injection is inexperienced. When deciding which doctor to see, ask about his or her training and education. How many injections did he have? Are they a board-certified physician or member of a medical association in their specialty? Also ask to see before and after photos of patients the doctor has treated.
Why lip enlargement is often accompanied by the appearance of herpes
The doctor who performed the lip augmentation procedure was not involved in the appearance of herpetic rashes. The reason for this phenomenon lies in the characteristics of the body, and sometimes in the patient’s irresponsible attitude towards her health.
The most common causes of herpes after lip augmentation procedure:
- Reduced immunity.
Sometimes the immune system is so weak that anything can cause a herpes outbreak. In this case, the provoking factor is the very fact of injection. In this case, herpetic rashes can also be caused by other cosmetic procedures, for example, peeling, mesotherapy, and plasma injection. Only in this case, herpes may appear not only on the lips, but also on other areas of the face, for example, near the nose. Therefore, you should inform your cosmetologist at your consultation about your tendency to develop a herpetic rash. The doctor will prescribe medications that suppress the activity of the virus. - Recent exacerbation of herpes
. This condition is a contraindication for lip augmentation. Therefore, in order not to overload the immune system, which has only recently fought the pathogen, the procedure should be postponed for a while. You should not hide a recent exacerbation of infection from your doctor - you can harm your immunity, which will not cope with the load and will not be able to “extinguish” the activity of the virus. - Bad feeling.
Sometimes patients ask for lip augmentation despite the painful condition. The doctor refuses in these situations, but some women hide this fact, doing themselves a “disservice.” The immune system cannot cope with the virus and the infection worsens.
Sometimes herpes occurs seemingly without any provoking factors. The reason for this phenomenon lies in the procedure itself. The introduced hyaluronic acid starts the rejuvenation process, increases blood supply, and stimulates metabolic processes. At the same time, the virus can be activated.
Most often, the situation arises if the patient does not follow medical recommendations. Exacerbation of herpes can be caused by the use of medications not recommended by a cosmetologist.
Not all rashes that occur after the procedure are caused by herpes. Sometimes this may be an allergic reaction or an inflammatory process caused by intolerance to the administered drug. Although the Center for Aesthetic Medicine uses hypoallergenic compounds for lip augmentation, this situation can arise, however, extremely rarely.
Therefore, if a rash appears at the site of filler injection, you should contact the doctor who performed lip augmentation, and under no circumstances self-medicate.
