A 9-point Injection Technique for Lip Augmentation and Lip Corner Lifting Using Sonographic Imaging of the Labial Artery Pathway.

Abstract

As lip enhancement using filler has grown in popularity, practitioners have sought to identify methods of injection that achieve aesthetically pleasing results while avoiding adverse events such as arterial injury due to intravascular injection. The primary objective of this study is to establish a safe injection technique for creating appealing, proportionate, and aesthetically pleasing lips while elevating the lip corners using filler. The author investigated the pathway of the labial artery using sonography and devised a 9-point injection technique (9-PIT) to reliably achieve fashionable lips. Before injection, the locations of the superior (SLA) and inferior labial arteries (ILA) were assessed using sonography. Particle HA filler was administered to 50 patients using the 9-PIT and followed up for 3 months. The extent of lip corner elevation and the angle of lip corners were quantified using the 3D-analysis, while changes in the length and curvature along the upper peristomal lines were evaluated after 1 week. SLA and ILA originated from the deep lateral aspect of the lip and gradually traversed toward the midline in the superficial layer. Superficial arterial branches were identified in the submucosal layer near the midline. All patients expressed satisfaction with the lip shaping and corner elevation, without any adverse effects or vascular complications. The angle of lip corners decreased by 8.80%, and lip corners were lifted by 1.02mm. The upper lip exhibited a more pronounced S-shape, with elongation of the upper lip line by 6.5%. This accentuated S-shape contributed to the appearance of lifted lip corners. The 9-PIT facilitated safe and aesthetically pleasing lip volumization with corner elevation in a consistent manner, while elucidating vascular pathways. Lip corner elevation was achieved solely using HA filler.