Dynamic muscle discord in the context of non-surgical lip enhancement

Abstract

Dynamic muscle discord (DMD) is a fundamental concept in facial soft tissue augmentation with dermal fillers, particularly in perioral rejuvenation and lip enhancement. It is frequently observed in patients with facial skeletal and soft tissue deficiencies. The lack of adequate structural support may result in compensatory muscle hypertonicity or confer a mechanical advantage in certain muscle groups over their antagonistic counterparts. This discord in activity between the various muscle groups can affect the posture and profile of mobile facial features both at rest and during facial expression. Unfortunately, despite being a condition that commonly presents to varying degrees in patients seeking lip enhancement, DMD is often poorly diagnosed and undertreated. The author describes the causes, consequences and treatment of this condition in relation to the perioral region, as illustrated by a case study discussion.