This is important: only use hyaluronic acid for the lips. Do not use anything semi-permanent or thicker in the lips. The density will vary with what you’re trying to do. If you’re trying to increase the size of the red lip, use a more robust HA. If you’re trying to gently define a vermilion border, use a lighter one. Don’t use Radiesse for the lips because it’s white and it shows.

For lip augmentation, HA can give a very pleasing, subtle result. You can define the vermilion border and give a little more size to the lower lip. If the patient has very little red lip showing, it’s important to put the filler just on the red side of the vermilion. Otherwise you might push the red lip in—you will have a larger vermilion but end up with less red lip showing.

I don’t do a tremendous amount in the chin but Radiesse, in particular, can be used for contour improvement. Some people are bothered by a deep labiomental crease and I’ve had some success improving that with Radiesse.

In terms of augmentation, it’s not as good as a chin implant, but Radiesse can help increase projection a little bit. For superficial lines in the chin, I would use an HA.

I also use a very small amount of neuromodulator in the skin for slight puckering that bothers some people. I’ll go down right down to the bone, withdraw slightly so I’m in the muscle, and inject a very small amount which seems to help.

Dr Michael Godin is a consultant facial plastic and reconstructive surgeon based in Virginia, USA
Article from Body Language: The UK Journal of Medical Aesthetics and Anti-Aging, www.bodylanguage.net