Man`s face gets botox injection for men near the eye

Botox for Men: Benefits and Side Effects

Botox Face Forehead Lips Wrinkles / By  Medicadepot Editor

25 Apr

Cosmetology has long since ceased to be a woman’s only service. It’s no wonder the popularity of Botox among men has increased: men also want to correct signs of aging, eliminate skin imperfections, and be attractive for themselves and in the eyes of others.

It’s no secret that even in business, it’s important to have some chemistry between people, and even more so in social communications. Minor cosmetic adjustments can significantly help with this – such as botulinum therapy, and that’s why men turn to Botox.

Men’s skin differs from women’s – it’s thicker, so the aging process is slower. But, mostly, signs of skin aging in men appear sharply and in a relatively concentrated manner. We use Botulinum therapy for men to remove wrinkles and correct other imperfections.

The Science of Botox

Botox is a medication based on botulinum neurotoxin type A, produced by Allergan (USA). This word is also used to refer to all its analogs. Botox binds to the nerve endings that release acetylcholine when injected into a muscle. 

It prevents the release of acetylcholine, which in turn prevents the muscle from contracting. As a result, the muscle becomes temporarily paralyzed and relaxed. The botulinum toxin injection procedure became popular at the end of the 20th century, and has remained the most popular non-surgical rejuvenation technique ever since. 

Botulinum toxin can smooth out wrinkles in almost any facial area. However, Botox has the most significant effect on the upper third of the face. Thus, it can eliminate horizontal and vertical wrinkles on the forehead and in the interbrow, crows feet, wrinkles on the bridge of the nose, and neck wrinkles. The most common places men get Botox are:

  • Interbrow crease;
  • Forehead;
  • Corners of the eyes;
  • Chin.

Top-class specialists also use Botox for:

  • Correcting the shape of the eyebrows and their height;
  • Narrowing the wings of the nose and raising the tip;
  • Lifting the lowered corners of the lips;
  • Lengthening the chin visually;
  • Correction of facial asymmetry resulting from blepharospasm and other spastic effects.

Botulinum toxin is often injected into the feet, palms, and armpits to reduce sweating. This procedure is indicated for people with hyperhidrosis but is often used in anticipation of summer by healthy patients.

When Can We See the Effect?

We can see the first results just a few hours after the procedure. After a few days, the effect is visible. The final result will take about two weeks to develop.

If the result is sufficient and satisfies both the beautician and the patient, then no more manipulations are performed. Otherwise, a correction session with a small dose of botulinum toxin is carried out if there is a slight asymmetry.

How Long Does Botox Last?

Men’s Botox can last 4–6 months. Gradually during this period, the muscle and nerve fibers recover. Six months after injections, the procedure can be entirely repeated.

Several courses of Botox injections for men can increase the patient’s tolerance to botulinum toxin, so subsequent treatments will require more of the drug; and they will act 1.5-2 times shorter in time.

Tolerance increases if Botox is injected more frequently than once every four months. Regaining the body’s sensitivity is possible, and the patient should take a break from injections for at least one year.

Benefits of Botox for Men

Botox is a revolutionary treatment that can help men get an enhanced, refreshed appearance. With Botox injections, men can say goodbye to wrinkles, fine lines, and facial asymmetry while improving their confidence and self-esteem.

Reduction of wrinkles and fine lines

Botox can help men achieve a more youthful appearance by reducing the appearance of wrinkles and fine lines. By relaxing the muscles that cause these imperfections to form, Botox can provide a smoother, more refreshed look.

Improvement of facial asymmetry

If your patients are concerned about facial asymmetry, Botox can help. By relaxing the muscles on one side of the face, Botox can improve facial symmetry and bring both sides of the face into better alignment.

Relief of migraines and other medical conditions

Botox isn’t just about looks, it can also relieve various medical conditions, including migraines, chronic pain, and muscle spasms. If patients suffer from any of these conditions, Botox may help.

Boost confidence and self-esteem

Taking steps to care for appearance and well-being can help your patients feel more confident and self-assured personally and professionally. With Botox, men can enjoy a smoother, more youthful appearance and the confidence that comes with looking and feeling their best.

Considerations for Treating Male Patients

Men’s forehead wrinkles are usually much deeper because their muscles are stronger on the body and face. Only when wrinkles have been visible for a considerable amount of time do men tend to turn to the expertise of a beautician. 

The interbrow area in men is also different. The eyebrows are more “overhanging” over the eyes and have a horizontal, almost unbent shape. The brow arches are expressed due to the bone component and tonus of the muscle itself. All this is expressed in vertical interbrow wrinkles and noticeable horizontal wrinkles between the eyebrows.

Therefore, most male patients who come for Botox treatment understand that it is impossible to eliminate these wrinkles completely with Botulinum Toxin alone. 

Generally, men don’t like people knowing that they’ve had any kind of procedure done. Hence, it should be done in such a way that everyone thinks it’s down to him being rested, eating healthily, exercising or simply being in a good mood.

Most men want to maintain a horizontal brow line, not raise it like almost all women want to; it’s something to keep in mind when we block the interbrow area. Always add at least a little Botox for men’s forehead lateral parts so there is no compensatory brow elevator. This also depends on the anatomy of an individual patient; the doctor should discuss this issue with the patient beforehand.

Concerning the technical side of botulinum therapy for men: As a rule of thumb, twice as much medication is needed for the procedure than for women. Therefore, its material cost increases as well. It is also necessary to clarify whether the patients want to leave a small amount of mobility in the forehead or block it completely.

Side Effects

Botox injections have potential side effects and complications, like any medical treatment. Discussing these risks with male patients before beginning treatment is crucial. They must fully understand what to expect, so that they can make an informed decision about their care.

The most common Botox side effects:

  • Injection site reactions. This can include pain, swelling, redness, and bruising at the injection site.
  • Headaches. Some patients may experience a headache after Botox injections, particularly in the first few days after treatment.
  • Muscle weakness. Botox works by relaxing the muscles, but sometimes, this can lead to temporary muscle weakness or drooping.
  • Dry mouth or difficulty swallowing. In rare cases, Botox injections can affect the muscles involved in swallowing, leading to dry mouth or difficulty swallowing.
  • Allergic reactions. Some patients may experience an allergic reaction to Botox, including itching, hives, and difficulty breathing.


In conclusion, Botox can be a revolutionary treatment for men wanting an enhanced, refreshed appearance. It helps reduce wrinkles, fine lines, and facial asymmetry while improving overall confidence and self-esteem. 

It is crucial to consider the unique needs of male patients when using Botox, as men’s skin is thicker; they have stronger facial muscles and want to maintain a natural-looking appearance after treatment. 

Therefore, it is essential to have an experienced practitioner carry out the procedure, discuss the treatment’s goals, and be familiar with the nuances of Botox for the male facial structure. With the right approach, men can enjoy the benefits of Botox, look and feel younger, and remain confident in their personal and professional lives.


Is Botox a good idea for men?

Botox can be a good idea for men looking to reduce wrinkles and fine lines, improve facial asymmetry, and boost their confidence and self-esteem.

Men get Botox injections because they can provide a smoother, more refreshed look by relaxing the muscles that cause these imperfections to form. Botox can also relieve medical conditions like migraines, chronic pain, and muscle spasms.

How long does Botox last in men?

The effects of Botox can last anywhere from 3 to 6 months in most people. However, some men may experience longer-lasting results, up to 8 months or more. 

At what age should men get Botox?

There is no specific age at which men should start getting Botox, and it depends on the individual’s skin and personal goals. Botox is often used to treat wrinkles and fine lines caused by repeated muscle movements, such as frowning or squinting: Therefore, men with these signs of aging who want to reduce their appearance may consider getting Botox injections.

Pretty lips gets a filler injection to show the migration of lip filler

Lip Filler Migration: Causes and Prevention Tips

Dermal Fillers Lip Fillers Lips Professionals / By  Medicadepot Editor

25 Apr

Disclaimer: Only trained professionals should perform dermal filler injections to the lips to avoid risks to the patient’s health. Lip dermal fillers can only be sold to certified aesthetic doctors, plastic surgeons, or special beauty clinics.

Lip augmentation with fillers is one of the most popular non-surgical procedures worldwide.

The main aim of dermal lip fillers is to add volume and elasticity and smooth out wrinkles. Fillers help eliminate asymmetry, align the lip contours, make lips plumper, and raise drooping corners.

Modern fillers are based on collagen, hyaluronic acid, and calcium. The lips gain the desired shape and volume less than an hour after the filler injection. Depending on the chosen filler, the desired effect lasts six months to three years.

Lip fillers are divided into two categories: permanent, which do not dissolve, and biodegradable fillers, which dissolve over time.

Permanent fillers were commonplace when the world started doing aesthetic injection procedures. Such preparations are made from synthetic materials: mostly biopolymer and polyacrylamide gels.

These gels have many delayed side effects. They do not degrade naturally, can be absorbed unevenly in the tissues, and settle in lumps in different areas of the lips.

Lumps of permanent filler cannot be removed if they were inserted more than ten years ago, as filler grows into the tissues. If the gel has been in the lips for a few years, it can be removed surgically. However, after surgery, scars may remain on the lips.

Biodegradable fillers are used to increase and moisturize the lips. Most often, these are preparations of stabilized hyaluronic acid.

Hyaluronic acid is a natural moisturizer that exists in human tissues. The body produces hyaluronic acid until a certain age, but its quantity decreases as tissues degrade with age. Introducing filler improves the lips’ condition and makes them plumper.

The body eliminates collagen fillers at high speed.This is undeniably a drawback, but such injectables stimulate the production of the body’s collagen, leading to natural skin improvement.

Lip Filler Migration

Getting lip filler treatment for a fuller, puckered pout remains one of the most talked-about cosmetic trends, but what’s less talked about is one of its potential side effects: lip filler migration or swelling of the lips.

This refers to a condition where the filler gel used in the area of the lips moves from the injection site, creating unnatural volumes and reliefs.

This potential side effect isn’t harmful; it could scare a patient as it’s not the result they expect when undergoing this noninvasive procedure. Fortunately, it isn’t permanent, and you can take measures to avoid it.

Why Does Filler Migrate?

Most specialists believe that the migration of fillers occurs due to incorrect administration of the drug. Both the technique and the amount of the product play a role here.

Of course, there is no specific universal dosage, as various individual nuances take place here. However, hypercorrection is one of the frequent causes of gel migration. Over-injecting the lips can stretch them beyond their natural capacity to accommodate the additional volume.

This excessive stretching can cause the filler to migrate into neighboring areas, resulting in an unnatural or uneven appearance. Therefore, injectors need to exercise caution and avoid using too much filler. You can control the amount of filler injected into any area. A less-is-more approach helps to ensure the gel is properly contained within the intended location.

In addition, the gel may not stay where it is supposed to be due to its superimposition on top of the previous filler. As a result, it simply has nowhere to go and will flow along the path of least resistance – often a little higher than the lips.

Also, among lip filler migration causes are injections that are too superficial or too quickly performed – which leads to the filler getting into the wrong tissue layer.

An incorrect selection of the filler is equally a problem. Each cosmetologist has a personal arsenal of products with different compositions and properties. It’s necessary to clearly understand which drug is more suitable for which zone – or for these or other individual characteristics of the patient.

Thicker, dense textures are injected deep into the tissues to create a lifting effect and increase the cheeks or chin line volume. Whereas light, liquid textures are applied superficially to smooth out fine wrinkles or create a light, natural lip volume. Migration is likely if you use fillers not intended for the zone you treat, such as thick gels in delicate areas.

A small percentage of patients can also experience lip filler migration due to an immune system response triggered by an illness or allergic reaction.

How To Understand That The Filler Has Migrated?

The predominant signs are unnatural volume, swelling, and lumpiness. When the filler migrates, the lips’ upper border may become less clear, and bumps may form on the skin above the lip. Another indicator to look for is difficulty closing the lips.

Migration is easily confused with edema, so informing a patient about such symptoms is essential. The fact is that many fillers attract water, and because of that, they can cause temporary swelling.

If hypercorrection is the cause of lip filler migration, it manifests itself quickly. But if it happens due to incorrect technique or short intervals between injections, then it only becomes noticeable after a few months.

Prevention and Management of Lip Filler Migration

First, always discuss a patient’s health during the preliminary consultation to detect the contraindications to the procedure.

Here are some tips for you to prevent lip filler migration during the injection process:

• Understand facial anatomy. It is vital to thoroughly understand facial anatomy and, more specifically, the lips’ anatomy to determine the correct filler placement. The doctor must be aware of the different layers of the lip and the muscles that surround them.

• Use the appropriate injection technique for the area being treated. Slow and gentle injections are recommended to prevent lip filler migration.

• Place filler strategically where the lips need the most volume or contouring. Avoid injecting too close to the lip’s border or the mouth’s corners to prevent migration.

• Choose the suitable filler for the procedure – only use HA gels for lip augmentation, and ensure you select a filler with the appropriate viscosity.

• Use the appropriate amount of filler: Use the appropriate amount of gel for the patient’s desired outcome. Overfilling can cause the filler to migrate.

• Have the patient move their lips during the injection: Having the patient move their lips during the injection can help ensure the filler is placed in the correct area and prevent migration.

• Provide aftercare instructions to the patient to minimize swelling and promote healing. Advise them to stay out of the sun, avoid saunas, touch or massage their lips, and not to exercise intensely or take very hot showers for at least 24 hours after the procedure.

• Schedule follow-up appointments to monitor the patient’s healing process and address any concerns they may have.

Always remember to prioritize patient safety and satisfaction. If you have any concerns about filler migration, discuss this with the patient and adjust the treatment plan accordingly.

If a patient experiences lip filler migration, doctors have several options available on how to fix migrated lip filler:

• Hyaluronidase: You can eliminate migrated HA-based filler with a particular hyaluronidase enzyme. Injecting hyaluronidase can dissolve the filler and reduce migration. Hyaluronidase breaks down hyaluronic acid, the primary ingredient in most lip fillers. However, this substance must be introduced precisely where migration is present. Otherwise, it is possible to get a deficit in the patient`s volume of hyaluronic acid.

• Steroids: Injecting steroids into the affected area can reduce swelling and inflammation, which can cause the filler to migrate.

One of the natural ways to manage lip filler migration is massage. It can help redistribute the filler and encourage it to settle into the intended area.

• Cold compress: Applying a cold compress can reduce swelling and inflammation, which can contribute to filler migration.

• Wait it out: HA-based <ahref=”https:”” dermal-fillers.html”=””>dermal fillers dissolve over time. Yes, preparations based on hyaluronic acid require an average of 6 to 18 months to degrade. Therefore, even if migration is an unsightly cosmetic effect, it will disappear over time and generally pose no health risk.</ahref=”https:>

• Adjust the treatment plan: Work with the patient to adjust the treatment plan to address any issues with the lip filler migration.

Doctors must communicate with their patients about the potential risks and side effects of lip fillers, including migration. Proper technique, appropriate filler selection, and careful patient selection can help minimize lip filler migration risk.

If the patient does experience migration, the doctor can work with them to develop an appropriate plan to address the issue and achieve a satisfactory outcome.


To summarize, lip filler migration is a potential risk associated with lip augmentation procedures. To minimize the migration risk, doctors should prioritize patient safety by carefully selecting appropriate candidates, choosing the filler, using the correct injection technique, and providing clear post-treatment instructions to patients.

In the event of migrating lip filler, you can work with the patient to develop an appropriate treatment plan, including options such as hyaluronidase, massage, cold compress, steroids, or adjusting the treatment plan.

Ultimately, by taking a cautious approach and remaining attentive to potential complications, you help ensure your patients achieve natural-looking, satisfying outcomes from lip augmentation procedures.


Does lip filler migration go away?

Migrated lip filler organically dissolves from the body with time. Still, it is possible to speed up this process by injecting hyaluronidase enzyme.

How long does it take for lip filler to migrate?

Lip fillers are not permeant, so after approximately 6-18 months (depending on the filler injected), the body will naturally metabolize the filler and break it down, so the migration stops.

How do you stop lip fillers from migrating?

To prevent lip filler migration, you must use the injection technique with the fewer injections possible. The more “holes” you make, the more likely lip filler will migrate above the lip.


Blandford A, Hwang C, Young J, Barnes A, Plesec T, Perry J. Microanatomical location of hyaluronic acid gel following injection of the upper lip vermillion border: comparison of needle and microcannula injection technique. Ophthal Plast Reconstruct Surg J. 2018; 34:(3)296-299

Broder K, Cohen S. An overview of permanent and semipermanent fillers. Plast Reconstruct Surg J. 2006; 118:(3 Supp)7s-14s

Cox S, Adigun C. Complications of injectable fillers and neurotoxins. Dermatol Ther. 2011; 24:(6)524-536

Demosthenous N. Lip augmentation. PMFA News Journal. 2017; 4:(3)1-3

De Boulle K. Management of complications after implantation of fillers. J Cosmet Dermatol. 2004; 3:(1)2-15

Eversole R, Tran K, Hansen D, Campbell J. Lip augmentation dermal filler reactions, histopathologic features. Head Neck Pathol. 2013; 7:(3)241-249

*Disclaimer: The contents of this article are not to be constructed as medical advice but for informational purposes only. MedicaDepot staff does not review any of these articles for medical validity. Opinions and views expressed in this article are not endorsed by MedicaDepot. Please always consult your doctor for professional medical advice.

A woman gets a dermal filler treatment for her lips with a syringe as a tool

Treating Lips – Analysis, Tools & Techniques, Complications

Lips / By  Medical Community

21 Mar

The look of a full and sulky lip has been desired by both genders for hundreds, if not thousands of years. They convey a sense of youth that is attractive and pleasing. The desire for luscious lips spares is one that is present in many cultures, both in the past and in the present. Indeed, even across the central steppes of Asia and the vast riches of the Middle East, the lips are regarded as the aesthetic center of the lower face. To many females in particular, they are a major sign for beauty. For many patients today, the lips are a prime aesthetic concern, especially for patients that have severe signs of aging such as a decrease in lip volume, perioral wrinkles, smoker’s lines, and downturned corners. However, many patients share a common negative perception about surgical procedures, including ones aimed at the lips, as the complications of such procedures have often been devastating and/or even permanent.

Fortunately, the days of exceptionally poor results from botched cosmetic surgeries are numbered. To help show this, this article aims to provide an overview of popular minimally invasive procedures. Hyaluronic acid (HA) fillers and ablative lasers have become popular treatment modalities over the years, as both are efficacious and have strong respective safety profiles.

Patient analysis

The best lip augmentation procedures give an ideal duration of action, low risk for side effects, and an optimal natural appearance. For every procedure that will be discussed in this article, they begin with patient selection and analysis. The most crucial process in any treatment should be evaluating the health and medical condition of your patient. Do this to ensure that they do not have any comorbidities that may impede the healing process, or any contraindications that preclude them from a certain treatment modality. Secondly, document the appearance of the lips before a procedure by measuring the lip dimensions and by taking photographs. Next, enquire if they have had any history of lip augmentation prior to this, and if the answer is yes, ask what type of injectable fillers were used. You should always discuss treatment expectations with your patients.

When doing so, maintain that the procedure is not meant to be a miracle, and it is sometimes in both of your interests that you cancel the treatment if the patient insists on unrealistic expectations. Carefully examine the severity or degree of structural degradation of the lower face and the volume lost in the lips, as you need information on both matters to know how much filler you will be using. Make sure that patients find the amount of filler you will use to be agreeable with your treatment plan. Patients may find it surprising or odd that your suggestions are against what they have been told or have seen.

For example, injecting large amounts of dermal fillers into the lips does not result in an aesthetically pleasing result, even though such an approach may seem intuitive. Explain that the ideal lips also require rebuilding the structural support around the lips. Lastly, reassure them that you will minimize pain during the procedure and that any post-operative complications are mainly transient except in a few severe cases. When you have done all of the above, have your patient sign an informed consent form to adequately document their approval.

HA dermal fillers

Hyaluronic acid (HA) fillers revolutionized the dermal filler industry, as they showed excellent results and long duration of actions in soft tissue augmentation. As manufacturers understand more of the cross-linking process and improve on their respective manufacturing techniques, many more modern HA-based fillers are able to last for at least a year. HA dermal fillers offer extraordinary flexibility during their treatment processes: if they are implanted in the wrong place, they can be dissolved with subsequent injections of hyaluronidase. Although there are a huge variety of filler materials available, none of them have a safety profile that approaches HA fillers.

Additionally, the lips are dynamic structures that are highly vascular, so using dermal fillers that are not based on HA would unnecessarily jeopardize patient safety. For example, calcium hydroxylapatite-based fillers are more suitable for use in the nasolabial folds and marionette lines because of their elasticity and higher innate viscosity. Furthermore, based on Emer and Sundaram, there is also substantial evidence against its use in dynamic areas, such as the lips and periocular area, as the risk for nodule formation can be exceedingly high in these areas.

Tools and techniques

There is a long-standing argument regarding the use of a needle or a cannula in augmentation procedures. The main point supporting the use of cannulas is that, theoretically, there is a reduced chance of damaging the vessels. However, even small cannulas have the capacity to damage blood vessels, particularly in regions where resistance to the insertion is high. The perioral and the vermilion border wrinkles can be extremely resistant to effacement with the use of blunt cannulas. Furthermore, the use of cannulas may also be costlier for the patient, as they generally require more filler materials to deposit adequately said filler into the deeper plane tissues. 4 Cannulas can be used when patients find it unacceptable to have any bruising or swelling. 25G or 27G cannulas are commonly used and work well with filler materials.

For needles, a 30G needle premixed with lidocaine and adrenaline is ideal. Inject at three to four injection areas along the lip and gingival mucosa. The patient feels less pain during the procedure because of the lidocaine, and the risk for inadvertent intravascular injection is reduced as vasoconstriction occurs. Correct the aesthetic defects to best suit the patient’s needs. Approximately inject 1 to 2ml of a dermal filler to the aforementioned area but expect to inject more since many practitioners advocate concurrently treating the nasolabial and marionette defects. When injecting with the needle at the outer area of the vermilion, the filler may fill up one half of the lip from this one point. Minimize these injection points, as they can contribute to bruising. A common order of events is to treat the vermilion border, augment the lips, efface the perioral wrinkles, and then proceed to the mouth angles. A side note: use the linear threading injection technique to treat the philtral columns.

Complications of dermal filler injections

As mentioned previously, most side effects of dermal filler injections are transient. Most come from the penetrating trauma caused by the needle or cannula. Complications from these injections that need active intervention are infections, granuloma formation, thromboembolism, and filler material migration. Thromboembolism remains the most severe complication, as it can cause permanent defects. The methods listed below are to guide you on how to reduce the risk of these complications occurring:

• Opt for local anesthesia with adrenaline either premixed (preferred) or in a separate injection.

• If you are confident and skillful of your injection expertise, use a blunt cannula.

• Stabilize your hands while aspirating before injecting.

• Gently inject the filler material and do so in small deposits.

• An early manifestation of intravascular injection is tissue blanching. Pay close attention to your patient’s skin to allow you to react quickly if blanching and, by extension, intravascular injection occur.

• Have a syringe prepared with hyaluronidase for emergency use.

How to avoid a poor aesthetic result

• Avoid being overzealous and filling with large amounts of filler material.

• Consider the entirety of the face when treating the perioral and lip region.

• HA dermal fillers with fine particle sizes should be used instead of fillers with large particle sizes to maintain the natural characteristics of the lips.


Non-ablative lasers are increasingly being phased out as one of the top treatment choices for the lip and perioral regions mainly due to unsatisfactory results compared to other more viable options. Vascular lasers, on the other hand, are more effective in handling vascular lesions. For example, venous lakes that are present in the lips can be treated successfully with long pulsed lasers. In terms of skin rejuvenation, ablative lasers, erbium, and CO2 lasers are more frequently used for wrinkles, fine lines, and to bring about an overall better skin texture. CO2 lasers have the added advantage of providing tighter skin and can be used on any skin types. Lighter skin types can opt for full ablative laser resurfacing, as that form of treatment is less prone to complications. 8 Full ablative CO2 lasers remove the epidermis and the upper parts of the dermis, which can result in significant pain during the procedure. Therefore, sedation and/or anesthesia is usually needed.

The efficacy of full ablative C02 lasers is supported through a prospective study that investigated the difference in outcomes between microdermabrasion and CO2 lasers and found comparative results. 9 CO2 lasers also induce histological changes that may explain its mechanism of action. To this point, new collagen formation begins at six weeks after treatment and then progressively increases at six months and one year after. 10 This pattern in collagen formation signifies the need to treat the face as a whole unit instead of individual areas so as to avoid obvious delineation between treated and untreated areas. These laser machines also come with different presets of energies, pulse duration, spacing, and patterns. Learn and understand their uses, as this is imperative for providing a good outcome. You should also take into effect the hydration levels of the skin and use of local anesthesia, as they are known to alter the function of CO2 lasers.  Post-operatively, fully ablative CO2 lasers require high-quality wound caring techniques so as to avoid the development of infections.

Complications of laser treatment

Reactivation of the herpes virus is a real concern for patients undergoing laser or filler injection treatments. Anti-viral prophylaxis is recommended. For full laser resurfacing, antibiotics, antifungal medications, and antiviral prophylaxis may be required. Keep in mind that adverse effects—such as post inflammatory hyperpigmentation and bacterial, viral, and fungal infections—can occur with laser treatment. Avoid overtreatment, as it can lead to the dreaded scarring complication. Sun exposure should be kept to a minimum, while the use of sunscreens must be advocated to the patient to reduce the risk of pigmentary side effects developing after treatment. Hydroquinone topical treatments may be applied onto hyperpigmented areas, but hypopigmentation is extremely resilient to most available treatment.

Other treatment methods

Both aging and gravity can increase the upper lip length. Therefore, any dermal filler deposited into this area can worsen its appearance. Surgical procedures may be more beneficial, as lip-lifts are known to restore the upper lip with better efficacy. Lip-lifts can also be done under local anesthetics, thus avoiding the complications of having to undergo general anesthesia. 19 Other treatment methods that can be used to treat the lip, such as mesotherapy treatments, carboxytherapy, and platelet rich plasma, vary in their effectiveness. Botulinum toxin can also be used along the borders of the lips and depressor anguli oris to treat dynamic wrinkles around these areas. Most of these treatment methods are ideally used when combined with another treatment modality, as the combination can produce the most optimal outcome. For example, platelet rich plasma has been shown to decrease the downtime related to laser treatments.


The lips offer a dramatic and defining attribute to the face. The aging process denies patients of the beautiful volume and structure of the lips. Fortunately, current modalities, as presented here, have their own capabilities to solve this issue. HA fillers are the treatment of choice for the lips, as they are strongly associated with good patient satisfaction and ideal outcomes. Lip rejuvenation and augmentation is a relatively safe and effective treatment, but it requires stringent patient assessment and consultation.


• San Miguel Moragas J et al, ‘Systematic review of “filling” procedures for lip augmentation regarding types of material, outcomes and complications’, J Craniomaxillofac Surg, 43 (2015) p.883-906.

• Pierre A, Levy PM, ‘Hyaluronidase offers an efficacious treatment for inaesthetic hyaluronic acid overcorrection’, J Cosmet Dermatol, 6 (2007), pp.159-62.

• Emer J, Sundaram H, ‘Aesthetic applications of calcium hydroxylapatite volumizing filler: an evidencebased review and discussion of current concepts’, J Drugs Dermatol, 12 (2013) pp.1345-54.

• DeJoseph LM, ‘Cannulas for facial filler placement’, Facial Plast Surg Clin North AM, 2 (2012), pp.215-20.

• Grippaudo FR et al, ‘Diagnosis and management of dermal filler complications in the perioral region’, J Cosmet Laser Ther, 16 (2014), pp.246-52.

• Beleznay K et al, ‘Vascular Compromise from Soft Tissue Augmentation’, The Journal of Clinical and Aesthetic Dermatology, 7 (2014), pp.37-43.

• Kim DW et al, ‘Vascular complications of hyaluronic acid fillers and the role of hyaluronidase in management’, J Plast Reconstr Aesthet Surg, 12 (2011), pp.1590-5.

• Gaitan S, Markus R, ‘Anesthesia methods in laser resurfacing’, Semin Plast Surg, 3 (2012), pp.117-24.

• Gin et al, ‘Treatment of upper lip wrinkles: a comparison of the 950 microsec dwell time carbon dioxide laser to manual tumescent dermabrasion’, Dermatol Surg, 6 (1999), pp.473-4.

• Rosenberg GJ et al, ‘Long-term histologic effects of the CO2 laser’, Plast Reconstr Surg, 7 (1999) pp.2245-6.

• Goldman MP, ‘The use of hydroquinone with facial laser resurfacing’, J Cutan Laser Ther, 2 (2000) pp.73-7.

•Duplechain JK, ‘Novel post-treatment care after ablative and fractional C02 laser resurfacing’, J Cosmet Laser Ther, 16 (2014), p.77-82.

• Gazzola R, ‘Herpes virus outbreaks after dermal hyaluronic acid filler injections’, Aesthet Surg J, 6 (2012), pp.770-2.

• Walia S, Alster TS, ‘Cutaneous C02 laser resurfacing infection rate with and without prophylactic antibiotics’, Dermatol Surg, 11 (1999) P.857-61.

• Metelitsa A, Alster TS, ‘Fractional laser skin resurfacing treatment complications: a review’, Dermatol Surg, 3 (2010), pp.299-306.

• Wanitphakdeedecha R, ‘The use of sunscreen starting on the first day after ablative fractional skin resurfacing’, J Eur Acad Dermatol Venereol, 11 (2014), pp.1522-8

• Goldman MP, ‘The use of hydroquinone with facial laser resurfacing’, J Cutan Laser Ther, 2 (2000), pp.73-7.

• Dover JS et al, ‘Lasers in skin resurfacing’, Semin Cutan Med Surg, 4 (2000), pp.207-20.

• Waldman SR, ‘The subnasal lift’, Facial Plast Surg Clin North Am, 4 (2007), pp.513-6.

• Leo MS et al, ‘Systematic review of the use of platelet-rich plasma in aesthetic dermatology’, J Cosmet Dermatol, 23 (2015).

• Klein AW, Ayers BW. Lip augmentation. (ed). Aesthetic Plastic Surgery. : Elsevier; 2009. pp. 855-860.