[Music] What’s the best lip filler?

The desire to have more attractive lips makes billions of dollars for companies in the business of selling lipstick fuller lips are generally appreciated as desirable and youthful

However the most significant concern for anyone interested in lip volume enhancement who I see in my practice is the fear of looking like a duck

They often will tell me how they or someone they know got a particular product placed into their lips and that they ended up looking crazy which then leads to the next question what’s the best lip filler

I’ll discuss the products I use in my practice and why the question what’s the best lip filler is the wrong question to ask

I’m dr. Amiya Prasad I’m a board certified cosmetic surgeon and fellowship-trained oculofacial plastic and reconstructive surgeon

I’ve been in practice in New York City and Long Island for over 25 years throughout my career I have used a wide range of non-surgical and surgical procedures to enhance lips this includes the original collagen injections such as zai plastun zai derm as well as surgical implantation of fat as well as tissue harvested during facelift surgery called dismiss and as well as commercially processed human tissue that all changed after the introduction of hyaluronic acid fillers in the United States in the mid-2000s

Whether it’s for lips or any other area it’s important for consumers to understand that the producers of hyaluronic acid products are creating through advertising a perception of product as being more important than anything else this includes the qualifications of the person actually performing the procedure since the companies are not subject to any licensed professional standards they don’t care who uses their product

What only matters to them is for consumers to ask for their products by name this is a problem the general public looks for the product without understanding the more important details of who is actually doing the procedure this has turned out to be disastrous with so many avoidable complications resulting in disfigurement and even death from filler injection think about it when a disastrous event occurs the person experiencing the problem is no longer content to look for someone like the person who injected them but rather for the highest level physician or surgeon to save their face and even their life

As I stated earlier someone like myself who’s performed so many different live procedures both non surgically and surgically over 25 year career has a deeper understanding of what to do and more importantly what not to do then a nurse or a physician’s assistant that’s obvious

I approached lip filler placement by first hearing from my patient what bothers them the most about their lips or what they want to see enhanced or accentuated typically my patients who are experiencing normal age-related changes focus on vertical lip lines thin lips and downward turning of the outer corners my younger patients tend to focus mostly on lip volume and lip border accentuation the purpose of volume enhancement

I like the softer hyaluronic acid fillers hyaluronic acid fillers come in a range of essentially different levels of thickness for example I perform a cheek volume enhancement at the bone level using a unique technique to deliver the material and create significant improvement in cheek definition for this objective

I use thicker hyaluronic acid fillers such as Juvederm Ultra Plus and Juvederm voluma for lips are used softer hyaluronic acid fillers such as Restylane Restylane silk Juvederm Ultra XC and Juvederm variably these less viscous fillers that are preferred for the lips as their physical properties allow for more natural movement such as talking kissing and smiling generally the softer and less viscous

The filler the more the material can adapt to the constant facial movement but it also doesn’t lasts long in order to reduce the probability of complications

I approach non-surgical treatments like injectable fillers the same way I approach surgery may not have thought of this but as soon as the skin barrier is entered the treatment is invasive therefore subject to many of the same potential complications as surgery lip enhancement begins with planning and having a shared vision between the patient and the doctor for a desired result my style is to create balance with the other facial features

So lips look better but don’t look like they don’t match the rest of the face something worth mentioning is that a growing number of men are actually coming in and during an overall facial evaluation are recognizing that subtle lip volume correction can be natural and masculine social media platforms which are driven by attention and in particular shock to generate more attention have created in some ways a new aesthetic which is appealing for some people I’m not one of those people

I see too many younger people with the naturally full lips show themselves being injected and end up looking exaggerated a patient will ask why a particular celebrity who can afford the best doctor can have such large and artificial looking lips

I explained that it’s mainly because that the celebrity and their doctor share the same exaggerated aesthetic ideal in other people their lips look large and overdone due to the combination of choices the choice of material by the doctor a complication and of course choosing a low-cost medical provider who rushes to make up for money lost in discounters that’s particularly scary you really do end up getting what you pay for

I’ve always believed in every face having a unique character that should be preserved whenever any aesthetic procedure is performed there is a difference between enhancing or accenting and exaggerating this is why making a choice of doctor comes down to expertise and artistic style

I also believe in the importance of communication skills and empathy as an artist I tend to apply the golden ratio which is a proportion of 121.6 and it’s found in nature in many beautiful things the golden ratio notwithstanding I customize to ethnicity and my interpretation of an optimal balance as many patients request a less-is-more approach

I apply a conservative volume of filler for subtle enhancement I use cannulas and my objective is to minimize the times that the skin is poked to minimize bruising and swelling so that my patient can go back to their day without any issue this is in contrast to celebrity doctors on TV and social media who are perceived as experts who use multiple pokes through the lips to add filler it’s important to understand that every entry point of the needle through the lips is a possible risk of more bruising or lumpiness that requires additional recovery time or even potentially needing to dissolve the filler and redo the procedure as far as follow-up is concerned

I routinely see my patients in two weeks and determine with them if additional volume would be of benefit I feel it’s better to add later than to overfill and have to dissolve in fact most of my patients are people who come to me for years as opposed to the transaction driven medical retailers my patients and I have long-term relationships

I essentially become their primary care doctor for beauty and I help them understand if the latest injectable or device that they’ve heard about is potentially a value for them the popularity of lip fillers can create a false equivalency between the highest level physician and the injector with a social media account the take-home lesson is to be mindful of the commercial goals of companies selling fillers as well as the commercial goals of low quality medical retailers successful people throughout the world never pay more than they have to for anything when it comes to accomplishing something that they want in value successful people seek out experts whose time and attention ensures them having a greater chance to have successful outcomes

A highly qualified and experienced doctor can help you look your best while minimizing the risk of serious complications complications can occur in anyone’s hands but filler complications require quick and competent management by an expert

If you are on a plane you would want the most highly skilled and experienced pilot since a split-second judgment in a potentially disastrous event can have a tremendous impact on you and the people who care about you

I hope you found this information helpful thank you for your question

[Music]