Lip correction involves more than just making it appear plumper. Thin lips are not necessarily a genetic condition, but it can affect many people. Some adults do lose a lot of volume in their lips due to the loss of fat and the decline in their concentration of hyaluronic acid, both of which can make skin appear thin and wrinkled. Smokers or individuals who tend to pout a lot may find vertical lines appearing on the lip and above the vermillion border as well.
Surgery, lip lifts, and fat grafts are often done in order to reshape the lips. While these methods have proven to be successful, not all patients are confident to go through such invasive treatment modalities. As a result of this reality, the medical community has developed a safer, less-invasive treatment modality that involves using hyaluronic acid itself. This substance rehydrates the skin while amplifying its volume, and with an adequate concentration, it can maintain a soft, supple, and natural-looking texture.
The anatomy of the lip
Before proceeding with a HA-based dermal filler treatment, the practitioner should fully assess the patient’s lip structure and its symmetry with other facial structures. An in-depth knowledge on the anatomy of the lip can increase the accuracy of lip augmentation and can be used to lower the risk of overcorrecting.
The most important part of the lips is the vermillion border of the upper lip, which defines the overall shape of the lips. Surrounding the vermillion border is a fine line of lighter skin that separates the vermillion and normal skin. The upper border also has two paramedian elevations that form the Cupid’s bow, which is later connected to two columns that create a midline depression. This section of the lip is called the philtrum.
Augmenting lip volume can be done for patients who wish to add more volume to their lips but want to maintain the softness of the submucosa. Generally, most lip treatments focus on the upper lip, but this depends on the type of defect and expected desires of the patient. Volume is added to the vermilion, or the pink-reddish part of the lips.
What makes Juvederm Volbella different from Juvederm Ultra?
Now that we have the anatomy covered, it is easier to understand the benefits that Juvederm Volbella and Juvederm Ultra give to the lips. Although these two products are from the same line and both utilize hyaluronic acid sourced from Streptococcus equi fermentation, they have different degrees of formulation. This difference amplifies their respective accuracy in treating various indications on the lips.
By default, the concentration of the hyaluronic acid plays a role in defining the lifting capacity of an injectable. However, the degree and rate of crosslinking also plays a huge factor in a gel’s viscoelasticity, another characteristic that can affect how a filler operates, Using BDDE as a reticulating agent, Juvederm fillers are comprised of hyaluronic acid chains that are linked together via covalent bonds that help the acid resist degradation in the body. This allows Juvederm products to last longer in the extracellular matrix.
Juvederm Ultra is a clear, colorless, viscoelastic and nonmutagenic hyaluronic acid injectable that is best used for correcting moderate to severe nasolabial folds, marionette lines, facial grooves, and sunken dermal areas. The hyaluronic acid used are monophasic strands that are bound together with a 9% crosslinking rate. Since hyaluronic acid has the capacity to attract water molecules at a rate of 1,000 times its own weight, patients should expect mild swelling within the first 24 hours of this product being implanted.
Juvederm Volbella is processed via Vycross Technology that, instead of combining uniform-sized hyaluronic acid chains together, combines both low- and high-molecular-weight hyaluronic acid in one gel. This creates a smoother, thinner, and more easily spreadable gel. The low-molecular-weight hyaluronic acid also allows this filler to blend with neighboring soft tissues smoothly. Compared to Juvederm Ultra, Juvederm Volbella also has a lower concentration of hyaluronic acid at 15mg/ml.
Both products are available with the lidocaine, an anesthetic that provides relief from the pain of the injection process for the patients.
The use of Juvederm Volbella and Juvederm Ultra in the lips
Based on the formulation of the gels, these two products may provide different types of results. The results of these fillers for lip augmentation are as follows:
Juvederm Ultra for Lip Augmentation: Although using this filler for this indication is an off-label use, many doctors have found that this product’s thick and strong gel is suitable for creating voluptuous lips. The Hylacross technology used in this filler allows its HA to expand at a rate of six times its own weight with water absorption, which creates significant amounts of volume that is still natural-looking. After the injection, doctors are recommended to gentle massage the treated (areas), so as to shape the gel in the desired manner.
Juvederm Volbella for Lip Rejuvenation: Specially formulated to enhance this vulnerable facial feature, Volbella is suitable for subtle corrections with the lips, such as removing lip lines and hydrating the lips. Unlike Ultra or other Juvederm injectables, Volbella does not expand greatly with water absorption. Its smoother gel also allows it to create minor but firm alterations at the vermilion border, Cupid’s bow, and/or philtrum, which can help fine tune the shape and form of the lips and revamp the submucosal tissue strength and structure.
These two products are expected to last for a year with repeat treatments.
Most importantly, practitioners and patients should have a discussion about expected results and realistic outcomes. For some patients, thick, pouty lips are desired. However, other adult patients may wish to have a subtler change that can makes a significant difference to their appearance. Regardless of whether Juvederm Ultra or Juvederm Volbella is used, great care and expertise are required to achieve voluptuous, lush lips.