Unlock the artistry of lip enhancement with Sarah’s Lip Matrix

 This is an educational webinar transcription and is designed and intended for the education of Healthcare Professionals only

00:00:07.905 --> 00:00:11.895
Really evening

1
00:00:13.355 --> 00:00:16.215
And welcome to Gel's Lip matrix webinar

2
00:00:16.405 --> 00:00:18.735
with lip experts Sarah Bannon.

3
00:00:19.385 --> 00:00:22.175
Sarah is a highly experienced cosmetic nurse known

4
00:00:22.175 --> 00:00:24.215
for her exceptional attention to detail

5
00:00:24.635 --> 00:00:26.535
and accuracy in facial assessment.

6
00:00:27.795 --> 00:00:29.085
With a background in plastic,

7
00:00:29.175 --> 00:00:31.285
Sarah possesses a comprehensive understanding

8
00:00:31.425 --> 00:00:33.485
of the intricacies of facial anatomy.

9
00:00:34.355 --> 00:00:37.525
Sarah's dedication to her craft, artistic flare

10
00:00:37.525 --> 00:00:39.405
and scientific knowledge has made her a truly

11
00:00:39.585 --> 00:00:41.405
gifted cosmetic injector.

12
00:00:42.235 --> 00:00:46.245
Tonight Sarah will share with you her lip matrix protocols

13
00:00:46.245 --> 00:00:49.325
to help you master advanced techniques in lip augmentation,

14
00:00:51.385 --> 00:00:54.565
Um, From, from a comprehensive understanding of anatomy

15
00:00:54.745 --> 00:00:56.245
to mastering injection precision

16
00:00:56.245 --> 00:00:58.005
and product selection, this will equip you

17
00:00:58.005 --> 00:00:59.805
with the knowledge and confidence to deliver

18
00:01:00.435 --> 00:01:02.525
exceptional results to your patients.

19
00:01:02.985 --> 00:01:04.925
We will have a q and a section at the end,

20
00:01:05.265 --> 00:01:08.605
so keep your questions for them and add it into the question

21
00:01:08.945 --> 00:01:09.945
Box.

22
00:01:10.355 --> 00:01:12.445
Without further ado, I'll hand you over to Sarah.

23
00:01:16.665 --> 00:01:20.445
Hi guys. Hello.

24
00:01:21.905 --> 00:01:24.525
Can everyone hear me okay? Is my screen working okay?

25
00:01:26.105 --> 00:01:27.285
Yep. Sarah, I can hear you

26
00:01:27.285 --> 00:01:28.685
and your screen is working. Working.

27
00:01:29.115 --> 00:01:33.325
Okay, perfect. Hi everybody, I'm Sarah Bannon.

28
00:01:33.545 --> 00:01:35.765
Thanks for having me. Um, all.

29
00:01:37.545 --> 00:01:39.685
So, um,

30
00:01:42.525 --> 00:01:45.695
tonight I'm presenting

31
00:01:46.355 --> 00:01:50.815
my liver ation complex approach to Lip anatomy

32
00:01:51.035 --> 00:01:54.135
and treatment center as

33
00:01:59.885 --> 00:02:02.115
don't my water in the back,

34
00:02:06.335 --> 00:02:10.985
um, getting a fair bit of playback in terms

35
00:02:10.985 --> 00:02:12.305
of microphones.

36
00:02:13.255 --> 00:02:16.185
Yeah. Could I ask everybody to mute the microphone

37
00:02:16.215 --> 00:02:17.585
because we're getting playback.

38
00:02:24.655 --> 00:02:29.355
Um, so basically I realized with my training

39
00:02:29.505 --> 00:02:32.555
that I was doing a lot of my lip, um, training.

40
00:02:33.525 --> 00:02:37.555
There was nothing really set in stone when it came to, um,

41
00:02:39.635 --> 00:02:43.635
technique or, um, essentially, um,

42
00:02:44.305 --> 00:02:46.115
enhance lips or more natural lips

43
00:02:46.115 --> 00:02:50.075
and based on our demographics that we all, um, are facing

44
00:02:50.225 --> 00:02:52.875
with, sorry,

45
00:02:54.185 --> 00:02:56.475
just having a little bit of technical issues.

46
00:03:01.075 --> 00:03:02.855
Can you still hear me okay, Charlotte?

47
00:03:06.855 --> 00:03:07.455
I can hear you.

48
00:03:11.785 --> 00:03:16.445
Sorry, it's just dropping out a lot. No, that's okay.

49
00:03:16.565 --> 00:03:17.565
I can hear. We can hear you.

50
00:03:20.235 --> 00:03:23.855
Oh, Perfect. So I just found that I, um,

51
00:03:24.025 --> 00:03:25.775
never really had a set technique

52
00:03:25.775 --> 00:03:27.295
that was being taught to me.

53
00:03:27.455 --> 00:03:29.895
I found that quite often I would learn a very

54
00:03:29.895 --> 00:03:33.815
generalization, um, lip augmentation type treatment,

55
00:03:33.835 --> 00:03:35.055
and then I was very much left

56
00:03:35.055 --> 00:03:37.135
to my own devices when I got into the clinic.

57
00:03:38.195 --> 00:03:42.455
Um, I really had to tailor it to my clients, my demographic,

58
00:03:42.455 --> 00:03:44.695
depending on where I was, um, working.

59
00:03:45.635 --> 00:03:50.215
So a lip matrix, um,

60
00:03:51.085 --> 00:03:55.095
tool really helped me depending on where I was working.

61
00:03:55.295 --> 00:03:56.855
I was, um, across Gold Coast

62
00:03:56.915 --> 00:03:59.335
and Clinic, um, in Brisbane as well.

63
00:03:59.515 --> 00:04:01.015
And I just found that my demographic

64
00:04:01.115 --> 00:04:02.695
of clientele was very different

65
00:04:03.275 --> 00:04:07.055
and I really needed to tailor my approach on my clients,

66
00:04:07.165 --> 00:04:09.135
depending on my clients, um,

67
00:04:09.135 --> 00:04:11.255
and what they were wanting, whether it was a bit more

68
00:04:11.255 --> 00:04:14.775
of a natural result or a bit more of a, um, enhanced result.

69
00:04:15.435 --> 00:04:20.015
So let's get into to our

70
00:04:21.325 --> 00:04:24.095
reasoning as why, I'm just gonna,

71
00:04:26.215 --> 00:04:30.435
sorry, I'm just having a lot of issues

72
00:04:30.505 --> 00:04:32.275
with my zoom.

73
00:04:32.325 --> 00:04:36.315
Sorry guys. Perfect. Okay, so let's get into it.

74
00:04:36.315 --> 00:04:38.755
So the lips are essentially a key function

75
00:04:38.775 --> 00:04:39.995
of our facial anatomy

76
00:04:40.295 --> 00:04:43.195
and they are critical for the use in our facial expression.

77
00:04:43.625 --> 00:04:45.875
Obviously our communication, our sensation

78
00:04:45.895 --> 00:04:47.675
and mastication, the ation,

79
00:04:48.135 --> 00:04:50.315
and also just as importantly responsible

80
00:04:50.315 --> 00:04:52.315
for physical attraction and intimacy.

81
00:04:52.815 --> 00:04:55.475
But as practitioners, our clients do come to us

82
00:04:55.655 --> 00:04:57.355
to improve the appearance of their lips

83
00:04:57.535 --> 00:04:58.755
for aesthetic purposes.

84
00:04:59.295 --> 00:05:01.915
And it is our responsibility to understand the role

85
00:05:01.945 --> 00:05:05.355
that the lips and the mouth play anatomically along

86
00:05:05.355 --> 00:05:07.435
with these important functions such as speech

87
00:05:07.735 --> 00:05:09.995
and pronunciation, sensation

88
00:05:10.015 --> 00:05:13.635
and mastication, so that we do not hinder negatively affect

89
00:05:17.515 --> 00:05:19.555
Proportions of facial harmonization.

90
00:05:19.815 --> 00:05:23.075
And realistic expectations are crucial elements

91
00:05:23.075 --> 00:05:25.275
that are needed to be assessed and considered

92
00:05:25.275 --> 00:05:26.835
before lip augmentation.

93
00:05:27.655 --> 00:05:29.795
Our clients rely solely on our ability

94
00:05:29.815 --> 00:05:33.115
to determine the best treatment options whilst educating

95
00:05:33.135 --> 00:05:36.235
and promoting a safe and aesthetically pleasing result.

96
00:05:37.895 --> 00:05:41.395
So when it comes to my consultation with clients, I found

97
00:05:41.505 --> 00:05:45.995
that a proper thorough consultation with them was obviously,

98
00:05:46.815 --> 00:05:49.915
um, really, really crucial when it came

99
00:05:49.915 --> 00:05:52.595
to delivering proper live augmentation.

100
00:05:53.495 --> 00:05:56.835
So I would break up my consultations with listening,

101
00:05:57.125 --> 00:06:00.685
interpreting expectations, forward planning, my procedure

102
00:06:00.785 --> 00:06:02.645
and my delivery and aftercare.

103
00:06:04.505 --> 00:06:08.525
So I'm just gonna break them down a little bit further, um,

104
00:06:09.475 --> 00:06:12.245
into what listening really meant for me.

105
00:06:12.385 --> 00:06:13.885
So having an awareness

106
00:06:13.885 --> 00:06:16.325
of the patient's insight into their treatment,

107
00:06:16.995 --> 00:06:19.605
whether they are naive, naive, or knowledgeable.

108
00:06:19.785 --> 00:06:22.205
And what are some of the external contributing factors?

109
00:06:23.175 --> 00:06:26.165
There are a lot of BDD issues going on at the moment

110
00:06:26.235 --> 00:06:28.045
that I think are a little bit more prevalent

111
00:06:28.045 --> 00:06:29.165
than we realize.

112
00:06:29.465 --> 00:06:31.925
And obviously some underlying mental health,

113
00:06:31.935 --> 00:06:34.805
their reasonings for being there is obviously something

114
00:06:34.805 --> 00:06:37.565
that needs to be taken into consideration why they might

115
00:06:37.795 --> 00:06:40.685
potentially want to be getting lip augmented

116
00:06:40.905 --> 00:06:44.445
or the ability To explain the treatment

117
00:06:44.505 --> 00:06:47.565
and the expected results back to the patient with clarity.

118
00:06:48.025 --> 00:06:51.165
So making sure that you are really ascertaining exactly

119
00:06:51.355 --> 00:06:52.805
what they're wanting

120
00:06:53.145 --> 00:06:55.765
and being able to explain that back to them so you know

121
00:06:55.765 --> 00:06:57.205
that you're on the same page as them.

122
00:06:58.145 --> 00:06:59.725
And then what are their expectations

123
00:07:00.145 --> 00:07:01.765
around the aesthetic result?

124
00:07:02.155 --> 00:07:03.965
What are their expectations around the pain

125
00:07:03.985 --> 00:07:05.765
or the discomfort, the downtime,

126
00:07:05.865 --> 00:07:07.365
the longevity and the price.

127
00:07:07.825 --> 00:07:10.445
So just making sure that we have clarity around that.

128
00:07:11.185 --> 00:07:13.685
And then what's our forward planning look like?

129
00:07:14.825 --> 00:07:16.685
Um, do we need to discuss the longevity

130
00:07:16.745 --> 00:07:19.205
of the treatment when they potentially might need a top up,

131
00:07:19.745 --> 00:07:23.475
um, plan, Um, for other areas?

132
00:07:23.815 --> 00:07:27.315
So if we're looking at a mature patient, um,

133
00:07:27.495 --> 00:07:29.195
and they're essentially coming in

134
00:07:29.195 --> 00:07:30.355
and wanting their lips treated,

135
00:07:31.295 --> 00:07:33.755
are we looking at their whole peri oral region?

136
00:07:34.455 --> 00:07:38.075
Um, have they got, you know, excessive, um,

137
00:07:38.335 --> 00:07:39.595
laxity around the area?

138
00:07:39.695 --> 00:07:41.075
Are we gonna need to be doing a little bit

139
00:07:41.075 --> 00:07:42.435
of lateral support, um,

140
00:07:42.575 --> 00:07:44.475
and do a bit more of a full face approach

141
00:07:44.475 --> 00:07:46.075
before we even address that area?

142
00:07:47.255 --> 00:07:49.395
And is it a, uh, once only treatment?

143
00:07:49.855 --> 00:07:51.515
Can you offer support for any future

144
00:07:51.795 --> 00:07:53.075
planning if they're not coming back?

145
00:07:53.085 --> 00:07:54.875
Quite often I have patients

146
00:07:54.875 --> 00:07:57.915
that are visiting me from interstate or they're on holidays

147
00:07:58.375 --> 00:08:01.195
and just, um, building that rapport with them

148
00:08:01.195 --> 00:08:03.315
and having that continu continuity of care.

149
00:08:03.455 --> 00:08:04.795
So if they are returning

150
00:08:05.295 --> 00:08:08.315
or even refer, referring their um, friends

151
00:08:08.335 --> 00:08:11.115
or family members, it's essentially what's gonna be

152
00:08:11.115 --> 00:08:12.675
supporting our business in the long run

153
00:08:12.735 --> 00:08:14.075
to maintain those clients.

154
00:08:15.015 --> 00:08:17.595
And then what are their expectations around the procedure?

155
00:08:18.055 --> 00:08:19.475
Do they wanna know how it's done?

156
00:08:19.855 --> 00:08:21.435
Um, are they someone that's just sitting there

157
00:08:22.395 --> 00:08:24.955
watching you set up more sterile field

158
00:08:25.135 --> 00:08:28.475
or you know, are they in their chair kind of freaking out,

159
00:08:28.855 --> 00:08:30.035
not wanting to know what you're doing?

160
00:08:30.545 --> 00:08:32.875
Then just understanding what their tolerance is to that

161
00:08:33.665 --> 00:08:34.795
treatment information

162
00:08:35.175 --> 00:08:37.715
and then what's their tolerance to the pain,

163
00:08:39.695 --> 00:08:40.785
Then delivery.

164
00:08:41.085 --> 00:08:42.085
Um,

165
00:08:43.175 --> 00:08:47.405
Just, And this all,

166
00:08:52.985 --> 00:08:54.765
Can we just check Everyone's on mute please?

167
00:08:55.985 --> 00:08:58.925
And it first ever video was uploaded on April 21st,

168
00:08:59.645 --> 00:09:01.205
18 and it's title.

169
00:09:11.025 --> 00:09:13.275
Cool. Is that still working Charlotte?

170
00:09:18.655 --> 00:09:20.355
Yep. It's still working. It's just hasn't,

171
00:09:20.865 --> 00:09:23.195
it's not in the, uh, viewing

172
00:09:25.775 --> 00:09:27.195
screen, but we can still see it.

173
00:09:27.905 --> 00:09:32.795
Sure. Cool. All right, play from, here we go.

174
00:09:33.145 --> 00:09:33.635
Perfect.

175
00:09:39.305 --> 00:09:44.055
Sorry. Alright, let's go through this. Perfect.

176
00:09:44.155 --> 00:09:46.495
And then your aftercare. What's your post-procedural photos,

177
00:09:47.235 --> 00:09:49.575
um, aftercare information and documentation.

178
00:09:49.795 --> 00:09:51.815
How can they reach you and what are your

179
00:09:51.815 --> 00:09:53.455
after hours emergency details?

180
00:09:53.525 --> 00:09:56.615
What are your follow-up appointment, um, with the next plan?

181
00:09:56.755 --> 00:09:58.335
And that is obviously following on

182
00:09:58.335 --> 00:09:59.695
with our continuity of care.

183
00:10:00.555 --> 00:10:04.575
So expectations is probably the biggest thing that we, um,

184
00:10:05.045 --> 00:10:06.415
deal with as injectors.

185
00:10:06.695 --> 00:10:08.775
I think with today's day

186
00:10:08.775 --> 00:10:09.775
and age with social media,

187
00:10:10.765 --> 00:10:13.175
it's having such a huge effect on our clientele.

188
00:10:13.935 --> 00:10:18.295
I am still of the generation that, um, you know, remembers

189
00:10:18.295 --> 00:10:19.495
before Facebook and Instagram

190
00:10:19.555 --> 00:10:22.815
and you know, we were getting our influences from

191
00:10:22.815 --> 00:10:25.535
celebrities through Women's Day and stuff like that.

192
00:10:25.675 --> 00:10:30.535
But the club are very much our, uh,

193
00:10:30.535 --> 00:10:31.735
social media babies

194
00:10:32.155 --> 00:10:35.695
and they are very much, um, influenced by social media

195
00:10:35.835 --> 00:10:37.095
and the celebrities that are on there.

196
00:10:37.095 --> 00:10:39.895
And unfortunately what comes with that is a lot of, um,

197
00:10:40.165 --> 00:10:41.935
filtering, um, of images

198
00:10:42.075 --> 00:10:44.535
and we know that it's a lot of, you know, false beauty

199
00:10:44.535 --> 00:10:45.535
that's being put out there.

200
00:10:45.635 --> 00:10:48.495
So ascertaining the expectations from our clients

201
00:10:48.555 --> 00:10:51.455
and what's actually achievable with cosmetic injectables

202
00:10:52.035 --> 00:10:53.815
is a really big thing that we're gonna have to be dealing

203
00:10:53.815 --> 00:10:55.015
with in our consultations.

204
00:10:55.075 --> 00:10:58.735
So if your client has realistic expectations,

205
00:10:59.275 --> 00:11:02.615
that's really easy and we can commence our treatment plan if

206
00:11:02.615 --> 00:11:04.415
they don't, we really need to ascertain

207
00:11:04.485 --> 00:11:06.015
what those contributing factors are

208
00:11:06.035 --> 00:11:08.415
and there are gonna have to be a lot of education that's

209
00:11:08.655 --> 00:11:10.895
provided if we wanna maintain that client

210
00:11:10.995 --> 00:11:13.695
and you know, be able to service them properly, they need

211
00:11:13.695 --> 00:11:16.415
to be educated, um, about cosmetic.

212
00:11:16.415 --> 00:11:20.555
If not, we need to figure out how

213
00:11:20.555 --> 00:11:24.755
to sort those, um, conversations out with them basically.

214
00:11:24.815 --> 00:11:29.355
So obviously celebrity in inspiration is a huge factor, um,

215
00:11:30.185 --> 00:11:31.355
that contributes to that.

216
00:11:31.905 --> 00:11:36.835
This is a perfect example of Molly May, how she basically

217
00:11:37.465 --> 00:11:39.675
went a little bit too far with her injectables

218
00:11:39.735 --> 00:11:44.275
and um, What she actually ended up having

219
00:11:44.275 --> 00:11:45.995
to look like, getting everything dissolved.

220
00:11:45.995 --> 00:11:48.955
And then we have obviously classic Kylie Jenner on the left

221
00:11:48.955 --> 00:11:52.195
of the photos that she is posting on her social media,

222
00:11:52.495 --> 00:11:55.525
but then, you know, the photos on the right are

223
00:11:55.875 --> 00:12:00.005
what the press is actually, um, capturing of her.

224
00:12:00.465 --> 00:12:03.125
So it's a nice one of her at the top there in the middle

225
00:12:03.125 --> 00:12:05.325
with her side profile of her lips.

226
00:12:05.905 --> 00:12:07.045
Um, for me,

227
00:12:07.045 --> 00:12:09.205
realistically I know her lips would probably look like

228
00:12:09.205 --> 00:12:12.205
that if she's getting them filled as much as she is

229
00:12:13.595 --> 00:12:17.005
then having conversations about whether the treatment is

230
00:12:17.005 --> 00:12:19.285
gonna enhance or hinder their faces.

231
00:12:20.705 --> 00:12:23.765
And then are we augmenting the lips to compliment the face?

232
00:12:24.305 --> 00:12:28.165
Um, are we having 45, they've never addressed their midface

233
00:12:28.345 --> 00:12:31.325
or, um, their necks or anything like that?

234
00:12:32.385 --> 00:12:34.485
So I have developed

235
00:12:35.595 --> 00:12:38.125
this lip matrix mapping tool

236
00:12:38.225 --> 00:12:40.405
and essentially this tool is

237
00:12:40.745 --> 00:12:44.245
to help you facilitate which avenue you're gonna go down

238
00:12:44.245 --> 00:12:46.845
depending on what your clientele are looking for.

239
00:12:47.025 --> 00:12:50.805
So in my clinic, a lot of my clients come to me

240
00:12:50.805 --> 00:12:54.605
because I can, uh, produce a more natural type of lip.

241
00:12:54.605 --> 00:12:56.045
They don't wanna look like they're, um,

242
00:12:56.045 --> 00:12:57.245
having their lips done.

243
00:12:57.435 --> 00:12:59.285
However, when I was on the Gold Coast,

244
00:12:59.845 --> 00:13:02.325
I had a lot more clients wanting an enhanced lip.

245
00:13:03.145 --> 00:13:06.485
So essentially when my clients are coming in wanting a

246
00:13:06.485 --> 00:13:09.565
natural lip, they're using quite specific descriptive words

247
00:13:09.595 --> 00:13:11.245
like hydration definition

248
00:13:11.305 --> 00:13:13.605
or they just want, you know, a little bit of, a little bit

249
00:13:13.605 --> 00:13:15.645
of plumping, but you know, nothing too obvious.

250
00:13:16.425 --> 00:13:20.045
So if my client is wanting a hydrated lip, I need to go

251
00:13:20.045 --> 00:13:21.525
through and and figure out

252
00:13:21.525 --> 00:13:23.725
what her anatomical considerations and land.

253
00:13:23.725 --> 00:13:25.965
Then I need to go through

254
00:13:26.065 --> 00:13:29.885
and choose the correct product that's going to give me

255
00:13:29.885 --> 00:13:31.005
that uh, look.

256
00:13:31.425 --> 00:13:34.405
And then I need to be able to figure out exactly what tools

257
00:13:34.545 --> 00:13:37.525
and techniques are gonna help me produce those results.

258
00:13:37.595 --> 00:13:39.325
Exactly the same with definition

259
00:13:39.865 --> 00:13:44.645
and uh, moderate volumization total enhancement essentially.

260
00:13:45.745 --> 00:13:48.765
Um, I need to be able to distinguish, uh, so

261
00:13:48.765 --> 00:13:51.365
that I can give them that result.

262
00:13:52.635 --> 00:13:56.045
Same with the uh, specific product selections that's going

263
00:13:56.045 --> 00:13:59.205
to give me an enhanced lip and then my tools and technique.

264
00:13:59.905 --> 00:14:03.805
So I'm just gonna break down what I would classify

265
00:14:03.905 --> 00:14:05.685
as a natural lip.

266
00:14:06.545 --> 00:14:09.005
Uh, natural lip augmentation is still subjective

267
00:14:09.005 --> 00:14:12.085
to the individual and relative to their natural lip shape

268
00:14:12.085 --> 00:14:13.685
and size, which is very important.

269
00:14:14.195 --> 00:14:17.005
Natural lip augmentation generally does not show an

270
00:14:17.005 --> 00:14:20.085
intentional increase in the shape or the size of the lip.

271
00:14:20.275 --> 00:14:23.325
Instead, natural augmentation often enhances

272
00:14:24.045 --> 00:14:27.525
a particular anatomical landmark such as the cupid's bow

273
00:14:27.585 --> 00:14:30.685
or improves specific deficits your patient may want

274
00:14:30.685 --> 00:14:32.485
to improve, such as hydration

275
00:14:32.785 --> 00:14:34.325
or the loss, loss of structure.

276
00:14:34.385 --> 00:14:37.205
In the familial border, it is important to assess

277
00:14:37.905 --> 00:14:40.565
any additional contributing factors such

278
00:14:40.565 --> 00:14:41.925
as peri oral support

279
00:14:42.065 --> 00:14:44.525
or muscle relaxants for a holistic approach

280
00:14:44.585 --> 00:14:46.445
to this aesthetic result.

281
00:14:52.305 --> 00:14:55.685
Now looking at a enhanced lip,

282
00:14:56.675 --> 00:14:58.165
it's still subjected to the individual

283
00:14:58.265 --> 00:15:00.765
and relative to their natural lip shape and size

284
00:15:01.785 --> 00:15:04.885
and enhanced lip augmentation should show an intentional

285
00:15:05.285 --> 00:15:07.325
increase in the size and the shape and anatomy.

286
00:15:09.295 --> 00:15:13.165
Often all areas of the anatomical landmarks are enhanced

287
00:15:13.465 --> 00:15:16.325
to create a fuller, more enhanced aesthetic.

288
00:15:16.595 --> 00:15:18.605
This may require more than one treatment.

289
00:15:18.865 --> 00:15:21.405
It is important to assess any additional contributing

290
00:15:21.405 --> 00:15:22.605
factors that may support

291
00:15:23.065 --> 00:15:25.245
or enhance the final aesthetic results such

292
00:15:25.245 --> 00:15:27.445
as peri oral support or muscle relaxants.

293
00:15:28.745 --> 00:15:30.205
So as an example here

294
00:15:30.905 --> 00:15:33.245
on the left you can see a hydrated lip.

295
00:15:33.345 --> 00:15:37.645
So she had beautiful lips, naturally nice, um, shape

296
00:15:37.705 --> 00:15:40.085
and size and she's more

297
00:15:40.085 --> 00:15:43.925
or less just wanted to hydrate that superficial layer

298
00:15:44.185 --> 00:15:47.245
of her lip in the center as your definition.

299
00:15:47.995 --> 00:15:50.405
That client really came to me, she's wanted more structure,

300
00:15:51.125 --> 00:15:52.925
structured, defined lip, um,

301
00:15:53.175 --> 00:15:55.205
while still keeping a really natural result.

302
00:15:55.545 --> 00:15:57.085
And then on the right, um,

303
00:15:57.315 --> 00:16:00.965
this client just wanted a little bit of volumization,

304
00:16:01.395 --> 00:16:03.565
very moderate though, still keeping it very natural

305
00:16:05.155 --> 00:16:07.215
and as you can see it's all well enhanced lip.

306
00:16:07.795 --> 00:16:11.615
Um, so this is a total enhancement

307
00:16:12.715 --> 00:16:15.215
and that essentially augments all

308
00:16:15.215 --> 00:16:16.895
of the anatomical landmarks.

309
00:16:17.035 --> 00:16:20.735
So that could be the cupid bow, the cubicles, um,

310
00:16:21.235 --> 00:16:24.495
it can improve the lip height, the projection, um,

311
00:16:25.325 --> 00:16:28.695
enhance all the ratios and define the vermilion border.

312
00:16:30.715 --> 00:16:32.295
So we will just quickly have a look at

313
00:16:32.295 --> 00:16:34.335
what those anatomical lip landmarks are

314
00:16:34.335 --> 00:16:36.615
because I think it's really important in our consultation

315
00:16:36.615 --> 00:16:39.815
that we use this language when we're describing the anatomy

316
00:16:39.915 --> 00:16:41.175
of our patient's lips.

317
00:16:41.555 --> 00:16:44.415
And the reason being, it becomes more clinical.

318
00:16:45.035 --> 00:16:47.255
Um, when you are telling someone

319
00:16:47.255 --> 00:16:50.415
that they have an asymmetrical, um, vermilion border

320
00:16:50.555 --> 00:16:53.335
as opposed to saying that they have wonky lips, um,

321
00:16:53.415 --> 00:16:55.015
I think it makes it less personal.

322
00:16:55.015 --> 00:16:56.855
They don't feel like you are critiquing them.

323
00:16:57.355 --> 00:17:00.215
Um, so I will often talk about,

324
00:17:00.215 --> 00:17:02.455
and I will actually explain to my patients

325
00:17:02.965 --> 00:17:05.375
what their wet dry mucosa is.

326
00:17:06.035 --> 00:17:09.095
Um, I'll outline, um, the GK points,

327
00:17:09.165 --> 00:17:10.815
I'll talk about the filter columns

328
00:17:10.815 --> 00:17:13.415
and the lengthening of the filter column, the

329
00:17:14.995 --> 00:17:16.695
border, et cetera.

330
00:17:21.795 --> 00:17:25.335
So let's have a look at some

331
00:17:25.585 --> 00:17:26.975
anatomical considerations.

332
00:17:27.875 --> 00:17:30.655
Um, so these are things that we also need to be able

333
00:17:30.655 --> 00:17:33.095
to point out in our consultations, um,

334
00:17:33.095 --> 00:17:35.935
because they're either going to inhibit our ability

335
00:17:36.035 --> 00:17:38.375
to give them the type of lip that they are wanting.

336
00:17:38.715 --> 00:17:41.735
So you can see up the top there that

337
00:17:41.965 --> 00:17:44.855
that patient has four tubercle cubicles,

338
00:17:44.995 --> 00:17:46.775
so two at the top, two down the bottom.

339
00:17:46.965 --> 00:17:49.965
Whereas in the center you'll see that that uh,

340
00:17:49.965 --> 00:17:51.605
patient has three cubicles.

341
00:17:51.605 --> 00:17:54.605
So that's a classic patients about those little deficits

342
00:17:54.675 --> 00:17:57.325
That they have on their lateral lip.

343
00:17:57.995 --> 00:18:01.605
I'll explain to them how I'm gonna augment their lip, um,

344
00:18:01.985 --> 00:18:03.965
and just basically point it out to them.

345
00:18:03.995 --> 00:18:06.045
I'll also explain little things like

346
00:18:06.755 --> 00:18:10.285
that central cubicle at the top will probably swell more

347
00:18:10.355 --> 00:18:13.685
post treat, so I'll have all of those conversations

348
00:18:13.795 --> 00:18:17.645
with them in the consultation just so they have realistic

349
00:18:18.485 --> 00:18:22.245
Expectations about what is achievable

350
00:18:22.865 --> 00:18:25.085
Saying with the cleft lip on the bottom,

351
00:18:26.425 --> 00:18:30.285
she obviously has scarring there that I need to work around.

352
00:18:30.305 --> 00:18:33.245
So the conversations that I'm having with her is basically,

353
00:18:33.905 --> 00:18:36.805
um, you know, under promising, over delivering.

354
00:18:36.865 --> 00:18:39.925
So I am gonna say that I can't guarantee

355
00:18:39.925 --> 00:18:41.045
what results we're gonna produce

356
00:18:41.045 --> 00:18:45.245
because when we are augmenting scarring we can never really

357
00:18:45.245 --> 00:18:47.005
guarantee how it's gonna turn out.

358
00:18:47.065 --> 00:18:49.565
And so she had very low expectations.

359
00:18:49.665 --> 00:18:52.125
So naturally she was very, very happy with anything

360
00:18:52.125 --> 00:18:53.565
that I did produce

361
00:18:53.565 --> 00:18:55.445
because I had that thorough consultation

362
00:18:55.445 --> 00:18:57.205
with her about her anatomy.

363
00:18:58.505 --> 00:19:02.965
Um, asymmetry with muscle contraction is obviously something

364
00:19:02.965 --> 00:19:05.325
that we all would be dealing with quite a lot.

365
00:19:05.705 --> 00:19:09.485
Um, I'm sure that you guys have a lot of clients

366
00:19:09.485 --> 00:19:13.685
that will come in and complain about their asymmetric lips

367
00:19:13.825 --> 00:19:17.085
and they'll say, you know, my lips are uneven

368
00:19:17.465 --> 00:19:18.925
and when we look at them we can see

369
00:19:18.925 --> 00:19:22.405
that they have an uneven contraction with their ll sands

370
00:19:22.585 --> 00:19:25.045
or you know, they might just need a bit of a lip flip

371
00:19:25.145 --> 00:19:26.285
or so on and so forth.

372
00:19:26.385 --> 00:19:30.405
So often I will treat them with TiVo first, any sort of, um,

373
00:19:30.515 --> 00:19:31.805
asymmetries that I can see

374
00:19:32.025 --> 00:19:34.925
and then I'll get them back in, um, at the two week mark

375
00:19:34.925 --> 00:19:37.605
and it's just going to give me a better, um,

376
00:19:37.945 --> 00:19:42.845
result if I have that, um, botulinum toxin on board, um,

377
00:19:43.405 --> 00:19:44.645
relaxing the muscles where needed.

378
00:19:46.475 --> 00:19:48.765
Then lip proportions and ratios.

379
00:19:50.065 --> 00:19:54.645
So also being able to, so the, that bottom left,

380
00:19:55.265 --> 00:19:58.925
um, client, she

381
00:19:59.885 --> 00:20:02.805
actually was complaining to me about the size of her nose

382
00:20:02.985 --> 00:20:04.325
and she just more

383
00:20:04.325 --> 00:20:07.885
or less wanted to augment anything on her face

384
00:20:07.885 --> 00:20:09.885
that was potentially gonna make her nose look smaller,

385
00:20:09.975 --> 00:20:11.445
which was quite funny.

386
00:20:11.625 --> 00:20:15.725
But she, I discussed augmenting her lips

387
00:20:15.725 --> 00:20:17.125
and she was really happy with that

388
00:20:17.185 --> 00:20:19.245
and I explained how the ratios work

389
00:20:19.385 --> 00:20:21.525
and that essentially it would just help

390
00:20:21.525 --> 00:20:23.565
to create the illusion of, um,

391
00:20:23.565 --> 00:20:25.005
making her nose look a little bit smaller

392
00:20:25.025 --> 00:20:26.125
and that's exactly what it did

393
00:20:26.125 --> 00:20:27.285
and she was really happy about that.

394
00:20:27.825 --> 00:20:31.485
Um, the patient on the top left and that it's more projected

395
00:20:31.955 --> 00:20:33.325
Then her told

396
00:20:35.065 --> 00:20:38.445
And talked to her a little bit about piriform um,

397
00:20:38.995 --> 00:20:41.445
treatment and obviously, you know,

398
00:20:41.445 --> 00:20:43.525
I wouldn't be augmenting her chin or anything like that.

399
00:20:43.545 --> 00:20:46.725
So just having conversations about proportions, um,

400
00:20:46.785 --> 00:20:48.285
and ratios as well.

401
00:20:49.675 --> 00:20:51.765
Then age relating, contributing factors.

402
00:20:52.065 --> 00:20:54.685
So a lot of our mature clients will come in

403
00:20:54.685 --> 00:20:58.765
and they'll have a loss of peral support, um, smokers' lines

404
00:20:59.485 --> 00:21:02.365
deficits within their marionettes downturn, oral comms

405
00:21:02.505 --> 00:21:04.445
and essentially they're obviously going

406
00:21:04.445 --> 00:21:06.045
through bony reabsorption.

407
00:21:06.185 --> 00:21:09.125
So quite often when these patients come through

408
00:21:09.505 --> 00:21:12.405
and they're wanting to enhance their lips

409
00:21:12.505 --> 00:21:14.405
or their, you know, mouth region,

410
00:21:15.125 --> 00:21:16.845
I will be having conversations about

411
00:21:16.985 --> 00:21:20.205
how we can support the whole peri oral um, area.

412
00:21:20.745 --> 00:21:23.485
And quite often when I go into those conversations

413
00:21:23.485 --> 00:21:25.765
with them, they're always happy to oblige, um,

414
00:21:25.955 --> 00:21:27.645
when I just educate them about

415
00:21:27.705 --> 00:21:29.725
how it's gonna support their lip structure.

416
00:21:33.365 --> 00:21:37.425
All right, so let's have a look at product selection.

417
00:21:37.685 --> 00:21:41.305
So we have four products in filler

418
00:21:42.085 --> 00:21:45.585
and rich, I only use volume

419
00:21:45.885 --> 00:21:47.585
and fill it in the lips,

420
00:21:47.585 --> 00:21:51.145
but I'll quickly just touch on our products just

421
00:21:51.145 --> 00:21:53.985
so you're aware of how they uh, fit into the portfolio.

422
00:21:54.685 --> 00:21:57.785
So our volume plus is our more structural product.

423
00:21:57.815 --> 00:22:00.665
It's got the highest degree of cross-linking, um,

424
00:22:01.015 --> 00:22:03.945
with 25 milligrams per ml with a little bit of lidocaine.

425
00:22:04.175 --> 00:22:05.465
This is our d dermis

426
00:22:05.525 --> 00:22:09.025
and super periosteal, uh, product that goes down on chin,

427
00:22:09.405 --> 00:22:13.105
uh, jaw, nose, cheeks, piriform, and the temple.

428
00:22:14.135 --> 00:22:16.945
Then the next product we have in the range is volume

429
00:22:16.975 --> 00:22:19.025
with the next degree of cross-linking.

430
00:22:19.175 --> 00:22:22.185
This is our more volumizing product, hence the name.

431
00:22:22.605 --> 00:22:25.545
Um, same amount of ha and lido in there.

432
00:22:25.725 --> 00:22:30.185
And this can be placed again down on bone to

433
00:22:30.405 --> 00:22:33.545
for jaw chin, but I do use it in the lips

434
00:22:33.545 --> 00:22:35.865
and it has a really beautiful volumizing effect

435
00:22:35.865 --> 00:22:39.505
for an enhanced lip cheeks and temples marionettes

436
00:22:39.505 --> 00:22:40.545
and nasal labia folds.

437
00:22:40.585 --> 00:22:42.425
A more structural product on someone

438
00:22:42.575 --> 00:22:44.945
with thin tissue coverage.

439
00:22:45.005 --> 00:22:48.025
So a more mature client, you'd be using this

440
00:22:48.045 --> 00:22:51.025
as their structural uh, product instead of volume plus.

441
00:22:51.815 --> 00:22:55.985
Then we have filler. This is the main lip product

442
00:22:56.175 --> 00:22:58.985
that um, we use and that's in the range.

443
00:23:00.055 --> 00:23:03.505
This has the same amount of ha and lecaine in it.

444
00:23:03.645 --> 00:23:07.945
Um, and we use this essentially everywhere in the face.

445
00:23:08.005 --> 00:23:10.425
So lips, hands, tear, TRSs, marionettes,

446
00:23:10.425 --> 00:23:12.305
and the peri oral and orbital region.

447
00:23:12.525 --> 00:23:13.825
The name, the labia folds

448
00:23:13.845 --> 00:23:17.505
and superficial temple as well, rich,

449
00:23:19.045 --> 00:23:22.825
um, which which has the 18 milligrams per mil

450
00:23:22.885 --> 00:23:24.465
and it's stabilized with glycerol.

451
00:23:24.575 --> 00:23:27.945
This is a really, um, a really versatile,

452
00:23:28.645 --> 00:23:29.945
um, skin booster.

453
00:23:30.305 --> 00:23:34.065
I actually use this in the lips, um, on myself

454
00:23:34.125 --> 00:23:35.945
and some mature clients as well

455
00:23:36.265 --> 00:23:38.625
'cause it's um, really versatile like that.

456
00:23:40.485 --> 00:23:42.785
Um, I won't go too much into,

457
00:23:43.965 --> 00:23:45.725
um, the solve

458
00:23:47.255 --> 00:23:50.615
Properties. So when

459
00:23:50.755 --> 00:23:54.055
We are playing around with different products in the lips

460
00:23:54.075 --> 00:23:58.815
and we're using them the way that I do, so I really play

461
00:23:58.815 --> 00:24:00.575
around with my tools and my products

462
00:24:00.575 --> 00:24:02.255
and I like to be a little bit creative.

463
00:24:03.075 --> 00:24:05.735
Um, I think it's important to understand

464
00:24:06.695 --> 00:24:09.015
ology properties in the product that you're using,

465
00:24:09.875 --> 00:24:12.855
having a good understanding on what elasticity is,

466
00:24:13.235 --> 00:24:15.175
the viscosity, the hydro felicity,

467
00:24:15.195 --> 00:24:17.615
and what the G prime with the artistry

468
00:24:17.835 --> 00:24:21.335
Of lip, Um, augmentation essentially.

469
00:24:22.595 --> 00:24:26.135
So these are the two products that um, I use in the lip.

470
00:24:26.785 --> 00:24:28.615
We've got your volume, um,

471
00:24:28.615 --> 00:24:30.735
which is your mid-range, uh, volume.

472
00:24:31.845 --> 00:24:33.255
It's got that larger molecule.

473
00:24:33.445 --> 00:24:36.215
It's got a beautiful volumizing um, capacity.

474
00:24:36.245 --> 00:24:39.735
It's a little bit firmer, it's got nice G prime for

475
00:24:39.735 --> 00:24:41.375
that contour and projection.

476
00:24:42.395 --> 00:24:43.395
Um,

477
00:24:44.655 --> 00:24:46.615
Slightly smaller molecule,

478
00:24:47.805 --> 00:24:50.855
More refined precision and it has a softer enhancement

479
00:24:50.875 --> 00:24:54.055
but it's still a nice element of structure, um,

480
00:24:54.055 --> 00:24:55.495
when you're creating shape.

481
00:24:57.715 --> 00:24:58.715
So

482
00:25:00.705 --> 00:25:04.055
Let's Talk about tools and technique.

483
00:25:04.915 --> 00:25:08.255
So a quick touch on anatomy just

484
00:25:08.255 --> 00:25:10.095
because it is important when it comes

485
00:25:10.115 --> 00:25:11.655
to depth with the lips.

486
00:25:12.075 --> 00:25:15.935
So if we broke up the lip layers into three specific ones,

487
00:25:16.635 --> 00:25:18.095
um, the most recent paper

488
00:25:18.125 --> 00:25:22.255
that Sebastian Cohan produced about the artery

489
00:25:23.015 --> 00:25:26.655
locations in the lip were defined, um, as such.

490
00:25:26.875 --> 00:25:28.735
So your submucosal layer,

491
00:25:29.065 --> 00:25:31.375
which you can see on the graph there with the blue,

492
00:25:32.155 --> 00:25:35.655
is essentially your wet dry border that in a mucosa inside

493
00:25:35.655 --> 00:25:39.015
of your lip, 78.1, uh,

494
00:25:39.085 --> 00:25:42.655
cadaver specimens located the arteries in this oral mucosa.

495
00:25:42.915 --> 00:25:45.975
Um, and the orbicularis orus muscle, which is classified

496
00:25:45.975 --> 00:25:47.055
as your wet dry border.

497
00:25:48.475 --> 00:25:51.095
And then so that would be our high occlusion is

498
00:25:51.095 --> 00:25:52.375
injecting into that space.

499
00:25:52.395 --> 00:25:56.095
We also know that the tissue quality on the inner mucosa

500
00:25:58.855 --> 00:26:01.465
Does not support Filler very well.

501
00:26:01.485 --> 00:26:02.825
And quite often you can see

502
00:26:02.825 --> 00:26:05.225
that in patients when they roll their lip out

503
00:26:05.225 --> 00:26:07.385
and we see, you know, there's bubbles in there

504
00:26:07.775 --> 00:26:09.425
that often have to be dissolved.

505
00:26:09.525 --> 00:26:13.025
And then the next layer is your intramuscular layer.

506
00:26:13.445 --> 00:26:17.425
So in yellow there I do find that a lot

507
00:26:17.425 --> 00:26:21.865
of nurses do inject into this muscle, um,

508
00:26:21.865 --> 00:26:25.265
which I classify as a little bit too deep.

509
00:26:25.965 --> 00:26:27.985
Um, and you had 17.5%

510
00:26:28.005 --> 00:26:30.225
of cadaver specimens located the artery.

511
00:26:30.225 --> 00:26:33.385
So that's your mid range in terms of safety when it comes

512
00:26:33.385 --> 00:26:34.745
to vascular occlusions.

513
00:26:35.405 --> 00:26:38.265
And then the subcutaneous, uh, fat layer,

514
00:26:39.035 --> 00:26:41.665
which is a epithelial type tissue.

515
00:26:42.135 --> 00:26:46.245
This had the least amount of arteries located in this layer.

516
00:26:46.505 --> 00:26:50.965
So this is the layer that I only ever inject in cannulas,

517
00:26:50.965 --> 00:26:55.815
uh, vascular injury I find less bruising occurs,

518
00:26:56.155 --> 00:27:01.015
um, and less severe inflammation when I am keeping it

519
00:27:01.015 --> 00:27:02.175
within this plane.

520
00:27:03.075 --> 00:27:07.335
So you can see there from right to left on that diagram,

521
00:27:07.675 --> 00:27:11.255
the orange and red colored uh, tissue.

522
00:27:11.445 --> 00:27:13.935
This is the plane that I inject in that, um,

523
00:27:13.935 --> 00:27:14.975
subcutaneous layer.

524
00:27:15.035 --> 00:27:16.215
And then in the center you've got the muscle

525
00:27:16.315 --> 00:27:21.175
and then as off to the left you have that deep mucosa.

526
00:27:23.795 --> 00:27:27.975
So we know where our, um, vascular anatomy is

527
00:27:27.975 --> 00:27:29.295
and where our arteries run.

528
00:27:29.635 --> 00:27:30.815
And the relevance of this

529
00:27:30.835 --> 00:27:33.655
and why I pointed it out was in terms of cannula,

530
00:27:34.395 --> 00:27:35.815
um, entry points.

531
00:27:36.075 --> 00:27:39.785
So you have your modus, um,

532
00:27:39.955 --> 00:27:42.665
there it is a dense compact muscle.

533
00:27:43.365 --> 00:27:47.185
Um, it's a fibro muscular mass performed by the interlacing

534
00:27:47.805 --> 00:27:50.505
of muscles located around the oral there.

535
00:27:52.785 --> 00:27:56.925
That's a point. So I avoid cannula entry in this area

536
00:27:57.385 --> 00:27:59.355
for a couple of reasons.

537
00:28:00.855 --> 00:28:05.335
And the main one is vascular injury,

538
00:28:06.015 --> 00:28:08.975
creating huge hematomas when I'm introducing my cannula,

539
00:28:08.975 --> 00:28:11.775
but also the chance of staying above the muscle into

540
00:28:11.775 --> 00:28:14.055
that subq plane is a lot harder

541
00:28:14.695 --> 00:28:17.415
I find when I'm introducing the cannula from this distance.

542
00:28:18.115 --> 00:28:20.895
So I bring my cannula point entry in

543
00:28:21.515 --> 00:28:23.495
and I just do it within the pink of the lip,

544
00:28:23.805 --> 00:28:25.135
very my cannula in.

545
00:28:27.145 --> 00:28:28.365
So tools for selection.

546
00:28:29.645 --> 00:28:33.525
I definitely encourage people, um,

547
00:28:33.755 --> 00:28:37.405
when I'm training them to play around with their tools.

548
00:28:37.845 --> 00:28:39.925
I think it really does help solidify

549
00:28:41.115 --> 00:28:45.245
your anatomy when you can change up your tools

550
00:28:45.385 --> 00:28:48.125
and techniques because you learn to feel

551
00:28:48.305 --> 00:28:50.925
and know uh, what layers you are in, you know,

552
00:28:50.945 --> 00:28:52.525
and anatomically where you are

553
00:28:52.635 --> 00:28:54.485
because of the feeling of different things.

554
00:28:54.625 --> 00:28:57.565
So I range from a 25 gauge cannula.

555
00:28:58.585 --> 00:29:00.285
Um, I use that

556
00:29:00.285 --> 00:29:04.245
because of um, thinner lateral lips.

557
00:29:04.245 --> 00:29:07.325
When I'm wanting to deposit a nice clean, uh,

558
00:29:07.325 --> 00:29:10.645
retrograde thread of product, it's gonna be nice and smooth

559
00:29:10.645 --> 00:29:14.045
and a lateral lip point of view as well.

560
00:29:15.065 --> 00:29:18.205
Um, when you have those thinner lips, you know

561
00:29:18.205 --> 00:29:22.645
that there is less depth between the superficial layers

562
00:29:22.785 --> 00:29:24.605
to the deep layers where those vessels

563
00:29:24.605 --> 00:29:25.685
could be tracing through.

564
00:29:25.785 --> 00:29:28.485
So quite often when you can actually locate, um,

565
00:29:28.755 --> 00:29:30.165
that labial artery

566
00:29:30.165 --> 00:29:33.205
and you can sometimes see it, often I'll opt

567
00:29:33.225 --> 00:29:35.525
for a cannula just from a safety point of view

568
00:29:35.805 --> 00:29:39.485
'cause I know, um, I'm gonna have a little bit less risk,

569
00:29:39.745 --> 00:29:43.205
um, if I'm using a cannula when I'm running across

570
00:29:43.205 --> 00:29:45.325
that vessel laterally.

571
00:29:45.825 --> 00:29:48.765
Um, I also still use a 30 gauge needle.

572
00:29:49.425 --> 00:29:53.125
Um, and then I change up my BD syringes.

573
00:29:53.185 --> 00:29:55.405
So depending on what type of lip I'm wanting

574
00:29:55.545 --> 00:29:58.965
and how much extrusion force I would play around

575
00:29:59.115 --> 00:30:01.645
with my needle, uh, size, so

576
00:30:02.365 --> 00:30:07.165
a 0.5 BD syringe and a 0.3 syringe.

577
00:30:08.105 --> 00:30:10.685
Um, 0.3 would be like if I was uh,

578
00:30:10.685 --> 00:30:12.085
depositing a softer product

579
00:30:12.145 --> 00:30:15.205
and I was wanting it just to smooth come out the end

580
00:30:15.205 --> 00:30:18.245
of the needle tip as opposed to the 0.5 that had

581
00:30:18.245 --> 00:30:19.605
that tighter extrusion force.

582
00:30:20.065 --> 00:30:21.605
If I'm wanting to get a lot of height

583
00:30:21.605 --> 00:30:24.205
and I'm wanting to tent, I want,

584
00:30:24.725 --> 00:30:26.245
I want a tighter extrusion force

585
00:30:26.245 --> 00:30:28.805
because it's just gonna give me a nicer

586
00:30:29.035 --> 00:30:30.405
tenting type structure.

587
00:30:32.955 --> 00:30:34.735
All right, let's have a look at a case study

588
00:30:35.155 --> 00:30:36.655
of a natural lip.

589
00:30:37.515 --> 00:30:41.535
Um, I performed and this is what I classify as hydration.

590
00:30:42.515 --> 00:30:45.255
So this is a mature client, she's in her fifties

591
00:30:45.355 --> 00:30:47.495
and was blessed with these beautiful lips.

592
00:30:47.665 --> 00:30:49.215
She's never had anything done before.

593
00:30:49.875 --> 00:30:52.255
She had sufficient volume in million upper body

594
00:30:52.835 --> 00:30:57.295
and her superficial epithelium and the border.

595
00:30:58.155 --> 00:31:01.975
Now I would call this almost like a dehydrated sultana skin.

596
00:31:02.235 --> 00:31:06.095
So I'm really not wanting to increase the size of her lips.

597
00:31:06.235 --> 00:31:07.855
I'm more or less just wanting to hydrate

598
00:31:08.685 --> 00:31:10.335
that superficial layer.

599
00:31:11.075 --> 00:31:14.975
So I'm using a 0.3 BD

600
00:31:15.965 --> 00:31:20.135
with a 12.7 millimeter needle tip.

601
00:31:20.675 --> 00:31:24.655
Um, quite often we, it's like a masseter needle essentially

602
00:31:25.635 --> 00:31:28.215
and that just enables me to get down

603
00:31:28.215 --> 00:31:29.455
to the wet dry border nicely

604
00:31:30.515 --> 00:31:33.945
and give uh, nice deposits of product.

605
00:31:34.765 --> 00:31:39.465
So I actually chose the chrome of volume um, for this.

606
00:31:40.685 --> 00:31:43.745
Now using the 0.3 syringe meant

607
00:31:43.745 --> 00:31:46.545
that the product came at nice and inside extrusion force

608
00:31:46.685 --> 00:31:51.265
and the large molecule of that chrome

609
00:31:51.265 --> 00:31:53.745
of volume was gonna spread

610
00:31:53.745 --> 00:31:56.065
and fill that space that she had nicely.

611
00:31:56.745 --> 00:31:58.585
I used 0.5 in total

612
00:32:01.455 --> 00:32:04.555
and I actually only focused on her vermilion body

613
00:32:05.055 --> 00:32:07.955
and it naturally popped out her vermilion border.

614
00:32:08.855 --> 00:32:12.655
So on the bottom I am working on her border,

615
00:32:12.835 --> 00:32:15.375
but at the top I did not, I only did the body just

616
00:32:15.375 --> 00:32:18.175
because she has some of those little, you know, age

617
00:32:18.765 --> 00:32:22.895
crinkly lines around her oral calm that I wanted to soften.

618
00:32:24.035 --> 00:32:27.235
So that is a hydrated natural

619
00:32:29.585 --> 00:32:31.485
lip lip that you can see.

620
00:32:37.915 --> 00:32:40.565
I use a dental block for all of my lips, so

621
00:32:40.565 --> 00:32:43.125
that's why she's looking very comfortable

622
00:32:46.105 --> 00:32:47.105
Before I get home.

623
00:32:47.515 --> 00:32:52.405
Perfect. So this is what her results look like.

624
00:32:52.785 --> 00:32:54.725
That's what they look like two weeks post.

625
00:32:56.695 --> 00:32:59.035
Um, and as you can see it's really just hydrated

626
00:32:59.035 --> 00:33:01.275
that top layer of her lip tissue.

627
00:33:02.895 --> 00:33:04.715
Now this is a natural

628
00:33:05.295 --> 00:33:07.995
lip with definition.

629
00:33:09.695 --> 00:33:12.315
So you can see my cannula entry point there.

630
00:33:13.865 --> 00:33:15.955
It's just outside the pink of the lip.

631
00:33:16.255 --> 00:33:18.955
And as I slip through there, you can see I'm actually

632
00:33:18.965 --> 00:33:21.355
above the muscle in that subcutaneous plane.

633
00:33:21.575 --> 00:33:23.915
You can literally see the tip of my cannula.

634
00:33:24.425 --> 00:33:27.035
That is the depth that I'm talking about.

635
00:33:30.145 --> 00:33:33.925
Now, I often, often get asked a question about kindling in

636
00:33:33.945 --> 00:33:38.805
the lips at this layer, the lip tissue I found is not

637
00:33:38.865 --> 00:33:41.965
of the same quality as say, like the tissue

638
00:33:41.965 --> 00:33:43.045
underneath the eyes.

639
00:33:43.825 --> 00:33:46.605
So kindling just does not occur in the lip

640
00:33:46.715 --> 00:33:48.245
with this product at all.

641
00:33:48.795 --> 00:33:51.525
It's not something I've ever encountered.

642
00:33:52.345 --> 00:33:56.245
Um, as you can see there, if it was kindling, you would,

643
00:33:56.345 --> 00:33:57.805
you would be able to notice it.

644
00:33:58.065 --> 00:33:59.765
Um, but it sits beautifully.

645
00:34:00.225 --> 00:34:03.085
The other reason as well why I make sure

646
00:34:03.085 --> 00:34:04.725
that my cannula is at this depth

647
00:34:04.745 --> 00:34:07.965
and it's not underneath the muscle is that I'm actually able

648
00:34:07.985 --> 00:34:10.645
to avert her lip and pop it out and up.

649
00:34:11.265 --> 00:34:14.885
Um, the tissue sits nicely like that when you are

650
00:34:14.895 --> 00:34:17.125
above the muscle and I can get that turn out

651
00:34:17.125 --> 00:34:18.485
of her top lip as you can see.

652
00:34:18.785 --> 00:34:21.885
And then I just come in, uh, with my BD just

653
00:34:21.885 --> 00:34:24.125
to give her a little bit of height in her GK points.

654
00:34:24.645 --> 00:34:27.205
I used chromo filler here, um,

655
00:34:28.865 --> 00:34:30.695
which gave a really beautiful result.

656
00:34:30.775 --> 00:34:33.615
I used one mil in total.

657
00:34:34.125 --> 00:34:37.455
That cannula was a 25 gauge, 50 millimeter cannula.

658
00:34:40.925 --> 00:34:45.265
And she was really just wanting me to work on her shape

659
00:34:45.325 --> 00:34:49.225
and structure a little bit and help upturn her oral comms.

660
00:34:49.525 --> 00:34:51.825
Now she has a beautiful little clef in the center

661
00:34:51.825 --> 00:34:53.985
of her lip, that little dip that she has

662
00:34:53.985 --> 00:34:55.105
where you can see the separation

663
00:34:55.105 --> 00:34:56.585
between her bottom cubicles.

664
00:34:57.545 --> 00:34:59.585
I didn't wanna run a cannula along there

665
00:34:59.585 --> 00:35:03.225
because I did not want to change the shape of her bottom lip

666
00:35:03.385 --> 00:35:06.425
'cause I thought it was so beautiful beating it

667
00:35:06.645 --> 00:35:08.625
and she was pretty happy with that.

668
00:35:08.965 --> 00:35:12.465
So that's what they look like one week post.

669
00:35:14.765 --> 00:35:17.425
And then this was a natural, uh,

670
00:35:17.665 --> 00:35:19.585
moderate volumization on a male.

671
00:35:20.725 --> 00:35:23.865
Um, he just had a really deflated, uh,

672
00:35:23.925 --> 00:35:26.105
volume in the vermilion body of his lips.

673
00:35:26.105 --> 00:35:29.025
He was quite asymmetrical in his oral comms, um,

674
00:35:29.285 --> 00:35:30.665
in the upper and lower lip.

675
00:35:30.765 --> 00:35:33.225
And the wet dry border was quite uneven at the top.

676
00:35:33.805 --> 00:35:35.425
So I chose chromo filler.

677
00:35:35.825 --> 00:35:37.525
I used 0.5, um,

678
00:35:38.025 --> 00:35:40.965
and I decanted that as well into uh,

679
00:35:40.965 --> 00:35:44.125
29 gauge your typical um,

680
00:35:45.395 --> 00:35:46.405
insulin type needle.

681
00:35:46.405 --> 00:35:49.485
But I used the 12.7 mls, the longer needle tip on it.

682
00:35:49.665 --> 00:35:54.205
Um, same layering, uh, subcutaneous fat layer

683
00:35:54.785 --> 00:35:59.085
and I was sure not to augment her, his vermilion border.

684
00:35:59.555 --> 00:36:04.245
Also, I did not wanna crisp up, I didn't wanna crisp up any

685
00:36:04.245 --> 00:36:06.965
of his um, Cupid's bow or anything like that

686
00:36:07.245 --> 00:36:09.485
'cause that would obviously get fina his lip.

687
00:36:10.185 --> 00:36:12.485
So that's what he looked like six weeks post.

688
00:36:13.835 --> 00:36:15.215
He was quite happy with that.

689
00:36:16.235 --> 00:36:19.455
Now this is just a variation to show you the difference

690
00:36:19.455 --> 00:36:22.735
between the chromo volume as opposed to the chromo filler.

691
00:36:22.845 --> 00:36:24.695
This was exactly the same technique

692
00:36:24.695 --> 00:36:28.295
and exactly the same, um, tools used.

693
00:36:28.395 --> 00:36:30.935
And this same amount patient on the left, it,

694
00:36:31.675 --> 00:36:33.095
she wanted a hydration.

695
00:36:33.235 --> 00:36:35.215
She chewed through her product quite quickly.

696
00:36:35.355 --> 00:36:38.175
So that's why I opted to use the chroma volume this time

697
00:36:38.375 --> 00:36:39.695
'cause I wanted to see if I got a little bit

698
00:36:39.695 --> 00:36:40.775
more longevity out of it.

699
00:36:40.795 --> 00:36:43.135
And I did. It's actually lasted her so long.

700
00:36:43.295 --> 00:36:46.175
I saw her the other day and it's been about eight months

701
00:36:46.195 --> 00:36:47.895
and her lips are still like that.

702
00:36:47.995 --> 00:36:50.975
So it had really, really good longevity.

703
00:36:52.235 --> 00:36:54.695
Now let's have a look at enhanced volumization.

704
00:36:56.155 --> 00:36:59.095
So this patient was lacking volume, um, and structure

705
00:37:00.035 --> 00:37:02.455
and asymmetry in her top lip.

706
00:37:02.555 --> 00:37:03.855
It was still quite a youthful lip,

707
00:37:03.855 --> 00:37:05.935
but she actually has a slight MHA lip

708
00:37:06.035 --> 00:37:08.175
and you can see that she has an upper center

709
00:37:08.485 --> 00:37:10.055
central cubicle.

710
00:37:10.285 --> 00:37:13.095
It's just not very obvious, but it's definitely there.

711
00:37:13.735 --> 00:37:16.775
I chose, um, chromo fill and I used 0.9.

712
00:37:17.595 --> 00:37:20.535
Um, and I used a 30 gauge needle here

713
00:37:20.605 --> 00:37:24.375
because I was wanting to create some nice structure

714
00:37:24.525 --> 00:37:25.895
with the product that I was laying down

715
00:37:25.895 --> 00:37:28.895
because she was wanting that enhanced volumization

716
00:37:28.995 --> 00:37:31.775
so I could afford to give it a little bit more.

717
00:37:31.875 --> 00:37:33.775
So that's why I stuck with the 30 gauge.

718
00:37:34.115 --> 00:37:38.015
So those two initially when I was addressing the top lip,

719
00:37:38.675 --> 00:37:40.215
um, I don't wanna go in

720
00:37:40.215 --> 00:37:43.015
and inject straight in that central cubicle first.

721
00:37:43.215 --> 00:37:46.295
I wanna work on the lateral little deficits either side.

722
00:37:46.755 --> 00:37:48.895
So the retrograde tenting I did

723
00:37:48.955 --> 00:37:50.775
for height in those little deficits.

724
00:37:51.485 --> 00:37:53.855
Then I'd work on some horizontal linear threads up

725
00:37:53.855 --> 00:37:56.535
to her GK point, connecting my tenting thread.

726
00:37:56.595 --> 00:37:59.535
So it's important that we're connecting the ha molecules

727
00:37:59.905 --> 00:38:04.015
underneath the tissue for, um, optimal tissue integration.

728
00:38:05.565 --> 00:38:07.695
Then we did some horizontal down the bottom

729
00:38:07.795 --> 00:38:11.055
and I did some tenting, uh, for length as well

730
00:38:11.075 --> 00:38:14.135
and that's what her lips look like immediately afterwards.

731
00:38:15.915 --> 00:38:19.495
Um, yes, so that was before and after.

732
00:38:19.515 --> 00:38:21.575
So you can see basically all areas

733
00:38:21.635 --> 00:38:23.815
of her lips were emphasized there.

734
00:38:23.815 --> 00:38:27.215
So it's an obvious, um, augmentation.

735
00:38:27.355 --> 00:38:29.455
She looks like she's had a noticeable change.

736
00:38:29.645 --> 00:38:34.015
This patient was just moderate volumization.

737
00:38:34.375 --> 00:38:38.445
I chose chrome of volume as well, uh, for this

738
00:38:38.445 --> 00:38:41.885
because she has big lips already

739
00:38:42.025 --> 00:38:43.525
and she had the space to fill.

740
00:38:43.645 --> 00:38:45.405
I actually wanted a nice, um,

741
00:38:45.515 --> 00:38:48.205
like I wanted a bigger molecule essentially

742
00:38:48.205 --> 00:38:51.005
and it worked really well, um, in her lips.

743
00:38:51.445 --> 00:38:54.085
I used the 30 gauge needle as well

744
00:38:54.145 --> 00:38:57.005
and I just really wanna work, wanted to work on, um,

745
00:38:57.025 --> 00:38:59.445
the disproportion of her upper lip a little bit

746
00:38:59.445 --> 00:39:03.325
and balance out her GK points if I could.

747
00:39:04.305 --> 00:39:05.525
And that's what they looked like

748
00:39:06.135 --> 00:39:07.685
afterwards, which was really good.

749
00:39:08.585 --> 00:39:10.765
And then this is

750
00:39:12.425 --> 00:39:13.885
my natural hydration.

751
00:39:14.585 --> 00:39:16.445
Um, so this patient came in

752
00:39:16.505 --> 00:39:19.085
and she was, um, very

753
00:39:19.915 --> 00:39:23.525
concerned about getting her lips done at in general.

754
00:39:23.865 --> 00:39:25.965
She had been a patient of mine for a long time.

755
00:39:26.435 --> 00:39:28.365
We'd always spoken about she was very, very scared

756
00:39:28.365 --> 00:39:30.165
because she just did not want her

757
00:39:30.385 --> 00:39:32.165
to look like she'd had lip filler at all.

758
00:39:32.745 --> 00:39:35.765
Um, so after a bit of um, convincing, um,

759
00:39:35.765 --> 00:39:39.685
obviously you can see that superficial epithelial layer is

760
00:39:39.715 --> 00:39:41.605
very dehydrated and deflated.

761
00:39:41.825 --> 00:39:43.085
She said that it only really had,

762
00:39:43.145 --> 00:39:44.565
she was in her late forties.

763
00:39:45.305 --> 00:39:46.925
She said that it only really,

764
00:39:49.775 --> 00:39:52.675
excuse me, occurred in the last like 10 years.

765
00:39:53.455 --> 00:39:56.835
Um, so we, um,

766
00:39:56.835 --> 00:39:58.835
she had her wet dry border, especially when she smiled.

767
00:39:58.835 --> 00:40:00.795
It was very uneven. So I have to be quite conscious of that.

768
00:40:01.235 --> 00:40:05.075
I use 0.5 of um, CHRO fill,

769
00:40:07.015 --> 00:40:10.795
um, for the soft volumization and structural support.

770
00:40:11.375 --> 00:40:13.035
And I decanted this one as well

771
00:40:13.035 --> 00:40:16.555
because I needed a smaller, um, needle

772
00:40:16.895 --> 00:40:20.875
and I wanted in a 0.3 syringe 'cause I wanted very smooth

773
00:40:21.495 --> 00:40:22.875
and slow extrusion.

774
00:40:22.875 --> 00:40:26.195
So if you can imagine when you are pushing out your, uh,

775
00:40:26.945 --> 00:40:29.475
your needle onto the back of your glove when we're,

776
00:40:29.615 --> 00:40:31.675
you know, baby injectors trying to figure out

777
00:40:31.695 --> 00:40:33.755
how filler looks when it comes out of the needle,

778
00:40:34.225 --> 00:40:36.035
when you've got that tight extrusion force,

779
00:40:36.055 --> 00:40:37.835
it almost comes out in its squiggles.

780
00:40:38.025 --> 00:40:41.595
Whereas when you have, um, a smaller syringe like a 0.3 in

781
00:40:41.595 --> 00:40:43.115
that long needle, as you squeeze it out,

782
00:40:43.115 --> 00:40:44.955
it just comes out a little bit smoother.

783
00:40:45.055 --> 00:40:46.715
So essentially wanted it to feel

784
00:40:47.095 --> 00:40:49.755
and almost hydrate like a sultana skin.

785
00:40:49.755 --> 00:40:51.955
That's exactly what it does when you use that tool

786
00:40:52.025 --> 00:40:54.635
with this product and that's

787
00:40:54.635 --> 00:40:57.115
what her lips look like immediately afterwards.

788
00:40:58.015 --> 00:41:02.595
So I did not actually enhance her vermilion border at all.

789
00:41:02.715 --> 00:41:04.355
I did not touch her Cupid's bow.

790
00:41:04.915 --> 00:41:08.995
I only introduce the needle in her vermilion body

791
00:41:09.695 --> 00:41:12.475
to uh, essentially fill that epithelial layer.

792
00:41:12.975 --> 00:41:16.475
And it's for me when I'm doing a really natural lip like

793
00:41:16.475 --> 00:41:18.875
this, it's important lip tissue, all those little

794
00:41:20.535 --> 00:41:22.855
ridges there is what makes their lips

795
00:41:22.985 --> 00:41:24.295
still look very natural.

796
00:41:24.405 --> 00:41:27.135
Like they have not had any filler, which is exactly

797
00:41:27.205 --> 00:41:28.655
what this patient wanted.

798
00:41:29.515 --> 00:41:32.135
Um, so yeah, I didn't expand to her tissue

799
00:41:32.135 --> 00:41:34.685
to capacity leaving natural epithelial tissue

800
00:41:34.685 --> 00:41:35.805
formation on the surface.

801
00:41:36.515 --> 00:41:38.325
When I filled out her body like that,

802
00:41:38.465 --> 00:41:41.485
it naturally puffed out her vermilion border

803
00:41:41.585 --> 00:41:43.125
and her GK points.

804
00:41:43.305 --> 00:41:47.325
So that's what her lip naturally was filled

805
00:41:47.425 --> 00:41:48.525
to when she was younger.

806
00:41:49.905 --> 00:41:52.485
And I just filled that central region there.

807
00:41:53.505 --> 00:41:56.405
That's what they look like six weeks post, um,

808
00:41:56.855 --> 00:41:58.525
which she was really, really happy about.

809
00:41:58.545 --> 00:42:03.045
She literally does not look like she's happy with that.

810
00:42:03.345 --> 00:42:06.845
Now this, um, patient came in

811
00:42:06.985 --> 00:42:09.125
and she was wanting her lips done,

812
00:42:09.865 --> 00:42:13.805
but luckily enough she allowed me to do a lot

813
00:42:13.805 --> 00:42:15.405
of other stuff were first

814
00:42:15.405 --> 00:42:17.445
because I had a really comprehensive consultation

815
00:42:17.445 --> 00:42:19.325
with her about aging

816
00:42:19.465 --> 00:42:22.325
and essentially what was contributing to all of that.

817
00:42:22.825 --> 00:42:25.245
Um, folding around her mouth,

818
00:42:25.945 --> 00:42:28.925
you can see her lower jaws there, her nasal labia folds

819
00:42:28.985 --> 00:42:32.805
and basically the loss of all of her peri, um, oral support.

820
00:42:33.785 --> 00:42:38.245
Um, so I essentially did a full face approach first

821
00:42:38.305 --> 00:42:40.845
and her lips were the last thing I actually,

822
00:42:43.145 --> 00:42:47.805
and she had a loss of her fat pad, um,

823
00:42:48.925 --> 00:42:51.245
volumization globally all over her face.

824
00:42:51.265 --> 00:42:53.645
So I actually augmented her temples.

825
00:42:53.725 --> 00:42:56.405
I did pre rick her midface, marionettes,

826
00:42:56.695 --> 00:43:01.485
upper peri oral nasal labia folds, um, pre jowls as well.

827
00:43:01.505 --> 00:43:03.405
And I actually did her lips last

828
00:43:03.625 --> 00:43:08.045
and that's what she, um, looked like at the end.

829
00:43:09.665 --> 00:43:13.365
So that was it. Thank you guys very much.

830
00:43:13.935 --> 00:43:15.485
Sorry for the technical issues.

831
00:43:16.045 --> 00:43:17.405
I hope it was all fine in the end.

832
00:43:19.465 --> 00:43:22.845
You, Sarah, that those results are incredible.

833
00:43:24.205 --> 00:43:28.665
Um, and that was an extremely insightful, uh, presentation.

834
00:43:28.925 --> 00:43:31.385
I'm sure the practitioners listening got some valuable tips

835
00:43:31.445 --> 00:43:32.945
to implement in their own clinics.

836
00:43:34.415 --> 00:43:36.715
We do have a few questions for you.

837
00:43:37.535 --> 00:43:42.235
So first up, um, do you get migration

838
00:43:42.235 --> 00:43:43.835
with any of your techniques

839
00:43:45.255 --> 00:43:47.275
and do you believe it's a product related

840
00:43:47.535 --> 00:43:50.315
or technique related with migration in general?

841
00:43:50.455 --> 00:43:51.455
Um,

842
00:43:56.405 --> 00:44:00.805
I do not get, um, any migration

843
00:44:00.805 --> 00:44:02.125
with this technique at all.

844
00:44:02.545 --> 00:44:07.325
No, because migration occurs

845
00:44:07.755 --> 00:44:09.525
from the layer.

846
00:44:11.025 --> 00:44:14.325
It, your filler is sitting within a muscular structure

847
00:44:14.745 --> 00:44:18.325
and that consistent contraction of the muscle is pushing

848
00:44:18.395 --> 00:44:21.045
that product into the path of least res resistance,

849
00:44:21.045 --> 00:44:23.245
which is your peri oral region.

850
00:44:23.345 --> 00:44:26.565
That's one contributing factor. So quite often can be depth.

851
00:44:27.305 --> 00:44:31.525
Um, another factor can be when you do your,

852
00:44:32.505 --> 00:44:35.005
um, when you're introducing your needle

853
00:44:35.505 --> 00:44:38.245
and you essentially have your white roll externally,

854
00:44:38.345 --> 00:44:39.965
you have your vermilion border

855
00:44:40.185 --> 00:44:42.725
and then you have your vermilion body internally.

856
00:44:43.305 --> 00:44:45.045
If you are introducing your needle

857
00:44:45.155 --> 00:44:49.045
through your vermilion border almost where you are tenting

858
00:44:49.045 --> 00:44:50.765
that way you are essentially breaking

859
00:44:50.865 --> 00:44:53.685
and opening up that vermilion border, which can lead to

860
00:44:54.355 --> 00:44:55.885
migration over time as well.

861
00:44:56.425 --> 00:44:58.405
And then you also have just filling the lip

862
00:44:58.555 --> 00:45:00.045
overfilling the lips as well.

863
00:45:00.625 --> 00:45:05.285
The, the lip capacity can only hold so much, um,

864
00:45:05.515 --> 00:45:09.365
product and essentially over time,

865
00:45:09.985 --> 00:45:13.725
if they are overfilled, it is just going to push out

866
00:45:13.725 --> 00:45:15.365
to a resistance.

867
00:45:15.385 --> 00:45:18.685
So quite often, no, it's never really the product,

868
00:45:19.305 --> 00:45:20.565
it is always gonna come down

869
00:45:20.625 --> 00:45:22.965
to the technique most of the time.

870
00:45:23.275 --> 00:45:25.885
Yeah, that's what I think. Well, thank you.

871
00:45:26.625 --> 00:45:30.325
Uh, next question, next question I have here is, um,

872
00:45:30.425 --> 00:45:33.245
how long do you leave between hilos and then retreating?

873
00:45:38.685 --> 00:45:42.075
Um, this is very different for everyone,

874
00:45:42.145 --> 00:45:46.795
however, I think from a, I can't speak, you know, um,

875
00:45:47.535 --> 00:45:51.315
too in detail about the science behind hila

876
00:45:51.315 --> 00:45:53.715
and the molecules and all of that, et cetera.

877
00:45:53.715 --> 00:45:55.395
However, um, we,

878
00:45:55.995 --> 00:45:58.155
I was always taught two weeks is sufficient.

879
00:45:58.395 --> 00:46:02.515
I personally encourage my clients to wait four weeks

880
00:46:02.735 --> 00:46:05.435
and that's got nothing to do with the hila

881
00:46:05.455 --> 00:46:07.675
or the enzymes on board or the hjs.

882
00:46:07.675 --> 00:46:10.995
But essentially from a trauma pointing dissolved,

883
00:46:12.055 --> 00:46:15.195
the trauma they do undergo is quite significant.

884
00:46:15.455 --> 00:46:18.395
If you can just leave that extra window, um,

885
00:46:18.715 --> 00:46:21.075
I just think your lip results look better at

886
00:46:21.075 --> 00:46:22.195
that four week mark,

887
00:46:22.215 --> 00:46:24.515
but I know nurses that do it after a week.

888
00:46:24.855 --> 00:46:29.315
So yeah, it comes down to the individual injector,

889
00:46:29.315 --> 00:46:31.595
but for me personally, four weeks is a good amount of time.

890
00:46:33.155 --> 00:46:35.225
Great, thank you. Um, next question.

891
00:46:35.485 --> 00:46:38.585
How would you, how should the injection technique be

892
00:46:38.705 --> 00:46:41.145
adjusted for patients with specific lip features such

893
00:46:41.145 --> 00:46:44.785
as asymmetry, scarring, or age related changes?

894
00:46:51.015 --> 00:46:52.155
Say, sorry, say that again.

895
00:46:52.215 --> 00:46:54.555
Say the first part again. How should you,

896
00:46:55.255 --> 00:46:57.515
How do you change your injection technique?

897
00:46:57.665 --> 00:47:01.595
Depending on certain things like asymmetry, scarring

898
00:47:01.595 --> 00:47:04.035
or age related changes, does it depend, uh,

899
00:47:04.355 --> 00:47:05.955
specifically on the person in front of you

900
00:47:06.055 --> 00:47:08.715
or do you have a specific technique, for example, scarring,

901
00:47:09.025 --> 00:47:11.115
like the cleft lift that you showed earlier.

902
00:47:11.205 --> 00:47:12.915
Would that, is there a specific

903
00:47:12.975 --> 00:47:14.035
way you would work around that?

904
00:47:16.175 --> 00:47:18.875
Yeah, yeah.

905
00:47:18.935 --> 00:47:20.115
So with a cleft lift,

906
00:47:20.255 --> 00:47:21.875
you wouldn't be using a cannula at all.

907
00:47:21.975 --> 00:47:25.155
So quite often, um, it, it actually depends on

908
00:47:25.305 --> 00:47:27.035
what the scarf formation is doing

909
00:47:27.215 --> 00:47:30.445
and how many layers that, um, cleft,

910
00:47:31.345 --> 00:47:32.445
um, is affecting.

911
00:47:32.505 --> 00:47:36.365
But you would think relatively deep, deeper than

912
00:47:36.365 --> 00:47:37.885
what we are putting lip filler.

913
00:47:37.905 --> 00:47:41.165
So I would say you would never be able to advance a cannula

914
00:47:41.165 --> 00:47:45.245
through that area, but you would just be using a needle, um,

915
00:47:45.945 --> 00:47:48.925
either just a normal vent, um, into a little bd.

916
00:47:48.925 --> 00:47:51.885
Personally for her lips, I did decant

917
00:47:52.425 --> 00:47:56.485
and I did, um, a, a tending technique

918
00:47:56.485 --> 00:48:00.645
because I actually wanted to enhance

919
00:48:01.105 --> 00:48:04.405
and inflate her vermilion border as much as possible,

920
00:48:04.415 --> 00:48:06.725
especially like where her GK points were

921
00:48:06.725 --> 00:48:08.125
because they were quite uneven.

922
00:48:08.665 --> 00:48:10.965
So I wanted to do a tenting technique

923
00:48:10.965 --> 00:48:12.725
that ran all the way up the lips

924
00:48:12.725 --> 00:48:15.685
and tried to fill out her, um, GK points.

925
00:48:16.065 --> 00:48:17.485
But to answer your question,

926
00:48:17.605 --> 00:48:20.165
I think it's very much dependent on who's in front of you.

927
00:48:20.665 --> 00:48:25.205
If you are wanting, um, if someone's got a really, you know,

928
00:48:25.515 --> 00:48:26.565
flat small lip

929
00:48:26.585 --> 00:48:29.645
and you're wanting to avert their lips outwards,

930
00:48:29.755 --> 00:48:31.245
then you would, I would be using

931
00:48:31.245 --> 00:48:32.965
that cannula technique, that version.

932
00:48:33.025 --> 00:48:35.085
You can also create some thickening on the lateral border

933
00:48:35.085 --> 00:48:38.485
of the lip where you can lay out your filler,

934
00:48:39.505 --> 00:48:41.765
not worry about lumps or bumps

935
00:48:41.785 --> 00:48:44.205
and not worry about injecting too deep

936
00:48:44.225 --> 00:48:45.965
and hitting vessels, et cetera.

937
00:48:46.065 --> 00:48:48.845
So I guess it just depends on the lip that you are,

938
00:48:48.985 --> 00:48:50.005
um, dealing with.

939
00:48:50.795 --> 00:48:53.905
Yeah, I hope that answers your question.

940
00:48:57.905 --> 00:48:59.755
That did answer my question. Thank you Sarah.

941
00:49:00.415 --> 00:49:01.955
Um, I have another question here.

942
00:49:02.055 --> 00:49:04.995
How many sessions usually do patients need

943
00:49:04.995 --> 00:49:08.515
to achieve an augmented result, especially a younger client?

944
00:49:13.935 --> 00:49:16.115
Uh, it depends how big they want their lips.

945
00:49:16.595 --> 00:49:18.835
I would say when my clients are coming in

946
00:49:18.835 --> 00:49:20.315
and they're wanting an enhanced lip

947
00:49:20.315 --> 00:49:25.115
and they want it to be relatively, I say, I say to them,

948
00:49:25.295 --> 00:49:26.875
do you want your lips as big

949
00:49:26.875 --> 00:49:29.315
as physically possible without looking silly

950
00:49:29.535 --> 00:49:31.515
and still respecting your natural shape?

951
00:49:31.655 --> 00:49:34.675
That's, that's probably the maximum that I would go in terms

952
00:49:34.675 --> 00:49:36.395
of like a really big enhanced lip.

953
00:49:36.895 --> 00:49:39.195
And quite often if they're starting from scratch,

954
00:49:39.635 --> 00:49:41.275
I would do it over two sessions.

955
00:49:41.775 --> 00:49:43.715
The only reason being is

956
00:49:45.035 --> 00:49:47.035
I think your injecting technique

957
00:49:47.035 --> 00:49:49.395
and how your lips look on the bed

958
00:49:49.455 --> 00:49:52.555
and as your client leave is one aspect of your half

959
00:49:52.555 --> 00:49:53.795
of your treatment.

960
00:49:54.215 --> 00:49:57.155
And I think to be a really good injector, you have

961
00:49:57.155 --> 00:49:58.875
to understand your product so well

962
00:49:58.875 --> 00:50:00.675
that you can almost predict exactly

963
00:50:00.735 --> 00:50:03.515
how it's gonna integrate into your client's lips.

964
00:50:04.255 --> 00:50:07.475
So I personally would rather my client coming back

965
00:50:07.575 --> 00:50:10.635
and wanting more than freaking out

966
00:50:10.695 --> 00:50:12.955
and being like, my, they're too much, they're too big

967
00:50:12.955 --> 00:50:14.195
and then I've lost them forever.

968
00:50:14.495 --> 00:50:17.675
So retaining my clients is very important

969
00:50:17.815 --> 00:50:19.115
as it should be for all of us.

970
00:50:19.175 --> 00:50:23.795
So I would probably start off doing more of like a half mil

971
00:50:23.895 --> 00:50:27.195
or 0.6 or 0.7 within reason.

972
00:50:27.825 --> 00:50:29.285
And then if they want to come back

973
00:50:29.305 --> 00:50:31.645
and I say, if you feel like you want them a little bit

974
00:50:31.645 --> 00:50:34.045
bigger, come back and see me in, you know, two

975
00:50:34.045 --> 00:50:36.125
or three months and we can put a little bit more in.

976
00:50:36.145 --> 00:50:39.165
And then generally speaking that's a perfect size

977
00:50:39.345 --> 00:50:41.205
and I never run the risk of losing them

978
00:50:41.205 --> 00:50:42.405
because I've overdone it.

979
00:50:43.745 --> 00:50:47.725
Um, for a natural enhance though quite often one session is

980
00:50:48.005 --> 00:50:51.125
sufficient because we're not really making them much bigger.

981
00:50:51.705 --> 00:50:55.005
Um, but it also depends if they are chewing

982
00:50:55.005 --> 00:50:58.845
through their product quickly or sometimes they want a

983
00:50:58.845 --> 00:51:02.885
little bit more, um, I might end up doing a little bit more,

984
00:51:03.065 --> 00:51:07.565
um, like a firming technique around their lips afterwards.

985
00:51:07.855 --> 00:51:10.045
Again, once they're really happy with their lips, they kind

986
00:51:10.045 --> 00:51:11.765
of come, come back wanting a little bit more

987
00:51:11.765 --> 00:51:15.285
and that's when I can start expanding across the fa a couple

988
00:51:15.285 --> 00:51:16.445
of sessions for me generally.

989
00:51:17.895 --> 00:51:20.825
Okay. And talking about the firming technique, um,

990
00:51:20.885 --> 00:51:22.225
how do you treat smokers lines?

991
00:51:22.225 --> 00:51:24.825
What product would you use and what technique do you use?

992
00:51:29.415 --> 00:51:32.795
Um, it depends on the thickness of the upper lip.

993
00:51:33.695 --> 00:51:37.195
So when you are assessing a patient, you need

994
00:51:37.195 --> 00:51:38.235
to turn them on their side

995
00:51:38.235 --> 00:51:40.995
and we need to assess how much projection they've got, um,

996
00:51:40.995 --> 00:51:43.555
from their maxilla, what their teeth are doing.

997
00:51:43.735 --> 00:51:45.875
So have a look at their teeth, um,

998
00:51:46.135 --> 00:51:47.595
are they straight, are they crooked?

999
00:51:47.595 --> 00:51:48.715
Are they pushing in and out?

1000
00:51:49.425 --> 00:51:51.075
Have they had any previous work done

1001
00:51:51.075 --> 00:51:53.115
with other people first?

1002
00:51:53.855 --> 00:51:58.525
So if they have that thicker upper lip

1003
00:51:58.525 --> 00:52:01.005
and they can't really afford for any volumization,

1004
00:52:01.285 --> 00:52:05.605
I will talk to them about doing, um, tibo across the top

1005
00:52:05.605 --> 00:52:07.485
of their lip to relax that muscle.

1006
00:52:08.025 --> 00:52:09.645
And I'll almost do it like a little bit

1007
00:52:09.645 --> 00:52:11.485
of a mezotox type treatment

1008
00:52:11.485 --> 00:52:15.365
where I'll just do it in the very superficial dermis knowing

1009
00:52:15.365 --> 00:52:16.445
that it is gonna go down

1010
00:52:16.445 --> 00:52:19.125
and hit the orbicularis um, aus muscle.

1011
00:52:19.385 --> 00:52:23.885
But I'm more or less just doing little mezotox to soften

1012
00:52:24.145 --> 00:52:26.805
and then I'll do a little bit across the vermilion border

1013
00:52:26.805 --> 00:52:29.365
there, but I obviously educate them on perfect

1014
00:52:29.555 --> 00:52:31.325
because it doesn't spread as far.

1015
00:52:32.505 --> 00:52:36.885
Um, if they can afford for a little bit of dermal thickening

1016
00:52:36.985 --> 00:52:41.365
as I would say, I actually treat

1017
00:52:41.695 --> 00:52:46.125
above the lip, I might run my cannula up there, uh,

1018
00:52:46.125 --> 00:52:50.085
which I quite often would do when they very much have a loss

1019
00:52:50.085 --> 00:52:51.325
of that structural support

1020
00:52:51.505 --> 00:52:53.045
or you can almost see that they have

1021
00:52:53.045 --> 00:52:55.205
that little dip before their lips.

1022
00:52:55.205 --> 00:52:56.205
And now mature clients,

1023
00:52:56.235 --> 00:52:59.645
I'll actually run my cannula all the way up to that aler

1024
00:52:59.645 --> 00:53:03.805
of the nose up to the filter column up to um,

1025
00:53:04.225 --> 00:53:07.085
the cupid bow and I'll softly drop a little bit

1026
00:53:07.085 --> 00:53:08.965
of product there as well as doing the lip.

1027
00:53:08.965 --> 00:53:11.725
And it gives me a nice, um, amount of aversion.

1028
00:53:11.825 --> 00:53:14.845
So it depends, yeah, on the thickness of the upper lip,

1029
00:53:14.845 --> 00:53:16.085
whether you can afford to be putting

1030
00:53:16.085 --> 00:53:17.165
product up there or not.

1031
00:53:19.165 --> 00:53:22.035
Thank you Sarah. Um, do you have advice

1032
00:53:22.035 --> 00:53:24.875
for new injected treating lips as, as it is difficult

1033
00:53:24.875 --> 00:53:26.565
to complete a full phase assessment known

1034
00:53:26.565 --> 00:53:29.965
that novice injectors are unable to inject in the

1035
00:53:30.615 --> 00:53:33.205
peral areas that support the lip structure?

1036
00:53:36.995 --> 00:53:38.095
Do you want me to say that one again?

1037
00:53:39.435 --> 00:53:43.855
Um, well, yeah, go one more time.

1038
00:53:45.485 --> 00:53:46.945
Advice for new injectors.

1039
00:53:47.685 --> 00:53:50.665
New injectors that cannot treat the full peral area.

1040
00:53:50.695 --> 00:53:52.585
They can only treat the lip, uh,

1041
00:53:52.585 --> 00:53:55.425
when you're doing an assessment on them, knowing that

1042
00:53:56.495 --> 00:53:58.905
they probably need support around the lip,

1043
00:53:59.325 --> 00:54:00.665
but you can't do that yet.

1044
00:54:01.535 --> 00:54:03.545
What would you suggest? Would you still treat the lip

1045
00:54:03.605 --> 00:54:06.205
or would you not?

1046
00:54:06.705 --> 00:54:07.705
Um,

1047
00:54:11.825 --> 00:54:14.035
Yeah, I would, I would still treat the lip.

1048
00:54:14.195 --> 00:54:17.675
I guess it's important to, oh, that's a really hard question

1049
00:54:17.675 --> 00:54:22.115
for me to answer 'cause it's like you are at, at that stage.

1050
00:54:23.175 --> 00:54:24.235
That's the trickiest question.

1051
00:54:24.515 --> 00:54:28.945
I mean, personally I would be, I would,

1052
00:54:29.185 --> 00:54:32.185
I would be upskilling yourself very quickly

1053
00:54:32.335 --> 00:54:35.425
because there's no reason why you need to be capped, um,

1054
00:54:35.645 --> 00:54:37.105
at just doing lips.

1055
00:54:37.405 --> 00:54:39.145
If you feel like you have the ability

1056
00:54:39.205 --> 00:54:40.425
to be educating yourself

1057
00:54:40.445 --> 00:54:42.945
and advancing yourself using a cannula

1058
00:54:42.945 --> 00:54:45.665
around the peri oral region, I wouldn't classify

1059
00:54:45.725 --> 00:54:47.345
as dangerous at all.

1060
00:54:47.655 --> 00:54:49.985
It's um, if you're wanting to excel at that,

1061
00:54:50.065 --> 00:54:52.665
I definitely would encourage you to do your own training

1062
00:54:52.725 --> 00:54:53.745
and learning to do that.

1063
00:54:54.285 --> 00:54:55.905
But you definitely should treat the

1064
00:54:55.905 --> 00:54:57.105
lips if it's still appropriate.

1065
00:54:57.285 --> 00:54:59.825
You, you do whatever you can if it's still appropriate

1066
00:54:59.925 --> 00:55:01.665
and you can just have conversations about

1067
00:55:01.855 --> 00:55:03.065
your forward planning.

1068
00:55:03.285 --> 00:55:04.665
So you could say, you know,

1069
00:55:05.545 --> 00:55:08.105
I reckon we'll probably look at doing a little bit

1070
00:55:08.105 --> 00:55:09.425
of support around your mouth,

1071
00:55:09.485 --> 00:55:12.505
but let's treat your lips first and see how it integrates

1072
00:55:12.505 --> 00:55:15.465
and settles and then keep them in mind when you're ready

1073
00:55:15.465 --> 00:55:16.705
to start doing that type.

1074
00:55:16.725 --> 00:55:20.305
So I never let them know what you can't do yet.

1075
00:55:21.005 --> 00:55:24.705
Um, just talk about your forward planning with them

1076
00:55:24.845 --> 00:55:27.865
and just reiterate that you wanna take the treatment slowly

1077
00:55:28.045 --> 00:55:29.865
and you don't wanna do too much at once.

1078
00:55:30.545 --> 00:55:31.545
I think if you're a beginner

1079
00:55:31.565 --> 00:55:33.585
and you you don't have the full toolbox,

1080
00:55:33.585 --> 00:55:36.225
that's probably the best way to go around it, um,

1081
00:55:36.535 --> 00:55:38.265
without telling them that you can't do

1082
00:55:38.265 --> 00:55:39.305
it because you're only a beginner.

1083
00:55:40.015 --> 00:55:41.225
Make it till you make it. I say

1084
00:55:44.425 --> 00:55:45.425
Absolutely.

1085
00:55:45.725 --> 00:55:47.305
Uh, so a couple more questions.

1086
00:55:47.615 --> 00:55:49.425
What if someone wants enhanced lips

1087
00:55:49.425 --> 00:55:52.505
but you don't, they don't have the lip face proportions

1088
00:55:52.605 --> 00:55:53.985
to treat it effectively.

1089
00:55:54.685 --> 00:55:55.705
How do you go about that?

1090
00:55:59.815 --> 00:56:02.235
It, when it comes down to your consultations?

1091
00:56:02.315 --> 00:56:05.355
I think it's very important that you have control

1092
00:56:05.355 --> 00:56:09.035
of your consultation and you know what your limitations are.

1093
00:56:09.055 --> 00:56:11.275
At the end of the day, you are the professional.

1094
00:56:11.805 --> 00:56:13.155
Don't ever get into the habit

1095
00:56:13.175 --> 00:56:16.075
of letting your clients talk you around in treatments

1096
00:56:16.075 --> 00:56:19.115
that you do not think are like ethical for them

1097
00:56:19.215 --> 00:56:20.235
or are gonna suit them

1098
00:56:20.235 --> 00:56:23.925
because at the end of the day, staying true to

1099
00:56:23.925 --> 00:56:25.285
what you think, um,

1100
00:56:25.425 --> 00:56:28.085
is suitable is always gonna be the best outcome

1101
00:56:28.085 --> 00:56:29.285
for you as an injector.

1102
00:56:29.985 --> 00:56:34.005
So it, it's always gonna come down to your, um, consultation

1103
00:56:34.665 --> 00:56:37.485
and just telling them it's not actually gonna suit

1104
00:56:38.215 --> 00:56:39.885
can't seem like it's your opinion.

1105
00:56:41.545 --> 00:56:44.845
You need to explain to them that, um,

1106
00:56:45.315 --> 00:56:47.005
it's gonna make this look smaller

1107
00:56:47.225 --> 00:56:48.325
or it's gonna throw out the

1108
00:56:48.445 --> 00:56:49.645
proportions of this, this and this.

1109
00:56:49.645 --> 00:56:50.805
And if you ever get to a point

1110
00:56:50.805 --> 00:56:53.285
where they're asking something that you simply don't

1111
00:56:54.015 --> 00:56:57.085
wanna do, there's no reason why you can't say like,

1112
00:56:57.785 --> 00:56:59.725
you know, I might not be the injector

1113
00:56:59.945 --> 00:57:03.765
for you if you feel like it's going over a threshold,

1114
00:57:03.985 --> 00:57:07.125
but if you're saying no to them, you need to kind

1115
00:57:07.125 --> 00:57:09.805
of facilitate an avenue that you can go down

1116
00:57:09.805 --> 00:57:12.765
and say, look, why don't we actually focus on this first

1117
00:57:12.825 --> 00:57:15.365
and then maybe you can show this some examples of

1118
00:57:15.365 --> 00:57:17.085
that on Instagram

1119
00:57:17.545 --> 00:57:20.405
or someone else's work that you've seen just to show them

1120
00:57:20.405 --> 00:57:23.845
what it might look like if you were to work on their chin

1121
00:57:23.865 --> 00:57:27.485
or their cheeks sort of practice though. Yeah.

1122
00:57:28.355 --> 00:57:31.205
Okay. Thank you Sarah. Uh, last question for you.

1123
00:57:33.205 --> 00:57:36.165
Practice makes perfect. Um, one last question.

1124
00:57:36.705 --> 00:57:39.365
The last lady that you've still got up there on the screen,

1125
00:57:39.945 --> 00:57:43.205
did you use the whole range tiba and the chroma fillers?

1126
00:57:46.645 --> 00:57:50.055
Sure did. Yep. Um, yep.

1127
00:57:50.155 --> 00:57:53.815
So I actually only used chroma volume

1128
00:57:54.035 --> 00:57:59.015
and chroma filler in her whole face and tibo.

1129
00:57:59.715 --> 00:58:04.015
Um, so the beauty of that is I used my

1130
00:58:04.675 --> 00:58:09.255
chromo volume as my structural product instead

1131
00:58:09.255 --> 00:58:12.135
of volume plus because she has really thin tissue coverage.

1132
00:58:12.155 --> 00:58:15.335
So down on bone I still used volume,

1133
00:58:15.795 --> 00:58:19.335
but I used it, uh, with a 27 gauge needle.

1134
00:58:19.955 --> 00:58:23.015
But then when I wanted to rejuve, I actually used a cannula

1135
00:58:23.015 --> 00:58:26.095
and I deposited obviously within that, uh, fatty layer

1136
00:58:26.115 --> 00:58:28.775
to rejuvenate her, um,

1137
00:58:30.195 --> 00:58:31.295
her deep fat pads

1138
00:58:31.295 --> 00:58:34.735
and the more superficial subcutaneous fat there.

1139
00:58:35.435 --> 00:58:38.375
Um, I used chromo filler in

1140
00:58:38.925 --> 00:58:42.095
down in her fascia in her temples to give her that lip.

1141
00:58:42.695 --> 00:58:45.575
I also used, uh, chromo filler in her marionettes.

1142
00:58:46.055 --> 00:58:49.095
I used it in her nasal labial folds and I blended.

1143
00:58:49.675 --> 00:58:53.375
So I introduced her cannula, um, where her oral calm is

1144
00:58:53.395 --> 00:58:56.735
and I fanned up to her nasal labial folds up to the ala

1145
00:58:56.735 --> 00:58:58.895
of her nose all the way up to her filter columns.

1146
00:58:58.975 --> 00:59:01.295
I fanned around and then I did the same thing

1147
00:59:01.295 --> 00:59:04.695
with her marionettes, um, popped out her, um,

1148
00:59:05.755 --> 00:59:08.855
her prejowl sulcus with volume down on bone.

1149
00:59:08.855 --> 00:59:10.815
And then I used filler in her lips.

1150
00:59:10.815 --> 00:59:13.015
So two products and I did her whole face,

1151
00:59:13.155 --> 00:59:16.255
but I changed up my layering, I changed up my tools

1152
00:59:16.315 --> 00:59:18.135
and my technique and that's how you can get

1153
00:59:18.135 --> 00:59:21.965
so much versatility, um, just with using two products.

1154
00:59:23.535 --> 00:59:25.035
That's incredible. Thank you Sarah.

1155
00:59:25.745 --> 00:59:29.315
Well, that is all the questions. Thank you. You are amazing.

1156
00:59:29.575 --> 00:59:30.635
You're a wealth of knowledge.

1157
00:59:30.805 --> 00:59:33.435
Sarah is doing a road show, fresh road show

1158
00:59:34.015 --> 00:59:35.515
in Melbourne on Monday

1159
00:59:35.735 --> 00:59:38.155
and then the following Monday in Sydney.

1160
00:59:38.775 --> 00:59:41.675
So there's still a few spots left for freshness

1161
00:59:41.675 --> 00:59:43.995
as if you want to jump, jump on the fresh website.

1162
00:59:45.525 --> 00:59:46.525
Thank you, Sarah.

1163
00:59:51.245 --> 00:59:53.905
Thanks guys. Thank you. Thank

1164
00:59:53.905 --> 00:59:54.905
You. Thank

1165
00:59:54.905 --> 00:59:57.385
you Sarah. Thank you Charlotte. Great presentation.

1166
00:59:58.435 --> 01:00:01.545
Thank you. Talk to you soon. Bye.

1167
01:00:03.075 --> 01:00:05.255
Thanks, God. See, bye.

Read our blog on Vascular Occlusions