Instagram Lip Deception

It is not possible to establish how many of the photos and videos of augmented lips in social media correspond to reality, but let's start from a fundamental error, very banal and understandable:

Showing a photo of the lips immediately after the injection of the filler may, on the one hand, give us a hypothetical idea of ​​how the result could be; on the other, it can be misleading, as it doesn’t take into account several factors that can affect actual results:

1. The action of topical anesthesia
2. The trauma of the needle or cannula and of the massage
3. The immediate recall of fluid inside the lips by the hyaluronic acid
4. Idealized versus everyday patient photos and videos

Topical Anesthesia

Let's start with topical anesthesia. Lidocaine-based gels or creams are commonly used and act for 20 to 30 minutes. This in itself causes a slight swelling of the lips and is therefore the first factor of "deception." Many patients ask to be able to look at their lips before the treatment once the anesthetic has been removed and they say, "Wow, Doctor. They already look more beautiful to me!" Clearly this effect is temporary, lasts a few hours and does not contribute in any way to the stabilized result.

Tissue Trauma

Let's now deal with the issue of the action of the needle and/or microcannula. What happens when we suffer a trauma? For example, when we hit a part of the body with some energy? The traumatized part "swells." In technical terms an edema develops. The same thing happens when we prick the lips and the needle or microcannula penetrates the tissues. They are traumatized and respond by swelling.

The aesthetic doctor also often performs a massage on the lips to even out the distribution of hyaluronic acid. This is another factor that generates swelling. It is, therefore, clear that immediately after the injection, the lips will show an increase in volume that does not correspond to what will be observed about seven to 10 days post-treatment when the result will be more or less stabilized and most of the oedema will be reabsorbed.

Hyaluronic Acid

What do we inject into the thickness of the lips to re-harmonize their shape? We inject hyaluronic acid-based fillers. Hyaluronic acid is widely present in our body and is able to bind with many water molecules reaching a high degree of hydration. In the initial phases and up to a few days after treatment, this too contributes to a greater volumetric increase in the lips than we will observe once the result has stabilized.

Everyday Patients

And what about the patients treated, photographed or filmed, and posted on social networks? Very young, often with already beautiful pre-treatment lips, smiling even with 13 mm needle stuck in the lips? This doesn’t depict a real situation. Patients often also need to have the perioral area rejuvenated, which requires a certain "support,” and a single vial of filler (1 cc of hyaluronic acid) is not always sufficient to obtain a result that satisfies both the aesthetic doctor and the patient.

If from a communication and marketing point of view the "everything beautiful" on the web attracts patients, from the point of view of mutual respect in the doctor-patient relationship, patients should also be exposed to different age groups receiving lip fillers and even those with "difficult" lips.

The Takeaway

Patients need to know that the beautiful photos shared on social networks of newly treated lips, shiny with oils and lip glosses, may not correspond to the final result. The injection videos are certainly fascinating, but it would be advisable to also show the photos of the results at least one week post-injection. The swelling or the initial edema also hides any asymmetries or imperfections. And vice versa, there may be immediate defects seen that will disappear after a few days. Importantly, over time it will be possible to observe the evolution of the treatment and proceed with a retouching, if necessary.

Dr. Annalisa Calisti is a physician based in Rome, Italy, who has been practicing aesthetic medicine for more than 10 years. She is a member of the Italian Academy of Aesthetic Medicine and Fellow of the American Board of Medicine.