Lip Filler: ‘the lunch time procedure’

The fullness and definition of our lips is commonly associated with attractiveness. Kylie Jenner, founder of Kylie Cosmetics specialising in all things lip kits, ultimately branded the voluminous lip back in 2015. Since then the market for lip augmentation has spiralled out of control, with a lip top-up as normal as a trip to the dentist for many.

My Story

I myself am very much guilty of jumping on the bandwagon of trends.  I study biology and have a natural interest in how things work and why things are the way they are.

Yet I so easily allowed an injection (of at the time an unknown to me substance) into my lips. I seeked the reassurance I needed from the hundreds of girls undergoing the procedure before me. Them too likely gaining reassurance from the girls that went before them. 

To be completely honest, I remember perching on the edge of a chair as the nurse (who recently left her position as an A&E nurse to fill the gap in the cosmetic market) popped numbing cream on my lips to ease any discomfort.

She handed me a waiver, littered with potential risks of the procedure and details of the substance of use. I merely glanced over, skipping straight to the signature section, completely consumed by the anticipation of the results. So, what is the science behind this trend? 

Dermal Filler: What are we Injecting into our Lips?

A Quick History Lesson

The syringe was invented back in the 1853 and has since paved the way for vaccinations for example, but also for facial injections to alter the natural shape of the face. Paraffin a colourless wax material, can be derived from petrol or coal and was one of the first filling materials ever used cosmetically.

Since then a series of different fillers have been developed, many of which, for example silicone were later banned for safety reasons. Silicone was used cosmetically as a dermal filler for well over 50 years and worked by altering the structure of the connective tissue beneath the skin. 

The agent is longer cosmetically used, due to issues such as collagen fibrosis arising. Collagen fibrosis occurs due to an excess connective tissue around the injected area, very much reminiscent of the scarring- the bodies natural response to injury.  

The Food and Drug Administration (FDA) is an American agency who protect public health by policing which foods and drugs are safe for human use.

The first ever cosmetic filler approved by the FDA was bovine collagen– a naturally occurring protein found in cows. The high demand from the growing cosmetic market has meant that there have been numerous filler alternatives that have been developed and approved by the FDA. 

The Age of Hyaluronic Acid- ”the Hydration Hero”

Every beauty guru under the sun can give you a 5 minute presentation the wonders of Hyaluronic Acid, as we enter an age consumed by the stuff (we’d add it in to our tea if we thought it would enhance our beauty.)

We plaster it on our faces in the form of a new ground-breaking facial serum and inject it into our face likes it going out of fashion. Which let me add it certainly isn’t, as our obsession for the stuff shows no slowing down!

But do we actually know what it is? Acid is associated with negative connotations in society, yet for some reason if we put the magic H word in front of it, it’s suddenly becomes a modern-day miracle. Magic!

As Smooth as a Baby’s Bum 

Roughly 15g of Hyaluronic Acid occurs naturally within our body, slowly decreasing as we age and helps to hold water, giving skin its soft texture. The natural aspects of the acid make it an attractive choice of filler, which reduced chance of toxicity and immune response compared to other candidates.

The ‘miracle’ compound is widely used due its high versatility; from moisturising the skin as we age (restoring a youthful glow) to creating the perfect pout. A secret hero across generations- from older individuals wanting to rewind time, to younger individuals wanting to enhance their facial features.

Hyaluronic Acid has been the leading dermal filler since the 1990’s-it’s amazing biological properties making it a household name. REVOLAX and JUVÉDERM are jargon you may have heard floating about the cosmetic word, as they are the most common HA based fillers.

HA typically doesn’t stay in the body long before its metabolised (broken down), in REVOLAX there is increased cross-linking of the acid to specific proteins added when making the filler. This cross-linking behaviour is what strengthens the filler and prevents its breakdown. The protein used to cross-link to the acid is what gives the different filler varieties. This increases the breakdown time, giving a lasting desired plump look for up to 6 months.

Grow up? More like glow up!

Biological powers: HA is the ultimate scaffold of our skin, providing shape, smoothness, flexibility and volume to our face. Reduced amounts of naturally occurring HA, effects all these properties of the skin, leading to a gaunt complexion, rigid skin and wrinkles.

So, it doesn’t come as a surprise, that restoring HA whether by the application of a serum or injection into effected areas, gives HA its anti-wrinkle effects. What ever happened to growing old gracefully?

 The pumping power of HA works by attracting and holding water (1000x its weight) to give the golden plump to the injected area. The injections will further work, by encouraging a natural increase of two important connective tissue porteins, collagen and elastin (two other buzz words in the cosmetic industry) , contributing to a youthful glow.

 HA increases the production of collagen by encouraging fibroblasts proliferation-a cell of the connective tissue. Think of collagen like the poles of a scaffold and the fibroblasts like the builders. The more builders you have the more scaffold can go up. Collagen production by fibroblasts, is what adds support to the scaffold of the skin, so increased collagen production will increase skin righty.

Safety first

“It’s easy for clients to confuse side effects to reactions, so it’s extremely important to understand what side effects can be expected,” says Dr Terry Loong a leading cosmetics doctor based in London.

Most people will suffer mild side effects. If you have ever had a blood test or vaccination for example, the next day you may have a war wound in the place of injection, whether that be redness or bruising. So, it doesn’t come as a surprise that, that also commonly occurs in patients undergoing lip augmentation.

I myself suffered from slight bruising around the area of injection. The nurse prior to any cosmetic procedure should advise on the do’s and don’ts’ to limit any side effects.

An important one is the avoidance of common painkiller ibuprofen as the drug acts to thin your blood ,making it less likely to clot- resulting in bruising.

Allergic reactions can also occur due to the manufacturing of the filler, which commonly employs the use of bacteria to culture the HA. There is also a chance of infection, a common risk associated with any abrasion to the skin.