Anatomical parts of the lip
The lip consists of several parts: (1) vermilion — the pigmented mucosal surface; (2) cupid's bow — the "heart-shaped" protrusion in the middle of the upper lip; (3) philtral columns — two parallel lines extending from the upper lip to the nose; (4) vermilion border — the boundary between pigmented and unpigmented skin; (5) wet line — the inner mucosal border of the lip. Each part is a component of the natural lip architecture; these lines should not be lost when adding volume.
Ideal ratio
Studies in the White American population have found that the upper:lower lip ratio in a young lip is approximately 1:1.6. This ratio may vary in populations of East Asian and African descent. The important thing is to choose a ratio that suits the patient's own facial proportions; "the individual's own golden ratio" instead of a "standard beauty ratio."
The "duck lip" trap
Excessive volume, especially filler that spills outside the vermilion, creates an unnatural "duck lip" appearance. This is often the result of injections performed by "fanning," placing the filler outside rather than inside the mucosa. Even in a young patient, this look gives the impression of aging — because it is unnatural.
Principles of natural lip augmentation
First: philtral columns should remain visible. Second: cupid's bow should be preserved or slightly enhanced. Third: volume should be placed from the inner mucosa outwards, not spilling over. Fourth: the upper:lower ratio should be balanced. Fifth: if 1 ml is sufficient, 2 ml should not be done — conservatism is rewarded in every session.
Quality lip filler checklist
- Cupid's bow preserved/and enhanced
- Philtral columns visible
- Vermilion border sharp, not blurred
- Side profile natural, not protruding
- Upper:lower ratio appropriate for the patient's age and face
- No asymmetry during speech/smiling
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Non-Surgical Nose Job: The Limits of Nasal Fillers