This document provides information on lip augmentation using the Teosyal pen. It begins with an introduction to the speaker's qualifications and objectives of the presentation. It then covers anatomy of the lips, how lips age, factors to consider for lip augmentation, and techniques for injection. The main technique discussed is using the Teosyal pen, which offers precise, homogeneous delivery of hyaluronic acid filler for lip augmentation in a minimally invasive manner. Key advantages include less pain on injection and quicker recovery time compared to manual injection techniques.

1. Lip Augmentation using the
Teosyal pen
Dr Lee Walker BDS MFDS RCPSG
MJDF RCS Eng

2. • Clinical director B city clinics Liverpool
• Founder and lead NAPG
• Expert advisory panel member- Save Face
• Clinical lead Formosa Aesthetics training
• National trainer Teoxane UK
• Medical education steering group member Teoxane
UK
• Panel expert – ACE complications group
• Clinical contributor – Aesthetics magazine
• Course co-director and senior lecturer EDMI NASI
Msc course

3. Objectives
• To have a practical, interactive session
• To take away something useful that can be applied to
your daily practice
• Understand anatomy and ageing of the lip
• To learn a new technique to safely and predictably
augment the lips

4. Lecture Content
• Introduction
• History of lip treatments
• Anatomy of the lips
• Ageing of the lips
• Lip enhancement assessment and
considerations
• Lip enhancement with Teosyal pen

5. Introduction
• Key to achieving attractive lips is strongly
related to understanding and respecting
anatomy
• Knowledge of ageing process essential in
appreciating what we need to focus on to
achieve more youthful lips
• Identifying key components affected by
ageing

6. History of lip beautification

7. Subjectivity of Beauty

8. Introduction
• Age, fashion, personal preference and cultural
differences significantly dictate what patients
desire
• Lips are an essential component of a beautiful
face as well as contributing functional roles in
communication, speech, expression and intake
of fluids and food

9. Lip Function
• Provide masticatory competence
• Maintain oral seal
• Indicator of general health ?
• Soft tissue boundary for dentition
• Tactile sensory organ
• Speech articulation and phonetics
• Facial expression
• Erogenous zone - kissing

10. Lip Anatomy

11. Classification of 15 Anatomical Lip Zones for Injection During Lip Augmentationa
Figure Legend:
Lip Anatomy

12. Sensory Nerve Supply
• Trigeminal nerve – v cranial nerve
• Maxillary and mandibular branches

13. Common Labial Artery Pattern

14. Injection anatomy

15. Injection anatomy

16. Injection anatomy

17. Injection anatomy

18. © 2014 The American Society for Aesthetic Plastic Surgery, Inc.
From: Complications of Injectable Fillers, Part 2: Vascular Complications
Cadaver cross section through central third of lower lip. Note large size and superficial location of labial artery (arrow). Note
proximity of the artery to buccal mucosa, posterior to the wet-dry line of the lower lip. This area is commonly injected when
trying to evert the red lip during augmentation with hyaluronic acid fillers.
Figure Legend:
Aesthet Surg J. 2014;34(4):584-600. doi:10.1177/1090820X14525035

19. Depth of ILA
Distance of ILA from the ORAL VESTIBULE
4.7 mm
Distance of ILA from the SKIN 2.3 mm
Distance of ILA from the ORAL MUCOSA
1.5 mm

20. Lip Anatomy

21. Position of Superior Labial Artery

22. Depth of SLA
Distance of SLA from the inferior border of the
red lip* 6.7 mm
Distance of SLA from the anterior border of the
red lip* 7.6 mm
Distance of SLA from the posterior border of
the red lip* 3.2 mm

23. Position of Labial Arteries

24. Analysis of youthful and ageing lips

25. Clinical Analysis Of Young Lips
• Smooth mucosa
• Defined cupids bow
• Median tubercule with bilateral depressions
• Corresponding small projections in lower lip
• Small depression in lower lip opposite median
tubercule of upper
• Defined philtrum columns

26. The tubercles of the upper and lower lips
are natural areas of prominence that should
be enhanced during lip augmentation.

27. Youthful lip

28. Clinical Analysis Of Young Lips
• In profile – short white lip with concavity
• Upper lip projection further than lower

29. Glogau-Klein Point

30. Injection Techniques

31. Injection Techniques

32. The Ageing Lip

33. Comparison of MRT images of typical ‘young’ (left) and typical ‘old’ (right) upper lip.
Journal of Plastic, Reconstructive & Aesthetic Surgery, Volume 61, Issue 10, 2008, 1170–1176

34. The Ageing Lip
• Loss of fullness and projection
• Development of rhytids
• Reduction in vermillion border
• Flattening of cupids bow
• Flattening of philtrum columns
• Lengthening of cutaneous upper lip

35. The Ageing Lip
• Genetics
• Sun exposure
• Smoking
• Thinning of musculature
• Atrophy of subcutaneous fat
• Dentoalveolar
• Ligamentous laxity
• Increase in skin laxity

36. Lip Dimensions
• Ideal lip proportions 1:1.618 = roughly translates to 40% upper 60% lower lip

37. Lip Dimensions

38. Lip Dimensions

39. Lip Dimensions

40. Lip Dimensions

41. Lip Dimensions – (Popenko 2011)

42. Lip Dimensions

43. FACIAL ATTRACTIVENESS IS HIGHEST
WITH AN AVERAGE +53%
ENHANCEMENT OF LIP SA.
Lip Dimensions

44. Injection Techniques

45. Patient Assessment
• Discuss desires and expectation
• Inform on nature of filler and product used
• Discuss longevity of filler
• Possible side effects
• Social downtime
• Costs
• Anaesthesia choice

46. Patient Assessment
• Asymmetry
• Scar tissue
• Lumps or nodules
• Discolouration
• Discrepancy in size pre operative
• History of previous treatments
• Document with photography
• Informed consent signed

47. Lip Augmentation
• Understand client expectations
• Take before photos and have consent form
signed
• Shape of lips – check for asymmetry (front
view and profile)
• Peri-oral ageing Rhytids
• Volume loss - perioral
• Flattening of columella area

48. Lip Augmentation
• Architecture of Cupid’s bow and philtrum
• Ratio of upper and lower lip (1:1.6)
• Integrity of vermilion border and lip
pigmentation
• Decide on volumes before starting Swelling
and bruising may alter appearance once
injecting has begun

49. Shape
The shape influences the final result and
cannot be drastically altered without
looking unnatural.
Proportion
The upper: lower lip ratio should be close
to 40:60 and never greater than 50:50
Lip Augmentation- key considerations

50. Volume
Lip volume must be appropriate to the age of
the rest of the face and the size of the eyes,
cheeks and jawline.
Symmetry and feature enhancement
Full philtral columns , a Cupid’s bow that is sharp
and well defined. Symmetry is also important to the
overall lip shape as is the presence or appearance
of the Glogau-Klein point, and a defined vermilion
border.
Lip Augmentation-key considerations

51. Lip Augmentation-key considerations
• There is no single prescription for the
“perfect lip”
• No “one size fits all” technique
• Basic template to achieve a fuller but more
“natural look”
• Can combine with neurotoxins and laser
• Results depend on pre-existing anatomy
and experience and skills of injector

52. Teosyal Pen

53. Teosyal pen
• Worlds first motorized and cordless delivery of
HA
• Lightweight, ergonomic
• Homogeneity and smooth filler delivery
• Offers precision in delicate areas where
natural results critical
• Ease of use

54. Teosyal Pen

55. Teosyal Pen

56. Teosyal Pen
TEOXANE-MAIN CLINICAL FINDINGS
• Less painful injection compared to manual injection
• Quicker recovery time
• Less product used
• Homogenous delivery
• Precise dosage
• High patient satisfaction
• Lower extrusion forces on delivery

57. Teosyal Pen
ADVANTAGES
• Less painful injection compared to manual injection
• smoother delivery
• Precise dosage
• High patient satisfaction
• Aesthetically, looks less intimidating than manual syringe
• Portable

58. Teosyal Pen
DISADVANTAGES
• More expensive than manual syringes
• Patient unease at electronic sound on
injection

59. Injection with Teosyal pen