The questions you need to ask before considering lip fillers

Forget the ‘scouse brow’- beauty norms up north have apparently shifted focus to further down the face according to a BBC report released this week. Liverpool is officially the lip filler ‘capital’ of the UK, with Google trends revealing that there are more searches for lip procedures in the ‘Pool than anywhere else in Great Britain.

Aesthetic clinicians in the city detail carrying out up to fifteen lip procedures a day in clinic, with risks including infection, scarring and allergic reactions, not to mention the dreaded duck pout, if procedures are not performed by a qualified, experienced practitioner. A lack of current legislation means that lip filler treatments can be carried out anywhere from a hair salon to someone’s garage, with Save Face , a national register of accredited practitioners, reporting that approximately 83 per cent of lip filler procedures are carried out by non-medics, with reported post filler problems soaring from 378 in 2016 to 931 in 2017. Basically, the Kardashian/ Jenners have a lot to answer for .

If you are going to go there, the bottom line is, as with teeth whitening treatments , never be seduced by discounted deals, offers to tag a bit of lip plumping onto your next dye job or social media promos. Dr Lee Walker, director and clinical lead at BCity clinics in Liverpool, an award-winning aesthetic practice that’s also one of the busiest in the city, explains exactly what to check before you even fathom stepping through the door:

Patients should always ask:

About the experience and qualifications of clinician.

How long the clinician been practicing in aesthetic medicine.

Are the clinicians fully indemnified?

Do they have before and after photographs of their work? (and no, filtered social media shots don’t count)

Can they deal with complications if they occur?

What filler do they use?

Will it hurt? Can I have anaesthetic?

What are the side effects, risks and how likely are they to occur?

Equally, if you get to a clinic (ALWAYS A CLINIC never a cowboy’s spare room), and the following doesn’t come up, grab your coat:

The clinician should:

Discuss desires and expectations of treatment – what is and what is not achievable and limitations of treatment.

Inform on the nature of filler and product used- this is usually a brand of hyaluronic acid filler.

Talk about the amount of filler requested and required to reach the treatment goal.

Discuss the longevity of the filler- this is typically six to nine months.

Clarify and fully explain anaesthesia choice –  none, ice, topical cream, local anaesthetic block.

Make the patient fully aware of possible side effects, which can include bruising, swelling, redness, infection, cold sore reactivation and more serious.

Detail any social downtime involved- will the patient need time off work? What’s the likelihood of bruising and swelling and when this go down?

Be upfront about all costs involved.

The lip filler procedure itself should follow this blueprint:

Pre-treatment photographs are taken.

Application or delivery of anaesthesia ( topical cream or dental injection).

Cleansing of perioral area with skin disinfectant.

Injection of upper lip with chosen dermal filler.

Injection of lower lip with chosen dermal filler.

Gentle massage of lips.

Application of post procedural cream such as arnica.

Written and verbal post-operative instructions.

Assessment of the final result with you in a mirror.

Post- treatment photographs.

In addition, Dr Lee stresses that “you should be provided with a designated contact number should you experience excessive swelling, bruising, pain or discolouration.” In terms of immediate post treatment aftercare, be aware of these guidelines:

“It’s normal for swelling to occur which will usually settle after two to four days. Use cold packs, ibuprofen and antihistamines to manage swelling if required. It is wise to be aware that directly after fillers you can’t apply makeup or lip products for 24 hours. For 48 hours post-treatment, you should not use sunbeds or saunas, drink alcohol or exercise.”

As for achieving a natural-looking result, a one-size-fits-all’ lip inflation simply isn’t possible, and referencing Kylie et al won’t deliver a believable outcome (but you knew that already):

“A deep understanding and respect for anatomy, symmetry and facial balance is critical in achieving a natural lip. We, as humans are 3D structures so we cannot look at the patient from just a frontal view or from a photograph. Observing the patient from an oblique angle and side profile gives the clinician a better idea of which lip needs to be projected in order to create harmony and balance between the nose and chin. The use of appropriate amounts and type of filler is also of paramount importance in achieving a natural looking lip.

“The practitioner needs to understand how lips naturally change with age. Trying to create the lips of a 25 year old on a 65 year old patient is not going to look natural, therefore a thoughtful and diligent clinician will ensure that the lips are ‘age appropriate’. Younger patients with full lips usually require definition whereas older patients with thinner lips often require volumisation and definition.

“In terms of all too common lip filler blunderr, too much filler in the vermillion border area (lip line) obliterates the shape of the ‘cupids bow’ leading to a ‘sausage’ like lip devoid of any natural anatomical features, while filler placed too deep in the lip can lead to the skin above the lip looking over inflated.”

If you really are still tempted to take to the needle, stay safe and consult Save Face to find a regulated practitioner. Plumper lips aren’t worth the potential pain, expense and permanent damage of mistaking the real deal for a rogue operator.

Tight leggings and spin classes are apparently increasing demand for vagina surgery. We say on yer bike…