Superficial injections and a perpendicular approach to the lip may help decrease the risk of vascular occlusion when augmenting lips with soft tissue fillers, say researchers Sebastian Cotofana, MD, et al.
For their study, published in the Aesthetic Surgery Journal (December 2020), the authors enrolled 41 healthy volunteers with a mean age of 26.17 ± 9.6 years and a mean body mass index of 23.09 ± 2.3 kg/m2. They used ultrasound imaging to determine the 3-dimensional pathway of the superior and inferior labial arteries within the lips. Imaging was performed at six different locations to identify the position of the labial arteries within the lips, depth of the arteries, cranio-caudal location of each artery in relation to the vermilion border and diameter of the superior/inferior labial arteries.
They found that the most frequent location of both the superior and inferior labial arteries was the submucosal plane (58.5%) followed by intramuscular (36.2%) and subcutaneous (5.3%) planes. The depth of the superior labial artery in the upper lip was 5.6 ± 0.13 mm. The depth of the inferior labial artery in the lower lip was 5.2 ± 0.14 mm. Both arteries were more frequently located within the red lip: upper lip (83% vs 18.7%) and lower lip (86.2% vs 13.8%). In the midline, the artery coursed within the red lip in all subjects.
As a result of these findings, the authors recommend a superficial injection plane for lip volumization procedures, noting that a perpendicular approach to the lip (coming from the cutaneous lip) might further increase safety as the artery is located most frequently within the red lip.