Lip Lifting Efficacy of Hyaluronic Acid Filler Injections: A Quantitative Assessment Using 3-Dimensional Photography

AI-Driven Assessment of Lip Volume Improvement Using Hyaluronic Acid Fillers: A Comprehensive Analysis

BACKGROUND

The lips are a popular area for filler treatments across all age groups. Existing evaluations of lip volume enhancement often rely on subjective, visual assessments, and fail to account for the overall facial balance and esthetic changes. To address this, this study uses various AI models for a comprehensive analysis to better evaluate the effects of lip enhancement and provide insights for patient-specific treatment plans.

METHODS

This study involved 31 participants (29 females, 2 males), all of whom received lip HA filler injections. Pre- and post-treatment facial images were captured in a relaxed state, and these images were processed using AI-based tools to record and analyze facial visual analysis, perceived age, and emotional expressions displayed on the face.

RESULTS

Post-treatment, the facial visualization analysis revealed that as lip volume increased, the lip line became more defined and the natural curve of the lips became more balanced. The MiVOLO model demonstrated high age estimation accuracy (MAE: 5.15; ICC:0.866; Pearson's r: 0.875), with a mean apparent age reduction of - 1.63 ± 2.51 years (95% CI = -2.78 to - 0.49, Cohen's d = -0.65), emotion analysis revealed a significant increase in neutral expression (72.97-83.44%, 95% CI = 3.38 to 17.56, Cohen's d = 0.58) and reductions in anger (10.25-5.84%, 95% CI = -8.53 to - 2.28, Cohen's d = -0.42).

CONCLUSIONS

This study provides significant insights by showing that lip volume improvement affects not only external changes but also emotional expression, age perception, and social interaction. This approach presents a new solution in the field of cosmetic surgery and will contribute to improving patient satisfaction through personalized treatments and multifaceted effect analysis.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Anatomical-Based Diagnosis and Filler Injection Techniques: Lips and Philtrum

Lip augmentation has become increasingly popular in aesthetic medicine, driven by advancements in dermal filler technologies and injection techniques. This review provides a comprehensive overview of lip anatomy, age-related changes, and current best practices in lip augmentation using dermal fillers. The complex structure of the lips, including multiple layers of skin, muscle, and mucosa, contributes to their unique appearance and function. Age-related changes, such as volume loss, thinning of the vermilion border, and flattening of the philtrum, significantly impact lip aesthetics. Understanding these changes is crucial for developing effective treatment strategies. The review discusses the importance of tailoring treatments to individual patient needs, considering factors such as ethnic variations in lip structure and cultural preferences. It emphasizes the significance of proper filler selection, with hyaluronic acid-based products being the gold standard due to their biocompatibility and reversibility. Injection techniques, including needle and cannula approaches, are described in detail, with a focus on safety and optimal aesthetic outcomes. Anatomical considerations, particularly the vascular supply to the lips, are highlighted as critical for avoiding complications during filler injections. The review also addresses the evolving approach to lip augmentation, which now focuses on restoring natural contours and addressing age-related changes in the perioral region rather than simply increasing volume. Finally, the importance of managing patient expectations and the potential for future advancements in the field are discussed, including the development of more targeted filler products and refined injection techniques.

The Tri-Lift suspension technique: a modified deep-plane lip lift for enhanced aesthetic outcomes-my personal approach

BACKGROUND

The subnasal lip lift has emerged as a popular intervention for correcting an elongated upper lip, although postoperative scarring remains a topic of concern. Various techniques have been discussed in the literature, with the Tri-Lift suspension technique highlighted in this study offering to reduce such complications and to assess the impact of modification in the deep plane subnasal lip lift, which includes triple suspension sutures, on nasal and labial aesthetic parameters.

RESULTS

A total of 193 female patients (mean age: 28 years) underwent the Tri-Lift suspension technique, while 50 female patients (mean age: 32.48 years) underwent the traditional lip lift (bullhorn technique). In the Tri-Lift group, 78.7% reported "very much improvement," 20.2% "much improvement," and 1% "no change," compared to 43% "very much improvement," 28.6% "much improvement," 21.4% "improved," and 7% "no change" in the traditional lip lift group. Quantitative measurements of philtral length, vermilion height, and dental show recorded preoperatively and 6 months postoperatively showed significant improvements in both groups. However, the Tri-Lift suspension technique achieved higher satisfaction rates, fewer adverse outcomes, and statistically significant differences in satisfaction levels (P < 0.05) compared with the traditional lip lift.

CONCLUSIONS

The Tri-Lift suspension technique offers a solution to the common issue of scarring in subnasal lip lifts, enhancing both nasal and lip aesthetics. It presents a promising alternative to the traditional method, providing higher patient satisfaction and better aesthetic outcomes with reduced scarring.

From Nasolabial Folds to Pan-facial Rejuvenation-The Evolution of Fillers in my Career

This is a comprehensive review of facial fillers including landmark studies and expert commentary spanning the years from 2003 (when the first hyaluronic acid [HA] dermal filler underwent Food and Drug Administration approval in United States) to present.

Three-Dimensional Photography for Evaluating the Effectiveness of Botulinum Toxin Injection for Masseter Hypertrophy

BACKGROUND

Masseter hypertrophy is a common condition that causes a undesirable square face, and often treated with botulinum toxin type A (BoNTA). Subjective assessments of BoNTA effectiveness vary from physician to patient, necessitating an objective approach for evaluation. This study introduces three-dimensional photography (3DP) for the first time in clinical assessment to evaluate BoNTA treatment for masseter hypertrophy.

METHODS

Ten patients received 36U of BoNTA at three injection points on each side masseter muscle. 3DP scanner using Artec Eva® was taken at the first, third, and sixth postoperative months for objective evaluation. Patient's self-perceived prominence, patients self-rated satisfaction, and physicians provided 5-grade scores were the subjective indicators.

RESULTS

A significant decrease in left masseter volume at the sixth month (P = 0.002, P = 0.004 at rest and clenching, respectively) was observed. Patient's self-perceived prominence decreased at the first (P = 0.021) and third (P = 0.039) months. Physicians' scores significantly decreased at all postoperative months. No significant changes were noted in the right masseter volume and patients self-rated satisfaction. Patient self-rated satisfaction did not consistently correlate with objective measures, except for left masseter with clenching at the sixth month.

CONCLUSION

Three-dimensional photography accurately quantifies facial changes post-BoNTA treatment. Despite objective improvements, patient satisfaction may not align consistently. Reliable assessment tools are crucial in cosmetic surgery to manage expectations and prevent disputes.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Using the depth deviation based on three-dimensional images to evaluate the correction of nasolabial folds: A prospective and quantitative analysis

BACKGROUND AND OBJECTIVE

The deepening of the nasolabial fold (NLF) is a common occurrence during the aging process, necessitating the development of an objective method to evaluate changes in NLFs. The objective of our study was to introduce a method of depth deviation based on three-dimensional (3D) image for evaluating the efficacy of hyaluronic acid (HA) injection in correcting NLFs.

METHODS

Between May 2019 and November 2019, we recruited 56 Chinese volunteers with moderate to severe NLFs for this study. The participants received HA injections and were followed up for a period of 12 months. Pre and posttreatment, we collected the Wrinkle Severity Rating Scale (WSRS) scores and 3D images. To assess the efficacy of NLF correction, we used the maximum value of depth deviation (MVD) based on 3D images and the Global Aesthetic Improvement Scale (GAIS) score. Additionally, we compared the relationship between MVD and other clinical parameters.

RESULTS

Fifty-four female participants completed the study and were included in the analysis. The HA injection resulted in a significant decrease in NLF severity (p < 0.05). One month after the injection, the average GAIS score was 4.72 ± 0.45, and the average MVD was 2.10 ± 0.56 mm. Both the GAIS score and the average MVD exhibited a decline over time during the follow-up period, with the average MVD showing a significant correlation with the GAIS score at all time points (p < 0.05).

CONCLUSIONS

Using 3D technology, we demonstrated that the quantitative data provided by MVD can serve as an objective method for evaluating the correction of NLFs.

Hyaluronic Acid-Extraction Methods, Sources and Applications

In this review, a compilation of articles in databases on the extraction methods and applications of hyaluronic acid (HA) was carried out. HA is a highly hydrated component of different tissues, including connective, epithelial, and neural. It is an anionic, linear glycosaminoglycan (GAG) primarily found in the native extracellular matrix (ECM) of soft connective tissues. Included in the review were studies on the extraction methods (chemical, enzymatical, combined) of HA, describing advantages and disadvantages as well as news methods of extraction. The applications of HA in food are addressed, including oral supplementation, biomaterials, medical research, and pharmaceutical and cosmetic industry applications. Subsequently, we included a section related to the structure and penetration routes of the skin, with emphasis on the benefits of systems for transdermal drug delivery nanocarriers as promoters of percutaneous absorption. Finally, the future trends on the applications of HA were included. This final section contains the effects before, during, and after the application of HA-based products.

Different Techniques and Quantitative Measurements in Upper lip lift: A Systematic Review

BACKGROUND

The upper lip area is an important component of facial aesthetics, and aging produces an increase in the vertical height of the upper lip. Different upper lip lifting techniques are described in the literature.

OBJECTIVES

This systematic review aimed to assess both invasive and noninvasive upper lip lifting techniques with patient satisfaction, adverse effects, and quantitative measurements of lifting efficiency.

METHODS

This study was conducted per PRISMA guidelines. MEDLINE (via PubMed), EMBASE (OvidSP), and Cochrane Library database were searched from September 14, 2022, to October 12, 2022. Inclusion criteria were reporting on upper lip lift efficiency with quantitative measurements of the lifting degree.

RESULTS

Out of 495 studies through the search strategy, nine articles were included in the systematic review, eight for surgical procedures and one for nonsurgical. Surgical procedures seem to have better longevity than nonsurgical techniques. Reported patient satisfaction for both surgical and nonsurgical treatments was good with no severe complaints. The quantitative measures differ between researches and may be classified into two metrics: anatomy ratio computation using photographic analysis or direct height measurement with a caliper and precise parameters utilizing a three-dimensional method.

CONCLUSION

In general, surgical therapies seem to have a longer-lasting lifting effect on upper lip lifts with an inevitable scar, while nonsurgical techniques are minimally invasive but temporary. There was a lack of consistency in the measurements used to assess lifting efficiency. A consistent quantitative assessment can be beneficial for both clinical decision-making and high-level evidence research.

LEVEL OF EVIDENCE III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .