A Safe and Effective Lip Augmentation Method: The Step-by-Step Φ (Phi) Technique

Abstract

Background: The shape and fullness of the lips are essential in facial aesthetics. We describe a safe injection technique of hyaluronic acid (HA), based on the well-known golden number Φ (phi), for lip augmentation. Methods: The name given to that procedure is “the step-by-step Φ technique.” Firstly, “step-by-step” because we never inject more than 1–1.5 ml of HA in 1 session, and “phi” because we apply the golden ratio 1.618—broadly known as Φ—to identify the proper points for injection. Using a specific caliper, we identified 3–4 points in each upper half of the lip. We injected 0.01–0.05 ml of lower concentration (25 mg/g) HA in these particular areas of the upper lip, from the vermillion border into the vermillion. We took into consideration the existing lip volume to decide the proper amount of HA to be injected in every single site, as lips are often asymmetric. On the lower lip, we use the same caliper to identify again the proper injection points. If necessary, the next 2 sessions are performed at an interval of 15–30 days. Results: Our technique was performed in 833 patients. Mean age was 30.2 years (range: 18–72 years), and most patients were very satisfied. With this technique, we avoid severe complications such as arterial embolism or venous occlusion and unnatural results. The most common side effects were swelling, redness, and mild pain. Conclusion: The step-by-step Φ technique is safe, easy to learn and perform, and can provide natural results in lip augmentation.

"Bi‐Bi” technique for lip augmentation: A retrospective study on 30 cases

“…Moreover, cannulas are considered safer as they reduce the risk of perforated blood vessels and intra‐arterial injection during the procedure 24,25 . Although 25‐gauge or larger cannulas were first recommended, since then the use of 27‐ and 30‐gauge needles and cannulas has been shown to be efficient and safe for lip enhancement 16,17,26 . In our “Bi‐Bi” Lips procedure, a 27‐gauge cannula was used for the deep intramuscular plane; however, a 25‐gauge cannula can be a safer alternative for less experienced practitioners.…”

“…A “No‐Touch” technique in which the mucosa is never violated during infiltration has been described by Surek et al 16 Moreover, Keramidas et al have recently developed a stepwise Phi technique providing natural results. The procedure applies the golden ratio of 1.618 to identify the proper points for injection 17 . Finally, Trevidic et al have conducted an anatomical study of the “French kiss technique” that could possibly produce a marked natural lip‐plumping effect with a low cohesivity hyaluronic acid filler 18 …”

“…The procedure applies the golden ratio of 1.618 to identify the proper points for injection. 17 Finally, Trevidic et al have conducted an anatomical study of the “French kiss technique” that could possibly produce a marked natural lip‐plumping effect with a low cohesivity hyaluronic acid filler. 18 …”

“…The procedure applies the golden ratio of 1.618 to identify the proper points for injection. 17 study of the "French kiss technique" that could possibly produce a marked natural lip-plumping effect with a low cohesivity hyaluronic acid filler. 18 Lip enhancement can involve creating a more marked lip border and increasing the overall volume.…”

Fillers for aesthetics on the face – Newer perspectives

“…To shape the lips, injection by a retrograde linear threading technique are recommended taking care to avoid the white roll. [21] Another report highlighted the use of a 4 mm, 30 gauge needle for safe lip filler injections. [22] The nasolabial fold is being addressed in multiple layers with fillers as it is a challenging area to treat due to dense fascia with a thin superficial fatty layer on the inside and a thick one outside.…”