Distribution Pattern of the Superior and Inferior Labial Arteries: Impact for Safe Upper and Lower Lip Augmentation Procedures

Cotofana, Sebastian; Pretterklieber, Bettina; Lucius, Runhild; Frank, Konstantin; Haas, Maximilian; Schenck, Thilo L.; Gleiser, Corinna; Weyers, Imke; Wedel, Thilo; Pretterklieber, Michael L.

doi:10.1097/prs.0000000000003244

Cited by 74 publications

(37 citation statements)

References 20 publications

(22 reference statements)

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“…The vascular patterns in the skin of the upper lip (intermediate skin zone between the nose and the upper vermilion border) and lower lip (skin zone just beneath the lower vermilion border) have been studied ultrasonographically [5]. In addition, macroscopic observations of the locations of the arteries throughout the entire lip have also been reported, but those studies focused only on the larger arteries situated deeper in the tissue, not on the superficial blood vessels in the vermilion [6]. Neither of those studies examined the blood vessels in the lip vermilion or the effect of aging on those vessels.…”

Section: Introductionmentioning

confidence: 99%

Age-related changes in the vasculature of the dermis of the upper lip vermilion

Gomi

Imamura

2019

Aging

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Lip redness is unique to humans and creates an important facial impression, but this redness decreases with age. Here, using histological and immunohistological staining of human upper lip vermilion from donors of different ages, we investigated blood vessels in the upper lip dermis and age-dependent histological changes. We found that both total vessel area in the dermis and vessel number in the upper dermis decreased with aging. Moreover, vessel number in the upper dermis correlated positively with development of rete ridges, which flattened with age, despite no significant change in the thickness of the stratified squamous epithelium. These findings suggest that age-related reductions in lip redness result from a decrease of blood vessels, which in turn leads to a flattening of the epithelium caused by the loss of rete ridges. This is the first study to histologically demonstrate age-related reductions in blood vessels in the lip. Our results provide an opportunity for enhancing blood flow/vascularization to improve the aesthetic appearance of the lips in the elderly.

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Section: Introductionmentioning

confidence: 99%

Age-related changes in the vasculature of the dermis of the upper lip vermilion

Gomi

Imamura

2019

Aging

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“…A specific body of evidence for aesthetic medicine practitioners is gradually being accumulated that can help inform them and avoid vascular complications. For example, Cotofana et al [31] performed a comprehensive cadaveric study of the superficial vasculature of the lip that was designed to provide clinicians with a framework for avoiding vascular occlusion. Additionally, a practitioner's years of experience appear to correlate with the lifetime risk of performing an inadvertent intravascular injection [32].…”

Section: Discussionmentioning

confidence: 99%

Laser Doppler Imaging for Treating Vascular Complications from Procedures Involving Dermal Fillers: Case Series and Literature Review

et al. 2021

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Vascular occlusion is a rare but severe complication of dermal filler injections. Early treatment of this complication produces better outcomes. Current diagnostic methods for vascular occlusion in the skin are subjective and imprecise; these include capillary refill time, skin color, and reports of pain. This study aimed to assess the use of laser Doppler imaging (LDI) in the evaluation and treatment of vascular complications caused by dermal filler injections. This retrospective study used laser Doppler imaging (LDI) in 13 patients who developed vascular occlusion after facial dermal filler injections, with subsequent follow-up. The precise areas of perfusion observed on LDI were compared with the findings of clinical and photographic evaluation. The results showed that LDI accurately identified areas of vascular occlusion and improved treatment precision among these thirteen patients. The procedure was more precise than visual inspection or photographic evidence. Satisfactory outcomes were achieved for all patients, and no procedure-related complications were reported. Collectively, LDI provides fast, noninvasive, and accurate delineation of areas of vascular occlusion caused by complications of dermal filler injections and avoids several subjective shortcomings of visual and photographic evaluations. Thus, LDI effectively tracks treatment outcomes. However, large-scale studies are required to confirm the present findings.

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“…32 The vasculature of the lips is also highly variable, and the course of the superior and inferior labial arteries within the upper and lower lips is not always submucosal (between the oral mucosa and the orbicularis oris muscle). 36 A study of 193 cadavers reported labial artery position as submucosal in 78.1% of cases, intramuscular in 17.5% of cases, and subcutaneous in 2.1% of cases. The course of the arteries also switched between planes at least once in around a third of the cadavers, with the greatest variability observed in the midline location.…”

Section: Anatomical Considerationsmentioning

confidence: 99%

Consensus on the Use of Hyaluronic Acid Fillers from the Cohesive Polydensified Matrix Range: Best Practice in Specific Facial Indications

Loghem¹,

Sattler²,

Casabona³

et al. 2021

CCID

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Background As the treatment indications for the Cohesive Polydensified Matrix ® hyaluronic acid (CPM-HA) portfolio continue to expand and diversify, injectors new to the range or those who are expanding the treatments they offer may be unsure of the optimal product and injection technique for specific facial areas. Each product in the CPM-HA portfolio has been intentionally designed to provide the best physical properties for a specific indication and target tissue. This document has been developed to provide a comprehensive, one-stop reference for clinicians using the portfolio. Methods An international panel of experts in the field of aesthetic medicine convened to develop guidelines on effective and safe injection technique when performing treatments with the CPM-HA range of soft-tissue fillers. Results Consensus members considered treatment indications in the upper, middle and lower face. Landmark deficiencies and anatomical considerations are described for each indication and consensus recommendations provided on the optimal product, injection depth and treatment technique. This is supplemented by the experts advice on avoidance of complications. Throughout, an evidence-based approach to selection of products and injection techniques is provided. The result is a fully tailored approach to a range of indications covering the full portfolio of CPM-HA products, including the newest addition for skin revitalization. Conclusion The recommendations in this consensus document are provided to assist clinicians in the selection of CPM-HA products, administration techniques and depths of injection with the aim of providing seamless and natural treatment results, enhanced safety and patient satisfaction.

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Distribution Pattern of the Superior and Inferior Labial Arteries: Impact for Safe Upper and Lower Lip Augmentation Procedures

Cited by 74 publications

References 20 publications

Age-related changes in the vasculature of the dermis of the upper lip vermilion

Age-related changes in the vasculature of the dermis of the upper lip vermilion

Laser Doppler Imaging for Treating Vascular Complications from Procedures Involving Dermal Fillers: Case Series and Literature Review

Consensus on the Use of Hyaluronic Acid Fillers from the Cohesive Polydensified Matrix Range: Best Practice in Specific Facial Indications

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