Should I go for lip filler?

Should I go for lip filler? 


According to trend forecaster Clare Varga, head of WGSN Beauty, the post-Covid-19 period will see a "total beauty reset." She believes that one aspect will be the diverted attention towards areas on display when wearing masks in public


With the lower half of the face covered up, the eyes will take on new significance, with emphasis on the eyes and brows and bold eye looks used to express individuality. Sales of eye make-up have skyrocketed, but with clinics set to open in the coming weeks all while adhering to Covid-secure guidelines – what about tweak-ments?


The post-lockdown look

Dr. Nyla Raja, points out that "the enforced 'detox' has allowed patients to reflect and recognise the benefits of the treatments that truly work and are worth investing in." She believes that it is not necessarily the thought of mask-wearing that is causing her clinics to "receive a marked increase in enquiries for the upper face."


Firstly without regular muscle relaxing treatments (such as Botox), "dynamic and static wrinkles, particularly in the upper face, have become much more prevalent." However, there are other reasons why we might notice changes in the facial structure more after the lockdown. 


Previously, many people supplemented injectables with non-invasive treatments such as collagen-stimulating facials using radiofrequency, which aids in the maintenance of smoother, tighter-looking skin. Furthermore, our unusually warm spring hasn't helped retain results: "We've had increased exposure to UV light, which is well known to cause the degradation of collagen."


Furthermore, as Dr. Raja explains, the natural ageing process is at work, as it always is. "As we age, our facial bones, including our eye sockets, nose, and upper jaw, change. For example, the eye sockets enlarge and the angle of the bones beneath our brows decreases, forming wrinkles in the upper face.”


Her approach is to treat all of this with a combination of non-surgical tweaks, such as advanced ultrasound energy treatments like Ultherapy and injectable skin boosters. "Profhilo and Volite will become favourites to jump-start the skin's collagen production and restore the glow," she says of hyaluronic acid injectables that improve skin condition.


What does this mean for the lip job, the most popular dermal filler procedure in the UK


"Most of my patients seek treatment for themselves rather than for others. It's about how they feel when they look in the mirror rather than how others perceive them." - mask or no mask


"I believe that treating the lip area will remain popularwhether for volume, shape, or fine lines around the mouth." She does, however, add that eye treatments are already extremely popular in her clinics. "I probably treat as many patients for peri-oral treatments as I do for peri-oral treatments"I believe that if people are prioritising, they will choose eyes over lips and then do lips later, but they will not forego them entirely she said."


The big lip dilemma: 

Aside from their popularity, masks pose another issue when it comes to lips: how injectors can work on them safely when a patient isn't wearing a face covering. Dr. Esho, tknown as "the lip doctor," says it's a serious concern.


"Lips are definitely one of the more high-risk areas to treat on the face due to the area's extensive blood supply," he says. Infection, bleeding, and tissue necrosis are risks, but "in a Covid-19 world, they pose an additional risk of virus transmission through the air between patient and injector." Despite the presence of PPE, he believes that this is a major concern for many.


The risk is reduced when treating the upper face because the patient can still effectively wear their mask while having Botox and filler injections given anywhere higher than the nose. As a result, he anticipates that these will be the first injectable procedures to return when clinics reopen. "However, below this point, the mask comes off, and the risk of virus transmission, despite the injector wearing PPE, is unknown."

With ten years of experience and thousands of lip filler procedures under his belt, Dr. Esho has looked for ways to reduce risk in this treatment while acknowledging that it will never be risk-free, "which should always form part of the consent process."


Virtual lip assessments

As much assessment of the lips and the dynamics of the peri-oral area should be done via video as well as standardised photos prior to an appointment. This will assist practitioners in developing an accurate treatment plan that can be shared with patients.


‘Mask on, mask off’: 

To reduce droplet spread, the mask should be worn by the patient until the point of cleaning and prepping the area. It should then be placed on the patient immediately following the procedure (once they have seen their results). FFP2/FFP3 masks are the best masks for this sitting and should be worn by both the patient and the injector whenever possible.



Because the lips are a high-risk area for infection, cleaning the treatment area prior to Covid was always critical." However, as we learn more about how the virus colonises the nasal and cavity, additional cleaning of these areas with nasal swabs and mouthwash will be required for pre-procedure preparation.



A lip filler procedure can last five to fifteen minutes, so even with PPE, this is a long time for an injector to be close to a patient without social distancing. Reducing droplet spread during this time is critical, and a variety of devices are now being introduced to assist with this. Some clinics use specific filters that patients place in their mouths, while others use suction devices that sit in front of the patient's face during the procedure to promote extraction.


Post-care: Delayed onset reactions

"One of the uncommon but well-known side effects of dermal fillers is a condition known as 'delayed onset nodules.' This is where the body's immune system kicks in, causing the filler to harden and form painful lumps. We don't know what effects Covid could cause in patients with dermal fillers because it's a new virus, but it's critical to make this part of the consent process and follow up with patients not just two weeks after treatment, but further down the line  to collect data and ensure the safety of all patients."


In conclusion, ultimately "these procedures are 'wants,' not 'needs,' and patient and injector safety must always come first." The new risk could mean that the way your cosmetic procedures are performed is simply different, as suggested above, or it could mean that lip fillers are postponed for the foreseeable future.

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