LAM FACIAL PLASTICS

When you inject one's lips, do you inject a filler into the actual lip or in the skin slightly above the lip. I have always wondered. I am also wondering that if you do inject your blunt cannula or needle into the lip, would that cause trauma to some lips in your opinion?

have you ever heard of doctors injecting the lips near the gum lines inside the mouth to bring the lip out more to create more shape. I had a nurse do that for me and I am wondering if you do that technique. I am not for that technique due to the gums being exposed and creating friction.

I know you have recreated your website and are stricter on rules, so just to let you know, i did carefully read your disclaimer information and it said that questions are intended for information and educational purposes. I feel my questions are informational so I hope you think they are appropriate questions to ask.

your questions are fine. don't worry. i don't inject deeply into the gum. i don't see a reason for that. i find that if you are going to inject that high up you risk expanding the white lip and not the red lip which can look bad. for lips, i do not use cannulas, i use needles. personally, i hate injecting the white lip (the area 'just outside' the red lip). i also hate very strong borders on lips. that's me. if you don't like my aesthetic, don't seek my services. i rarely bend. people who pick me like my aesthetic. fundamentally, i look at my work as my art.
best,
sml

Thanks Dr. Lam,

I hope this next question is appropriate for you to answer, I just never know. I had my lips injected with a half a syringe top and bottom one month ago. I have spoken to the nurse several times and followed up with her, but she just doesn't know what to tell me. I went to a med-spa for my treatment.
I am seeking a professional opinion and I don't know who else to ask since I have bugged my nurse several times already and she just doesn't know.

My lips still hurt very badly. They are tender to the touch and swell each morning. I have small lesions or some sort of sore that is not discolered at all. My nurse said they are not canker sores or cold sores in my lips. She did inject the gummy part of the lip top and bottom.

In your opinion, what could cause this pain to keep going for a month? I have never had pain in my lips before I had them injected and I wonder if the trauma or technique the nurse used could be why. Also, I am thinking bacteria or germs are making the problem worse or I have infection. Sorry if I am crossing the line with these questions, but it is so a mystery to me and you seem to know a lot about things. Thanks!

honestly, i have no idea. you really need to check with your doc.

Well thanks anyway,

I have asked doctors, nurses, just about everyone and nobody knows. I guess it will be a mystery.

i'm sorry. i don't have any bright ideas. you might seek acupuncture assistance?

Dr. Lam,

I have heard there is a steroid they can inject to dissolve juvederm. I have thought about getting the steroid injected into my lips to dissolve the juvederm. Is it safe to dissolve the juvederm and does it affect the tissue?

you do not want to use steroid. that is a disaster. you are referring instead to vitrase, the brand name for hyaluronidase. and yes, it is very safe for your lip to get rid of the juvederm. it will selectively knock out the juvederm without hurting your lip.

Thanks dr. Lam, I do have a few more questions if you don't mind.

I have heard you speak of the white part of the lip and the red part of the lip. Is the white part referred to as the vermillion border of the lip and is the red part referred to as the mucosa area of the lip.

I think I had injections in the mucosa are of the lip (the body of the top lip) I also had injections in the very bottom area of the top lip where it is a different type of texture then the upper portion of the lip.

Do you do lip injections along the vermillion border and the mucosa area of the lip?

Also, I am thinking of getting it dissolved but I heard that vitrase should not be injected if there is inflamation or infection in the lip because it increase the spread of infections. what are your thoughts on that. i never heard that before. now I am not so sure I should get it dissolved.

I have heard you speak of the white part of the lip and the red part of the lip. Is the white part referred to as the vermillion border of the lip and is the red part referred to as the mucosa area of the lip.

NO. THE VERMILION BORDER DIVIDES THE WHITE AND THE RED LIP. THE WHITE LIP IS THE AREA BETWEEN THE BASE OF THE NOSE AND THE VERMILION BORDER. THE MUCOSA IS THE WET RED LIP. THE OUTER DRY RED LIP IS SEPARATE BETWEEN THE VERMILION BORDER AND THE MUCOSAL BORDER.

I think I had injections in the mucosa are of the lip (the body of the top lip) I also had injections in the very bottom area of the top lip where it is a different type of texture then the upper portion of the lip.

OK.

Do you do lip injections along the vermillion border and the mucosa area of the lip?

NO MUCOSA. NO REASON TO DO THAT. I AM NOT A BIG FAN OF AGGRESSIVE VERMILION BORDER TREATMENTS ALTHOUGH THAT IS WHAT IS IN VOGUE OUT THERE. I LIKE A SOFTER LOOK. THAT IS MY AESTHETIC.

Also, I am thinking of getting it dissolved but I heard that vitrase should not be injected if there is inflamation or infection in the lip because it increase the spread of infections. what are your thoughts on that. i never heard that before. now I am not so sure I should get it dissolved.

I WOULD SAY IF YOUR LIP IS REACTING TO THE JUVEDERM (WHICH IS RARE BUT POSSIBLE) THEN DISSOLVING IS THE ONLY AND BEST OPTION. IF THE PRODUCT IS INFECTED, THEN DISSOLVING IS THE ONLY AND BEST OPTION. OBVIOUSLY, YOU WOULD HAVE TO UNDERSTAND THAT COMMON SENSE IS UNCOMMON. I CAN'T MAKE ANY RECOMMENDATIONS FOR YOU SPECIFICALLY. THESE ARE ONLY BROAD STROKES.

Since I had this done at a spa run by cutsie girls, I want to make sure I am not getting into any more disasters.

I called and asked to have it dissolved and they said they ordered a product. In your opinion, do I need to make sure it is hyaloraonodase (vitrase) or should I trust they are ordering the best product for dissolving the juvederm out of my lips.

My lips hurt but I am not sure they are infected or not. Can vitrase hurt lip tissue or does it just kill the juverderm. My fear is that the vitrase can hurt other tissue, can it or am I just a worrier.

Have you ever had to use vitrase to dissolve a filler before and do you trust it. I Know it is FDA approved but my body is wierder then some.

I can't say who doing what is safe or not. In my opinion, I do Vitrase all the time and it is safe. It does burn quite a bit and hurt so I always do a dental block so it does not hurt. If they are not doctors they probably do not have any knowledge how to do that. If that is the case, just grin and bare it. I cannot sanction another person's work or correction of it. I can only speak of my experience with a product. Anything more falls beyond the scope of this forum.
best,
sml