FINAL PROGRAM 6TH EDITION - EuroMediCom

FAT GRAFTING OF THE LIPS: WHAT TO DO ? WHAT TO AVOID ?GREFFE GRAISSEUSE DES LÈVRES: QUE FAIRE ? CE QU’IL FAUT ÉVITER ?ANTOINE PARASKEVAS (FRANCE)FAHD BENSLIMANE (MOROCCO)Fat grafting of the lips, when properly planned and performed, can have excellent and very long lasting results.An attractive upper lip has a well defined white roll and philtral columns, under these filtral columns there is a well developed centralfullness. Medially to each commissure there is an other fullness but which is significantly less protuberant than the central one.In the lower lip, the white roll is less developed than in the upper lip and the anatomy of an attractive lower lip follows the shape of theupper lip in a " reverse " pattern: in the center there is a depression (opposite to the central upper lip fullness), bordered on either sideby tubercles significantly larger than the central protuberance of the upper lip.The amount of vermilion visible on the lower lip is much greater than in the upper lip.The goal of lip augmentation is to " flip out " the vermilion to create attractive and full lips, while placing the least fat volume possible.To achieve that, almost all of the grafted fat should be infiltrated superficially, immediately deep to the mucsa. Placement opposite tothe teeth provoques a" push " of the teeth to the mucosa that leads to the desired eversion.Placement into the orbicularis oris muscle should be avoided because it makes the lip thicker and prevents eversion, creating anartificial look. Also, fat should not be placed deep to cutaneous portion of the lip for the same reason.The volumes used to enhance the white roll are about 1cc, for the body of the upper lip 2 to 4 cc and in the body of the lower lip 3 to8 cc are generally needed.We use the technique of "micro fat grafting" with infiltration cannulas less than 1mm in diameter. This allows better take of the fatgrafts with less irregularitiesAESTHETIC DERMATOLOGY & SURGERYLIPS ENHANCEMENT: HOW TO ACHIEVE A NATURAL LOOK?EMBELLISSEMENT DES LÈVRES : COMMENT OBTENIR UN ASPECT NATURELMARK LUPIN(CANADA)PERMALIP ® :A NEW METHOD FOR LIPS ENHANCEMENTPERMALIP ® : UNE NOUVELLE MÉTHODE D’EMBELLISSEMENT DES LÈVRESSERGE LETESSIER(FRANCE)Multiple procedures have been already tried for lips enhancement with satisfactory results but also sometime impredictible reactionsgoing from disappointment with injection of biodegradable products to inesthetic or ugly aspect with non resorbable products.PERMALIP is a soft solid silicone implant giving a permanent and natural esthetic aspect.The procedure under local anesthesia is easy and safe and do not require repeated treatments.Complications are possible but extremely rare.PERMALIP is approved by USA FDA and is fully CE marked.We will discuss the best indications and compare with other techniques of lips enhancement.THE AGING LIPS: A PHOTOMORPHOMETRIC AND MRI BASED STUDYLES LÈVRES VIEILLISSSANTES : UNE ÉTUDE PHOTOMORPHOMÉTRIQUE BASÉE SUR L’IRMNIKLAS IBLHER(GERMANY)Introduction: A lack of scientific data about the complex three dimensional changes is the reason for the multitude of rejuvenationapproaches to the aging upper lip. In recent years rejuvenation approaches to the upper lip mainly focused on volume substitution ofpostulated volume loss by injecting various filler materials. Although regaining (temporary) volume the hereby treated lips often acquirea certain "blown up look", suggesting that this approach is not the single right answer. In this study we scientifically investigate thecomplex three dimensional changes to the aging upper lip for the first time.Methods: To achieve reliable results we performed a study with different approaches. In the first part 182 standardized subjectphotographs proportions of the upper lip were measured, compared to facial dimensions and correlated to age. In the second partthree dimensional measurements of the upper lip complex were performed on cranial MRI scans of 30 women aged 20-35 years and30 women aged 65-80.Results: Photomorphometric data shows a significant lenghtening of the upper lip and the upper lip skin with decrease of visible lipred. This is confirmed by MRI scans which prove a redistribution of the volume. The thickness at various levels of the upper lipdecreases while the length increases. Remarkably, the volume showed no changes in the two age groups. The nasolabial angledecreased with age easily explained by the well known phenomenon of ptosis of the nose. The angle between the upper lip and thevertical did not show any changes.Conclusion: Our results demonstrate that the aging process of the upper lip consist of a redistribution of the same volume fromthickness to length, but not an absolute volume loss. This can be explained by the loss of elasticity and following ptosis of the upperlip tissues. Consequently rejuvenation techniques which address the lengthening and ptosis of the upper lip might lead to a morenatural rejuvenation result. Volume augmentation as a sole approach might not address the important changes in the aging upper lip.49