For me, science is a passion, so I feel lucky to have published several articles, in addition to being an editor and reviewer.
I have always been a big believer of critical thinking. The human mind has extraordinary powers, and the core of our industry is to keep innovating and implanting new ideas into our practice of aesthetic medicine. This progress will eventually reflect on our patients and other colleagues who learn from our experience and ideas.
In terms of lip beautification, lips are everything to females and males. We use our lips in almost every part of our day-to-day lives, we can even convey certain signals and messages with our lips without uttering a word.
When we are speaking about injecting the lips, I previously used needles to provide artistry; however, the side effects included a great deal of bruising, swelling and the risk of vascular occlusion.
This prompted me to make the switch to cannulas. As a result I was able to overcome these side effects, but the outcomes were subtle and natural.
Do not get me wrong, I am not against natural results, but in the Middle East many patients want big, heart shaped lips, which I was not able to provide with just a cannula. I came up with an idea that made absolutely no sense, but I did it anyway: I used a mix of both a cannula and needle in the same patient.
Then one day, as I was training some doctors in an academy here in Egypt, a new idea on how to use a cannula to provide both artistry and safety flashed into my head. One of the doctors I was training agreed to let me try this new technique on her.
The original gold-standard cannula technique involves two entry points, one from the corner of the mouth followed by oblique injections. In my signature technique I modified these entry points to be as follows:
• One entry point right at the Glogau-Klein (GK) point on the right side of the tip of the cupid’s bow
• One entry point right at the GK point on the left side of the tip of cupid’s bow.
• One entry point right at the midline of the lower lip.
This was followed by vertical strut (tenting, fencing posts) and oblique injections; aliquots were injected into lip tubercles if needed. All injections were done in a superficial plane, no injections were performed on the vermillion border nor the wet / dry border.
I used a 22G cannula, which I realize seems big, but this is for extra safety. I also used a high G’ prime (G’) product. While this is not standard practice, this is quite common in the Middle East. Successful treatment is based on how you use the product, amount injected and patient selection.
After we finished the injection, the doctor treated had a WOW! reaction. She had the large, sharply demarcated, curvy lips that she wanted all along with an accentuated cupid’s bow.
Usually, vertical strut injections – sometimes called the “Russian Technique” – are usually accompanied by local spread of the filler or migration to the skin side of the lip which eventually gives a plateau. This is due to a violation of the vermillion border, allowing filler to escape later. With my technique I do not violate the vermillion so the filler will not spread furthermore. And since I do not create many channels through the vermillion border, the filler does not spread.
Whenever I had a patient seeking a “Russian” lip, I would introduce my 3-Point Lips technique. Now, they come seeking my technique specifically! And more recently, I have introduced a bit of a modification for male patients. Instead of 3-points I may do four points – doing two points of entry at the lower lip right at each tubercle – so it looks wider and more masculine.
Now that I have practiced this technique on many patients, using both soft and heavy G’ prime fillers, I am happy to announce my research article on my technique has been published at the PRS Global Open.1
1. Adel, Noury MSc. A New Approach for Lip Filler Injection Using an Inverted Mercedes Benz Sign. Plastic and Reconstructive Surgery - Global Open 9(12):p e3999, December 2021. | DOI: 10.1097/GOX.0000000000003999