Enhancing Lip Augmentation Safety and Aesthetics Through 11-Point Injection Technique and Sonographic Vascular...

Lip augmentation using hyaluronic acid fillers is a popular cosmetic procedure; however, vascular complications remain a concern. The 11-point injection technique (11-PIT), combined with sonographic vascular mapping, enhances safety by guiding precise filler placement while achieving optimal aesthetic outcomes.

A prospective study was conducted on 25 female patients (21-65 y) undergoing lip augmentation with Cleviel Volume hyaluronic acid filler. High-frequency ultrasound (Aplio-i700, Canon Medical Systems) was used to measure the depth of superior and inferior labial arteries at 6 key points before injection. The 11-PIT was performed to enhance specific lip landmarks while minimizing vascular risks. Postprocedure assessments included 3-dimensional imaging for volume changes, sonographic analysis for lip thickness and projection, and Global Aesthetic Improvement Scale surveys at 1, 3, and 6 months.

The mean arterial depth at the midline of the upper and lower lips was 2.54 ± 1.89 and 1.91 ± 1.58 mm, respectively, increasing laterally. Lip volume increased immediately postinjection (0.96 ± 0.24 mL) and gradually declined to 0.58 ± 0.17 mL at 6 months. Upper lip thickness increased from 8.94 ± 1.16 to 10.98 ± 1.03 mm at 1 month before regressing. Lip corner elevation was measured at 1.21 ± 0.35 mm at 1 month. Global Aesthetic Improvement Scale scores remained favorable (3.28 ± 0.75 at 6 mo). No major complications occurred.

The 11-PIT, combined with sonographic vascular mapping, provides a safe and effective approach for lip augmentation. This method minimizes vascular risks, enhances aesthetic outcomes, and offers reproducible results, supporting its adoption for safer lip enhancement procedures.