On achieving lower facial optimization This patient displays typical age-appropriate changes in lips: maxillary retrusion leading to lack of bony support, elongation of upper lip unit, loss of philtral definition, architectural changes (loss of fascia/ligamentous support), deflation of the vermillion, as well as dynamic peri-oral rhytids. I typically have patients animate and evaluate them while talking. I also evaluate their lip tooth ratio while in repose and while smiling. I evaluate the chin and mentalis muscle as well as mandibular support. The correct analysis helps me make recommendations for surgical correction versus volumetric enhancement. This patient passed my criteria for volumetric enhancement with filler to restore youthful contours and ratios. This patient received only I cc Revanesse Versa lip filler. I like this filler because it is prehydrated, meaning, less swelling and a softer appearance. I also like RHA2 in lips and Restylane Kysse for my younger patients. If I need more border definition I often go to a Restylane Refyne or Defyne. Sometimes I combine fillers to optimize different rheologic properties. I massage lips and apply moisturizer. Expect bruising and swelling to subside at 5-7 days. More to come on surgical correction or lip lift

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