Bespoke lip augmentation

Step 1—Pearls to perfect the consultation process

For Dr Romanowska, the ideal consultation includes both the emotional side from the patient, finding their 'why' and desires from the treatment, coupled with critical anatomical assessment. This allows her to obtain a result that not only is highly satisfactory but is safe and respects the framework and features of the individual.
For the anatomical assessment of the perioral and surrounding areas, Dr Romanowska starts by assessing the patient with the naked eye, then moves onto ultrasound. This helps her minimise complications, while highlighting how much space there is to work with, to avoid over filling.

Step 2—Matching the patient request with the patient profile

Dr Romanowska categorises the two types of patients she sees: those with thin lips and those who naturally have fuller lips. Both come with their unique challenges with treatment, which much be addressed in the consultation.
For those with thin lips that lack space, Dr Romanowska puts a gradual augmentation plan in place and emphasises the importance of not over injecting, which can easily be done in such cases. She goes as far as to show her patients a series of less than aesthetically pleasing results where filler has migrated above the vermillion boarder and created a 'duck' appearance from being over filled. For Dr Romanowska will enhance lips gradually by spreading out treatments three to six months apart to stretch the mucosa and then build the volume and shape. Explaining this before the treatment commences is essential for managing patient expectations.
The second type of patient that Dr Romanowska meets are those who have full lips naturally, even if some volume has been lost with the ageing process, which usually shows as grooves and wrinkles. With these types of patients, the aim is to balance the proportions and restore the lost volume. Examples of beautification include lifting the Cupid’s Bow, enhancing the lateral sides or building two lobes to create that Angelina Jolie effect—it all comes down to the patient desire and the possibility with their unique anatomy.
With patients who have had previous lip filler where the results are irregular and/or there is migration, it is best to dissolve before you inject any more filler—you want to be
starting with a blank canvas. Dr Romanowska calls this the 'clean up'—more on this in Step 3.

Step 3—Know when it is time to clean

Dr Romanowska is known for a practice which she calls the 'clean up'. This is where she goes in with hyaluronidase to dissolve all the accumulated product, likening it to decluttering your house. She states that as the perioral area is so dynamic, the muscle activity can contribute to filler migration, particularly when they have been overinjected in the past. This is more common in the upper lip, where the space is naturally smaller. In many cases, it is clearly visible to the naked eye that there has been filler migration, but Dr Romanowska will also use her ultrasound machine to see what is beneath the surface.
For minimising filler migration in the first place, Dr Romanowska says the best practice is to avoid over injecting and increasing space first. This takes us back to Step 2, where she discussed her plan to gradually build volume by spreading treatments apart.

Final thoughts from Dr Romanowska

It may come as a surprise, but Dr Romanowska does not have a signature injecting technique. This is because for her, it is interesting to read each pair of lips as a completelynew case, and not give a 'cookie cutter' approach. No two lips are the same—so why should the technique be?
For the product, Dr Romanowska will alternate between the French brand STYLAGE Special Lips and STYLAGE Lips Plus, depending if she wants a softer or more viscous filler respectively. The tool used will also come into play—she will use different sizes of needles to achieve the desired result.
Finally, if you are to take one thing away from Dr Romanowska, it is that over injecting is never the answer—slow and steady wins the race for a beautiful lip enhancement.

Results


STYLAGE is available from Wigmore Medical, to purchase contact Customer Service on 020 7514 0150 or email orders@wigmoremedical.com