Lip augmentation with the "flat" method

Almost every patient who sits down in the chair before lip augmentation says one sentence. Sometimes straight away, sometimes only after a moment's hesitation: "Just please, no duck lips".

That fear is understandable. We have all seen lips that arrive half a step ahead of the face. And it was precisely in response to them that the technique called the "flat" method came about.

But before you check whether it is for you — one honest remark. It is not for everyone. You may have lips that need no correction at all. It may be that in your case this method would upset the harmony of your face. See what it really involves, and then decide.

Where did the "duck pout" come from in the first place

Lip augmentation and modeling with hyaluronic acid remains one of the most frequently performed aesthetic medicine treatments. There are several techniques for administering the product, and the doctor selects them individually — to suit the patient's preferences and expectations, but above all the natural shape of the lips, the facial expressions and the proportions of the face.

Because there is simply no single universal shape of lips. Every one of us is different — even identical twins only look like two peas in a pod at first glance. Nature means diversity, and the aim of aesthetic medicine treatments is merely to underline natural beauty subtly.

The "duck lips" effect comes from excessive protrusion of the lip — from the lip growing forward instead of filling out within its natural outline.

What the "flat" method involves

The aim of the treatment is precise modeling with hyaluronic acid of the upper lip and emphasis of the Cupid's bow — but without too much protrusion, that is, without the unfortunate pout that makes lips look unnatural. The lower lip is modeled minimally.

As a result the proportions of the lips change completely. The difference between the upper and the lower lip, which is usually 2:3, is upset in favor of lips that are full and almost perfectly symmetrical.

It is worth knowing which way this change goes. In studies on the attractiveness of lips, the proportions rated highest are those with a clear predominance of the lower lip — the ratio of the upper lip to the lower one is most often given as somewhere around 1:1.6 to 1:2. Aiming for symmetry therefore moves away from that canon and at the same time closer to the model that has appeared most often in social media over the past few years. This is not an argument against the technique — it is an argument for deciding consciously what you want.

Hyaluronic acid is a glycosaminoglycan that binds water, and it is to this that the gel owes the volume and the springiness of a freshly modelled lip. It is worth knowing, though, what a filler does not do: it does not moisturize or revitalize the skin of the lips themselves — separate, moisturizing products administered with a different technique are used for that.

Don't lips done this way look artificial?

A good question, and it deserves an honest answer.

By design this technique is meant to give the most natural effect possible. The line is very fine, though, because perfect proportions do not exist in nature. It takes only a little too much hyaluronic acid to turn full, attractive lips into artificial ones.

So the result depends largely on the skill and judgment of the person performing the treatment. Not on the name of the method.

Needle or microcannula — what is the difference

Every lip augmentation starts the same way: with applying an anesthetic ointment. After that the techniques part ways.

• What the product is administered with — A microcannula — a blunt-tipped needle that glides through the tissue · A needle, in precisely defined places.
• Why exactly this way — It minimizes damage to blood vessels, and therefore the risk of swelling and bruising · It allows precise placement of the product.
• Direction of insertion — Parallel to the vermilion border · Perpendicular to the vermilion border.
• Where the product goes — Modeling of both lips · Above all the upper lip and the Cupid's bow.

That perpendicular direction of injection is in fact the hallmark of the "flat" method. It is what makes the lip fill out in width rather than forward.

Does it hurt?

Each of us feels pain differently and reacts to it differently. In my experience, in most cases the anesthetic ointment relieves the unpleasant sensations sufficiently.

There is a second mechanism on top of that: most lip filler products contain the anesthetic lidocaine. That is why patients usually feel only the first prick of the needle — after that the unpleasant sensations are effectively neutralized by the product being injected.

One thing to mention at the consultation: recurring cold sores. Puncturing the lip can wake a dormant virus and trigger an outbreak within a few days of the treatment. If you get cold sores, tell the doctor — they will suggest antiviral cover. And if you happen to have an active lesion on the lip, we postpone the treatment until it has healed.

What happens after the treatment

A treatment performed with a microcannula is minimally invasive and requires no recovery. A microcannula reduces the risk of bruises and of damage to a vessel, but it does not remove it — the lips are an area with a rich blood supply, which is why the experience of the person performing the treatment and a careful technique matter. You can go back to normal activity right away.

If you have a wedding, a photo session or an important meeting ahead of you, book the treatment at least two weeks in advance. Cool compresses on the first day, sleeping with your head raised and giving up alcohol for a few days will help.

Swelling after a lip treatment is the rule, not the exception — and in itself it is not a sign of a mistake. It is greatest on the first day, clearly smaller after two or three days, and in some patients slight puffiness or an unevenness you can feel stays for another week or two. This is the strongest argument for not having aesthetic medicine treatments in random places.

For the final effect you have to wait two weeks — that is how long the gel needs to bind water and settle into the tissues. During that time drink more fluids and give the sauna and the solarium a miss.

There are a few symptoms with which we do not wait until morning. Pain that, instead of easing, increases and is out of proportion to the treatment. Paling of the skin around the lips, or net-like, marbled redness. A change of colour to bluish. These are possible signs of the product blocking a vessel — a very rare complication, but one that requires immediate action. The good news is that hyaluronic acid has an antidote: the enzyme hyaluronidase, which dissolves it. The outcome depends on how quickly it is given — which is why you always get a contact number from us that you can call.

How long it will last

Hyaluronic acid occurs naturally in the skin, so the body removes it on its own. The results usually last from 6 to 12 months.

Much depends on genetics, diet and lifestyle. The rule is simple: the more stimulants, the less hyaluronic acid.

Finally — one question worth asking yourself

The "flat" method is one of the so-called treatments of the moment. And here comes a question that nobody asks in the office: is it worth being fashionable at any price?

Changing your wardrobe or your hair color every season is one thing. Modifying your own body according to imposed — and short-lived at that — standards is something else entirely.

So at the consultation do not ask: "will you do my lips flat?". Ask: "which technique will be best for my lips and my face?". That is a question the doctor can answer honestly — and it is that question which protects you from the effect you are afraid of.

Instead of insisting on what is fashionable, it is better to choose what is best for you.

You can have the treatment in this technique with us as part of lip augmentation and modeling with hyaluronic acid — the first ampoule costs 1800 zł.

This article was prepared by Aneta Bembenek, MD — ophthalmologist, aesthetic medicine physician.