Treating the Perioral Area

Aesthetic nurse prescriber Rosey Drewitt-Staples provides her holistic approach to rejuvenating the lips and perioral area

The lips are a popular area to treat, but the perioral area is one of the most complex regions to master and difficult to get right. I regularly treat ageing lips of middle-aged patients, and it’s one of the first areas, together with the mid-face, that patients ask about. Here are many factors to consider such as the down turning of the mouth, loss of volume in the lips, and fine lines in the perioral area can create negative signals, which patients feel makes them look sad. With so many fears surrounding dermal filler treatments, particularly in the lip area due to a lot of unnatural, over-volumised lips, I find that a holistic consultation and treatment is a good approach for optimum results and happy patients.

The holistic consultation and assessment Connecting with your patient with empathy and understanding is key. To do this, learn about their lifestyle, general health, diet and psychosocial wellbeing. As the consultation must involve careful assessment, which often can often feel negative, I always ensure that I balance this out by pointing out their unique beauty and complimenting them on this. Explaining the ageing process is so important and enables the patient to understand your treatment approach – this is never a waste of time and lays foundation for return visits. I explain every level of the ageing process from the skin surface to the bone including dentition. Although a patient might present with perioral concerns, it’s important not to view this area in isolation and conduct a full-face assessment as all the facial landscapes relate to one another. In filler consultations, I begin with the mid-face by assessing the volume, lateral support and how this is impacting the lower face. Look at how they express themselves and how you might need to treat individual layers. The more you can show that you understand your patient, the more trust they feel and know they are in safe hands. Remember, the consultation and assessment is your chance to show yourself as a true leader in aesthetics, so do this thoroughly.

Product selection I’ve always used the Juvéderm portfolio because it’s a brand I trust with an excellent support network. When the Juvéderm Vycross range first launched it demonstrated a coordinated full-face approach. It’s important to match your products to the key facial areas they are indicated for.

Volite: I use this product to hydrate the skin, soften lines and inject into the lip for those who prefer hydration rather than volume. Volbella: for more mature lips adding subtle volume, can form a crisp vermillion boarder and improve perioral lines. It’s also useful for tear troughs! I advise a slow injection to reduce swelling. Volift: I use this for more youthful lips as it’s soft. I also find it helpful for improving lateral support of the mid-face and for nasolabial lines, which helps enhance the look of the perioral area. Voluma: I use this to support the underlying structures. It is a mouldable product and my go-to for temples, mid-face and occasionally the labiomental crease. Volux: for treating the jawline to improve definition, structure and support to the perioral area! You can really profile balance with this in your toolkit.*

60-year-old patient before and immediately after using the full-race approach with 5ml of Juvéderm Voluma to the mid-face, 3ml of Juvéderm Volux to the chin and jawline and 1ml of Juvéderm Ultra to the lips. My top treatment tips Tip 1: If your patient has perioral lines, I suggest you enter the lateral aspect of the lip with a cannula and go back and forth to break collagen fibres (subcise) before placing the filler. I have found that this releases the tissues, activates neocollagenesis and the filler can play a role in dermal cell biochemical response. Tip 2: Remember to have a full-face approach as it’s possible to cause facial disharmony and make patients look worse otherwise! I believe you shouldn’t just treat one area in isolation and explain to the patient why this approach is necessary. Tip 3: Always consider safety – I use a mixture of needle and cannulas and will choose cannulas in higher risk areas like the nasolabial folds and marionette lines. When using a needle, I will always aspirate. Also know the anatomy and how vessel location may slightly differ.

Learn more tips & tricks live at ACE 2022! A thorough consultation and assessment is vital, as is informing and educating your patient to get them on board with your treatment plan. To learn more about my holistic approach, come to my talk on treating the perioral area at ACE 2022 in March (HCPs only). Scan the QR code to register! This talk is produced and sponsored by Allergan Aesthetics.

Rosey Drewitt-Staples has been working in aesthetics for 17 years. She has practised at The Hospital Group, Transform Medical and now has her own clinic, ProAesthetics (Nottingham) and training company, ProAesthetic Courses. Rosey is one of four UK nurses on the esteemed Allergan Faculty. Qual: RGN, HV, INP

This advertorial was produced and funded by Allergan Aesthetics

UK-JUV-220039 DOP: February 2022

*Please see the respective product ‘directions for use’ before administration. The Juvéderm range is only licensed for patients over the age of 18. Please ensure the filler risks, complications and potential side effects as listed in the directions for use have been fully communicated to the patient prior to use.