Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct;21(10):4339-4344.
doi: 10.1111/jocd.15221. Epub 2022 Jul 19.

"Bi-Bi" technique for lip augmentation: A retrospective study on 30 cases

Smarrito Stéphane  1 , Smarrito-Menozzi Candice  1 , Brunel Florence  2
Affiliations

"Bi-Bi" technique for lip augmentation: A retrospective study on 30 cases

Smarrito Stéphane et al. J Cosmet Dermatol. 2022 Oct.

Abstract

Introduction: Lip augmentation is achieved mainly by using hyaluronic acid (HA) fillers. The injection procedures are performed either superficially or deeply with a needle or a cannula, and only one type of hyaluronic acid is used. The authors' objective was to evaluate the feasibility, safety, and satisfaction level of a procedure combining two anatomical injection plans, two injection modes (i.e., cannula and needle), and two types of hyaluronic acid fillers.

Method: The retrospective study included 30 patients who underwent the following procedure: Intramuscular retro-trace injections of Stylage M (Vivacy® Laboratories) were conducted through a 27-gauge cannula at the level of the upper and lower hemi-lip. Then, intradermal injections of Stylage Lips (Vivacy® Laboratories) using a 33-gauge needle were carried out on the entire lip border as well as the cupid's bow. During a post-injection follow-up, subjects were asked to evaluate satisfaction level and the effect of fillers over time. Elastic (G') and viscosity (G″) moduli of HA fillers were measured with a rheometer (AR2000, TA Instruments) prior to and after extrusion through a 33-gauge needle.

Results: Rheological assessment showed that passage through a 33-gauge needle did not alter the viscoelastic properties of HA fillers. After the clinical procedure, no side effects were observed except for standard post-treatment bruises and edema. No vascular incident occurred. Moreover, overall patient satisfaction was high (2.6/3) and there was a long-lasting perception of the effect of the filler.

Conclusion: The current study demonstrated that dissociating the anatomical zones of the lip during the injection procedure by means of different hyaluronic acids in the muscular and dermal planes would efficiently and safely provide both lip projection and fullness for a natural and lasting effect.

Keywords: Stylage; cannula; hyaluronic acid; lips; needle.

PubMed Disclaimer

Conflict of interest statement

Dr Stéphane Smarrito is a conference speaker for Vivacy Laboratories. The authors have explicitly stated that they have not received any specific funding in connection with this article. The authors have received no form of payment whatsoever from Vivacy Laboratories for their participation in this study.

Figures

FIGURE 1
FIGURE 1
First example: before (A) and after (B) photographs of “Bi‐Bi” Lips procedure. Three quarters (A), front (B), and side (C) views
FIGURE 2
FIGURE 2
Second example: before (A) and after (B) photographs of “Bi‐Bi” Lips procedure. Three quarters (A), front (B), and sides (C) views
FIGURE 3
FIGURE 3
Third example: before (A) and after (B)photographs of “Bi‐Bi” Lips procedure. Three quarters (A), front (B), and sides (C) views
FIGURE 4
FIGURE 4
Fourth example: before (A) and after (B) after photographs of “Bi‐Bi” Lips procedure. Three quarters (A), front (B), and side (C) views
See this image and copyright information in PMC

References

    1. Lip Augmentation Market Size, Share & Trends Analysis Report by Type (Temporary, Permanent), By Product (Hyaluronic Acid Fillers, Poly‐L‐Lactic Acid Fillers), By Region, And Segment Forecasts, 2020–2027.
    1. Clymer MA. Evolution in techniques: Lip augmentation. Facial Plast Surg. 2007;23(1):21‐26. doi:10.1055/s-2007-970129 - DOI - PubMed
    1. Sarnoff DS, Saini R, Gotkin RH. Comparison of filling agents for lip augmentation. Aesthet Surg J. 2008;28(5):556‐563. - PubMed
    1. San Miguel Moragas J, Reddy RR, Hernández Alfaro F, Mommaerts MY. Systematic review of "filling" procedures for lip augmentation regarding types of material, outcomes and complications. J Craniomaxillofac Surg. 2015;43(6):883‐906. - PubMed
    1. Mannino GN, Lipner SR. Current concepts in lip augmentation. Cutis. 2016;98(5):325‐329. - PubMed