Proposed Guide to Lip Treatment in Caucasian Women Using Objective and Measurable Parameters

Abstract Background The lips are a focal point of the face; however, their aesthetic proportions and effect on perceived facial beauty remain poorly defined. Perioral aging is highly individual, with several distinct and often simultaneous processes contributing to changes in lip contour and surface. These processes can affect lip volume and length, shape, and the degree of vermilion inversion. Objectives We aimed to develop a treatment guide for Caucasian women that combined a complete analysis of the lips (including the effects of aging) with consideration of the rheological characteristics of the products used to assist practitioners in tailoring rejuvenation treatment to individual patients. Methods We reviewed existing literature to analyze the parameters that make the lips of Caucasian women “attractive” and investigated the rheological characteristics of different hyaluronic fillers to provide guidance on the optimal treatment for each woman. Results Our numerical definition of the lips is based on 4 specific parameters: philtrum height, upper vermillion height, ratio between philtrum and upper vermillion height, and golden ratio between upper and lower vermillion height. In our opinion, conserving the length of hyaluronic acid chains results in dynamic fillers that may provide better results with lower risk of asymmetry compared with conventional products. Conclusions This new classification and associated treatment guideline aims to allow accurate assessment and enable practitioners to customize treatment for individual patients.