How to Define the Vermillion Border with Filler
Do you know how to define the vermillion border to help your lip filler results pop? Let us help you.
Lip fillers are one of the most popular aesthetics treatments that patients ask for. Knowing how to add definition to this region provides aesthetic practitioners with the expertise to level up their lip filler treatments.
Dr Kalpna Pindolia is Harley Academy’s Director of Clinical Education and an expert in medical aesthetics. We sat down with her to understand:
- What is the vermillion border?
- Why you may want to treat this area
- How to define the vermillion border.
What is the vermillion border?
Dr Kal breaks down the anatomy of the lip, as follows:
“When describing the lip and surrounding region, the pink lip is non-keratinising epithelium, which is known as the vermillion area. The white lip is keratinising epithelium and is the cutaneous lip.
“The cutaneous lip is the space between the bottom of the nose and the top lip.
“The vermillion and cutaneous lip are divided in the dermis by the vermillion border. This is also known as the lip line or lip border.
“A crisp, defined vermillion border is considered beautiful. Many people will use makeup or semi-permanent makeup to highlight and achieve this. Fillers can also be used to define the vermillion border.”
When to define the vermillion border
The requirement of a vermillion border definition isn’t specific to one lip filler patient cohort. As Dr Kal explains, “Younger patients may request a more defined vermillion border.” Equally, you may have older patients asking for this too.
She goes on to highlight, that there are “two characteristics of an ageing lip that may affect the vermillion border. These include reduced vermillion border definition and vertical lines above the top lip, sometimes called smoker's lines or barcode lines.
“Patients may complain that their lipstick 'bleeds' into the line above their lip as a result.”
Understanding your patient’s aesthetic concerns is the first step in treating them. As you assess them during the consultation, you’ll be able to develop a clear understanding of what their treatment plan could be.
Assessing the vermillion border
“On examination, you can assess the vermillion border for its sharpness and definition. Furthermore, you can ask the patient to ‘blow a kiss’ which helps to accentuate the perioral lines,” Dr Kal advises.
She continues, “These factors can help you decide whether vermillion border treatment is appropriate.”
When to treat the vermillion border with fillers
Not every patient will require filler in the vermillion border. Dr Kal notes, “If the vermillion border lacks definition or there are vertical lines that break through the vermillion border, this may be an indication for filler treatment. This is especially true if the patient seeks instant and quick results.”
Alternatives to lip filler to enhance this region
“It's also useful to be aware of alternatives to filler treatment to augment the vermillion border. For example, semi-permanent makeup for lip borders, or a course of microneedling for fine perioral lines,” Dr Kal suggests.
These are conversations you may want to have with your patient during the consultation element of their appointment. Take into account their aesthetic concerns and goals and the best way to achieve them. This could include recommending treatments outside of aesthetic medicine such as semi-permanent makeup. You can consider a longer treatment plan with multiple treatments consisting of skin and injectables if there are numerous concerns.
How to define the vermillion border
When it comes to injecting the vermillion border, Dr Kal recommends, “using a needle with a retrograde thread technique. This offers precise placement of very small amounts of filler just under the vermillion border superficially.”
You can opt for a smaller gauge needle here, such as a 30G, for finer, more targeted filler injecting. This is also a great technique for patients experiencing volume loss due to thin lips or ageing.
She further comments, “The ideal filler needs to be suitable for superficial placement, but also give a crisp localised structure. Softer products will achieve a softer impact.”
Massaging after lip filler
You may opt not to massage filler if you have produced the desired result. Massaging after injecting lip filler can also help to improve your results. This is especially the case if there’s a slight asymmetry after treatment. A robust massage will help you to smooth this out for a more even outcome.
Apply firm pressure while massaging the area, guiding the filler towards where volume is needed. This technique also helps to smooth out lumps and bumps.
Vermillion border considerations when treating different genders
Lip augmentation in male patients seeks to offer a subtle enhancement while maintaining a masculine aesthetic. For female patients, the aim often involves creating volume, definition and symmetry.
The main point of difference when treating male patients is to inject lip filler into the body of the lip in line with the width of the patient’s chin. Furthermore, maintain a straighter and not-so-defined vermillion border.
When it comes to injecting, in-depth knowledge of facial anatomy is also crucial! Understanding this ensures you’re administering filler accurately for the best, most aesthetically pleasing results.
Lip filler is one of the first treatments new aesthetics practitioners learn when starting their injectables training. However, this doesn’t mean it's an easy filler treatment to master.
Creating proportionate, natural-looking results that consider a patient’s anatomy is an art form.
We’ve developed our Perioral & Lip Filler Masterclass to help enhance your injecting skills and improve your cannula confidence. You’ll also receive mentorship from our clinical trainers and treat your own patient.
At Harley Academy, we don’t believe in group injecting where no one completes a patient’s entire treatment cycle. This means you get gold-standard training with a focus on your growth.
How long does vermillion border filler last?
Dr Kal notes, “Many factors can affect how long results last with vermillion border filler. It’s a mobile region of the face. This means the filler will be subject to the physical forces of lip movement, leading to filler breakdown.
“Lips are often neglected when it comes to sun protection too, this can also contribute to filler breakdown. Most lip filler results will last 6-18 months.”
Advise your patients to use - and regularly reapply - lip balm with a high SPF rating as part of their maintenance. It’s a fantastic little entry-level product you could introduce to your practice if you’re looking to sell products!
When defining the vermillion border leads to lip filler migration
As with any aesthetic treatment, there’s always a chance of concerns occurring. Being aware of the common mistakes associated with lip filler can help new and established aesthetic practitioners avoid any missteps.
Dr Kal tells us, “First of all, many patients may not be suitable for vermillion border treatment, for example, when the border is already well structured, why treat?.” You can achieve some definition by adding volume to the body of the lip, instead of the vermillion border, which is trickier to treat and may migrate.
"Novice injectors may be taught to treat the vermillion border as standard and perhaps when it is not necessary - we advise that if there is no issue, there is no need to treat it.
“Use of inappropriate technique or repeating injections in this region traumatises the vermillion border tissue. This can lead to an increased risk of filler movement into the white lip, commonly known as migration.”
What does lip filler migration look like?
Dr Kal shares that lip filler migration may be seen as a ledge above the lip, sometimes referred to as a ‘shelf’. You can see an example of what this can look like, below.
Over-filling the vermillion border
“Adding too much volume to the vermillion border is also a concern and can lead to less natural-looking outcomes," notes Dr Kal.
"The 'less is more' principle is applicable here. If it doesn’t need treatment, it’s best to leave it! Furthermore, avoid treating the area too often, this can help to lessen the chances of migration.”
Consider the Cupid’s bow
When treating the vermillion border, the Cupid’s bow is an area that needs to be considered.
Dr Kal adds, “The Cupid’s bow is where the upper lip comes to two distinct peaks in line with the philtrum columns. There is a dip in between the two peaks. This is generally viewed as an attractive feature.
“Injecting the vermillion border between the two peaks of the Cupid’s bow may inadvertently flatten it, which would be a poor aesthetic outcome. So I advise you to leave the central aspects of the vermillion border alone unless you are very experienced.”
Become a skilled injector with outstanding aesthetics training
Lip filler is among the many treatments you’ll learn to inject with us at Harley Academy. Developing your skills as an injector is crucial to ensure you’re practising safely and effectively. This is our mission when training the next generation of aesthetics practitioners.
Our Level 7 Diploma in Botox & Dermal Fillers is not only JCCP-approved but also Ofqual-regulated. This means you’re getting the gold standard in aesthetic medicine training. Innovated by our Founder and CEO, Dr Tristan Mehta, our Level 7 combines eLearning with in-person training.
You’ll also attend Foundation Training at our City of London campus, Harley Academy Threadneedle Street - a short walk from Bank Station. Here, you’ll see live injecting demonstrations and treat your own patients. All of our training days consist of small groups, for an intimate learning experience, void of distractions.
With specialist direction from our clinical trainers and one-on-one mentorship, you’ll develop the skills to become a safe and competent injector. To find out more about which course suits your career needs, book a call with one of our Course Advisors.
All information correct at the time of publication
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