Among the notable highlights of these voyages was developing a proficiency in the renowned ‘Russian lip’ technique, a skill I honed through experiences garnered in Russia, Ukraine and London, U.K. To my surprise, it became evident that the journey toward achieving the quintessential Russian lip was not confined to a solitary technique, but rather an amalgamation of distinct approaches, each unique to the practitioner.
Upon returning to my practice in Ontario, Canada, I started to gradually integrate the invaluable knowledge I had acquired, culminating in the development of my own distinctive method, which I have branded ‘The Nurse Yara Lip Technique.’ It is crucial to appreciate that this technique, while transformative, is not universally applicable; instead, it can be appropriately tailored to accommodate the specific needs and preferences of each client.
This technique is most advantageous for clients seeking pronounced attributes such as a well-defined cupid’s bow, a meticulously detailed vermilion border, and a heart-shaped lip shape with a flattened lip profile.
In practice, I employ a 30G, one-inch needle in conjunction with a dermal filler possessing a high G-prime. The volume of dermal filler employed varies according to characteristics of the individual client, but generally falls within the range of 0.5 mL to 0.8 mL of product. In a patient with initially voluminous lips, an upward limit of 1.2 mL may be considered, making sure to never exceed this threshold within a single session.
While this technique typically involves two injection points, there is a strict limit of three points per side of the upper lip. The first injection point is strategically placed at the apex of the cupid’s bow, followed by a second injection point positioned approximately 0.5 mm below the first, in a tapered fashion. Should the lip require a third point, it is executed in a corresponding tapered manner beneath the second, thereby preserving the consistent geometric progression essential for the creation of a heart-shaped lip.
Each injection point follows an identical pattern, characterized by the retrograde depositing of the filler product. This is facilitated by a technique resembling ‘tenting’ or the ‘fencing method’ designed to ensure the precise and conservative application of product in a linear fashion. Administered without retraction from the injection site, the retrograde injections maintain a continuous trajectory throughout each point. An overlapping pattern of injection ensures a seamless transition between the points.
Applying downward pressure on the lip tissue while effectively depositing the product in a retrograde fashion constitutes the two fundamental principles of this technique. This pressure is pivotal in creating a lip with enhanced dimension and detail, diverging from traditional techniques focused on volumetric augmentation. Additionally, at the first injection point, positioned at the apex of the cupid’s bow, increased pressure is employed on the plunger of your syringe during retrograde injections to amplify the product’s concentration in this region.
It is imperative to perform injections at a depth that is neither too superficial nor too deep. Adequate needle placement is ascertained when the client experiences minimal discomfort, and the needle remains within the lip tubercule. Furthermore, to confirm the appropriate depth, one may verify the needle’s visibility at the wet-dry border. Notably, no product is introduced at the wet-dry border; instead, a retraction of approximately 0.3 mm is executed, subsequently initiating retrograde injection.
Throughout the injection process, vigilant assessment is maintained by periodically massaging the lip to safeguard the integrity of the capillary refill and prevent the emergence of any irregularities.
Once practitioners have attained proficiency in this technique, the experience is akin to a methodical ‘sawing’ motion during injection.
It is essential to note that the suitability of this technique is based on a meticulous assessment of the client’s lip characteristics prior to treatment. Ideally, the technique is most suitable for clients with no prior filler treatments, freshly dissolved lip fillers, or an absence of pre-existing filler migration.
Compared to conventional techniques, the primary objective of this method is not volumetric augmentation; although some degree of volumization may occur, the central focus is enhancement of the intricacy and dimensions of the lip, and the attainment of the perfect cupid’s bow.
While the primary emphasis has been placed on the upper lip, it is imperative to highlight that only one injection point is employed in the case of the lower lip. This has consistently left a profound impression on nearly every practitioner I have had the privilege of training.
Similar to the upper lip, this singular injection point again utilizes a 30G needle of either the same needle length (one inch) or one slightly longer. The precise site of injection is situated at the center of the vermilion of the lower mucosal lip. Involving the application of downward pressure on the tissue, along with the retrograde linear deposition of the product, this technique culminates in creating the heart-shaped lower lip, mirroring the approach utilized in the upper lip.
A comprehensive understanding of this technique is best acquired through practical observation, as the specific hand movements and strategic pressure points call for visual guidance. Furthermore, it is imperative to recognize that this technique is adaptable and subject to modification according to individual client profiles.
One of the most notable aspects of this technique is its relatively low level of discomfort compared to traditional lip injection methods. Once a practitioner becomes proficient in this technique, it can be executed a relatively quick three minutes or less per treatment. According to patient feedback, eight out of ten individuals have assessed the pain level at a modest 3.5, utilizing a pain scale ranging from 0, signifying minimal discomfort, to 10, representing the most pain they have encountered.
