Lip Augmentation with Lip Codes.
by Dr Keith
Treatment ‘Lip Codes’ are a sequence of numbers and letters that accurately represents how and where filler was placed by the cosmetic injector.
There are millions of possible lip codes or ways to perform lip augmentation.
Background
Lip augmentation is performed by many different practitioners with varying backgrounds, experience and training. Techniques for augmentation also varies widely, for example the cannula technique may have only 2 entry points compared to the Lip tenting technique (4) with 40-45 needle entries.
Accurately recording the technique used, quantity of product, and where it was placed enables reproducibility of results and avoidance of undesirable results. It also enables a common language among colleagues for teaching and continuity of care.
Previous lip classification systems by Gordon 2007(1) and Jacono 2008(2) were reviewed and considered but we believe the ‘Lip Code’ system
better represents the modern day injecting techniques and placements. Studies(3) show 98% of current injecting techniques can be recorded accurately with the ‘Lip Code’ system.
How to use
The upper right side of the lip is divided into 9 segments and numbered from 1-9. As symmetry is desirable the upper left side of the lip is filled the same. The lower lip is also divided into 9 segments on each side. Numbering always starts at the corners of the mouth as this is where most injectors start. (3) For each segment the border is numbered first followed by the body then the wet-line area of lip.
The amount of product used to fill each segment is recorded on a scale of 0-3 with zero = no fill, 1= mild fill, 2= moderate fill and 3= maximum fill.
Next any other areas outside the red lip are recorded using the same 0-3 scale of fill e.g. Ph 2 = moderate fill of the philtral columns and C3= maximum fill of the Commissures. Other techniques are also recorded. Struts (S) are a column of product used to evert the lip. e.g. S6 on upper lip = 6 Struts (3 on Right upper lip and 3 on Left upper lip). If an odd number of struts are used it implies a strut in the centre of the lip. MicroStruts (mS) are small, short columns of product as used in the Lip Tenting technique (4). Eg mS 18 on the upper lip= 18 micro struts were used on upper lip.
Muscle relaxant use is recorded on upper lip eg. Dys 3uX4 = 3 units of muscle relaxant on 4 locations on upper lip.
Other uses
Lip Codes can also be used to record the baseline lip volume. Combinations that work can be noted. Example- In the lower lip a maximum fill of the Segment 5 with no fill of Segment 8 gives the desirable central depression appearance of the lower lip. Treatment lip codes that result in the daffy duck or trout pout appearance can be identified and avoided.
