Lip Injections

Announcer (00:06): This is Behind the Double Doors with Dr. Bob Basu.

Dr. Bob Basu (00:11): I'm Dr. Bob Basu and with me today is our certified master nurse injector, Denae Murphy. Welcome, Denae.

Denae Murphy (00:18): Hello.

Dr. Bob Basu (00:19): And I've asked Denae to talk to us today about fillers for lip injections. This is one of our most popular non-surgical procedures at Basu Aesthetics and Plastic Surgery, and we've all heard about this, both from the reality TV show stars. We've seen, unfortunately, no shortage of bad lip jobs and duck lips walking around, and then we also see results that are also very balanced and beautiful. So I wanted Denae to dive deep on lip enhancement and lip injections. Now, Denae, you've been injecting for close to 14 years now.

Denae Murphy (00:54): Yes.

Dr. Bob Basu (00:54): How did you get into injecting?

Denae Murphy (00:56): Well, I mean, I'm a nurse, I'm a registered nurse. I started in 2003 in pediatrics and then an opportunity rose in 2007 to get into aesthetics. I started with lasers and chemical peels and things like that, and then started to inject with Botox and fillers, and that really became my love. I really enjoy putting the art together with nursing and getting that instant gratification and making people happy.

Dr. Bob Basu (01:24): Now, when you're talking with patients who are interested in making their lips look better, what are some of the usual complaints that those patients have?

Denae Murphy (01:32): Well, a lot of times they think that their lips have deflated or they can see the wrinkles more. And some people just want fuller lips from what they even started with.

Dr. Bob Basu (01:43): You mentioned fillers, for our listeners that don't know what fillers are, what are fillers made of? What is this stuff?

Denae Murphy (01:51): Most fillers are made out of hyaluronic acid. That's a sugar molecule that's naturally produced by your body. It helps to bind water to collagen, to make the area appear more plump. There are some other fillers out there that are made out of different products. There's calcium hydroxyapatite, there's polylactic acid, there's also a polymethyl-methacrylate, but the best fillers and the most common fillers for the lips are hyaluronic acid. So that's going to be your Juvederm products and your Restylane products.

Dr. Bob Basu (02:23): How long can you expect results to last?

Denae Murphy (02:26): Typically about a year.

Dr. Bob Basu (02:29): Now I have to ask you, when we talk about lip fillers, how do we avoid getting those horrible duck lips that I know every listener on this podcast has seen walking around in Houston or your local communities? So how do we avoid duck lips?

Denae Murphy (02:42): I know everyone is really afraid of duck lips. I mean, it doesn't happen all that often, but it's all about technique. If you're injected a little bit too high, you can cause a duck lip, but really it all comes down to technique. And I don't want anyone to walk around looking like a duck.

Dr. Bob Basu (02:59): Okay, very good. Now let's say you have lip injections and a few weeks go by, and you want a little bit more, can you do touch ups?

Denae Murphy (03:07): Yes. Yep, you can do touch-ups. I prefer to wait until the swelling and bruising has gone down, but that's about two weeks. But anytime after that, you can do a touch up.

Dr. Bob Basu (03:16): The other concern that patients have is injections are into the lips, that seems kind of painful. Does it hurt to have fillers put in your lips and how do you make it comfortable and pain-free?

Denae Murphy (03:27): Well, so we use topical numbing. So put a numbing cream on top of the lips and let it sit for a few minutes, and then there's also lidocaine and numbing inside the syringe of filler. So the two together really help, and then we can also do a nerve block or a dental block if needed.

Dr. Bob Basu (03:47): Excellent. So a lot of options to make it pain-free.

Denae Murphy (03:49): Yes.

Dr. Bob Basu (03:51): Let's say that someone's interested in getting a lip filler for the first time, how long should the appointment or the treatment take?

Denae Murphy (03:57): Normally about an hour to an hour and a half, and that's taking into account the numbing.

Dr. Bob Basu (04:03): Okay. You mentioned swelling. There's clearly swelling after the procedure, but how long will the swelling last? And can you go out afterwards and should you lay low for a bit? What's the recovery after a treatment?

Denae Murphy (04:16): Yeah, well, everyone's different. Some people will swell up quite a bit and some people barely noticed that much swelling, but just to stay on the safe side, always tell people to schedule any major events, at least two weeks out just in case they have some bruising and some swelling, it can take up to two weeks to go away.

Dr. Bob Basu (04:35): Now, are there any common side effects we should be aware of?

Denae Murphy (04:39): Well, the most common side effects are definitely swelling and bruising, but there is a potential to have a vascular occlusion, meaning that the filler compresses on the vessel. This can be reversed by hyaluronidase if we're using a hyaluronic acid, which is the Restylane and the Juvederm that I was talking about. That's also a good reason to use a hyaluronic acid because we can go in and dissolve the filler if we need to.

Dr. Bob Basu (05:04): Now, is this common or is it very, very rare?

Denae Murphy (05:06): That's very, very rare.

Dr. Bob Basu (05:08): Extremely rare. And for our listeners, we're talking about vascular occlusion. So lips, just like everywhere on the face, have a lot of different capillaries and blood vessels and if filler is injected into a blood vessel or around it, it can block off the blood supply and that could lead to a vascular occlusion that could create some healing problems on the lips or other areas of the face. And a wonderful thing about the hyaluronic acid products, like Juvederm or the Restylane family of products, is that we have a reversal agent. So should there, in the rare, rare circumstance, something should manifest and we're concerned about it, then we have the medicines in our office to be able to inject it and dissolve the filler to hopefully rectify the situation as quickly as possible. So for someone who's never had lip injections before, what are the three most important things they need to know now?

Denae Murphy (06:00): Avoid blood thinning agents three to five days prior to injections. This includes NSAIDs, like your Aleve, ibuprofen, BC powder, aspirin, also alcohol and fish oils. Also, plan ahead. Try not to treat before a major event. Not right before pictures, right before a wedding. And then the third thing is, most lips look very natural. So take a deep breath, it will be good.

Dr. Bob Basu (06:30): Denae, you've worked in different environments before we were able to recruit you here at Basu Aesthetics and Plastic Surgery, which I'm very excited you're part of the team after, 14 years of experience, you've worked in different aesthetic environments. Tell us how it feels for you to now work in a plastic surgery practice that specializes only in aesthetic surgery and aesthetic medicine.

Denae Murphy (06:53): Yeah, it is definitely different because when patients come in and they have certain concerns that are kind of out of my scope, I can recommend them to you. If someone is really more of a facelift candidate or a tummy tuck, if they're coming in for CoolSculpting, whereas in a med spa situation, you don't have anyone to send that patient to. You're really just going to try to treat them with whatever you have.

Dr. Bob Basu (07:19): And I think that's one of the things that we take pride in, in a comprehensive aesthetic center, is that we recognize that surgery is not right for everyone. There are some very effective non-invasive modalities out there, but being in a comprehensive aesthetic center that's backed up by a board certified plastic surgeon, like myself, we have the power to be honest with our patients and to tell them what we think will work best to achieve their goals, whether that be a non-surgical procedure or a surgical procedure. So we have the full armamentarium of options to provide our patients, not just a one size fits all.

Denae Murphy (07:55): Yes, it gives them a lot more options.

Dr. Bob Basu (07:58): And the wonderful thing about working with Denae is that we work together and she is constantly communicating with me with about the patients she's treating, we discuss treatment plans, and so I have an input in her treatment plans to make sure our patients are getting the best treatment modality to best meet their goals, or I can also suggest some alternative treatment modalities that may require some more intervention from me or one of my other team members. So we see a lot of inquiries through our direct messages on Instagram for, "Do you do the Russian lip treatment?" Now, can you please pull back the curtain and educate our listeners, is this something real or is this just some more marketing mumbo-jumbo or marketing malarkey that people are just falling for? So what's the deal with this Russian lip treatment?

Denae Murphy (08:48): I mean, I think a lot of it is marketing. It's really just a different injection technique. Instead of going in from the side and horizontally, you're going in from the top and vertically. I mean, that's really the only difference.

Dr. Bob Basu (09:00): So basically it's just marketing, right? The other inquiry we get quite commonly is they want the lip flip, what's that all about? Is that filler, is that Botox, can you share with us what the lip flip is with patients?

Denae Murphy (09:13): The lip flip is just a little bit of Botox just above the lip. A long time ago, we used to do this and it was specifically for pucker lines and those little vertical lines that you get above your lip. It wasn't for lip flip. This just happened to be a side effect and now it's been remarketed as a lip flip.

Dr. Bob Basu (09:33): So it is effective, it does work in the right patients. It does raise an important point about the distance between your nose and your lip. And so for some patients, doing a little bit of Botox, as Denae mentioned, in the upper lip, can evert that lip and help reduce the distance between your nose to the lip. Why is that important? That's important because if you look at your pictures from 10, 15, 20 years ago, odds are, you'll notice that the distance between your nose and lip was likely shorter. Whereas as we age, that distance between the nose and lip actually gets longer.

Dr. Bob Basu (10:08): For patients that come in with a longer nasal to labial, or nose to lip, distance, lip flip might be an option, but another alternative could be a very minimally invasive procedure called a surgical lip lift, where we hide the incision underneath the nose, and we actually evert the lip or raise the lip up, balancing it to bring it back to what you used to have 10, 20 years ago. Something that I often do with my surgical facelift. So there are a lot of different options to reshape the lip and a lot of these options are complementary to fillers as well, too. So they go hand-in-hand.

Dr. Bob Basu (10:43): We interviewed you for a podcast episode just about you called Meet Denae, where our listeners can learn more about your experience and approach, but where else can people find more information about you and the services that you are?

Denae Murphy (10:55): You can find me on the web at basuplasticsurgery.com, that's B-A-S-U plasticsurgery.com, also on Instagram @Basuplasticsurgery, and also on my own Instagram @Injectionsbydenae, spelled D-E-N-A-E.

Dr. Bob Basu (11:14): If someone's listening and they're a first timer, or even if they've had a set of treatments before, and if they want to visit with you for a treatment, what's the next steps?

Denae Murphy (11:22): They can come in for a complimentary consultation. We can come in person, we can do it by zoom. We don't have to treat that day. We can discuss what your options are.

Dr. Bob Basu (11:32): How much does the typical lip injection treatment cost? And just in general ranges, obviously everyone needs are slightly different and some may need more filler than others, but what can we expect in terms of cost?

Denae Murphy (11:42): Most people, I start them with one syringe because we can always add more, much easier to add more than to take it out. So I start with one syringe, which is about $700.

Dr. Bob Basu (11:53): Before we wrap it up, for listeners of our podcast, we give $50 off any service, including lip injections. So Denae, do you have any other recommendations for saving a little money on fillers?

Denae Murphy (12:04): You can sign up for reward programs, either Alle or ASPIRE, they both have great loyalty programs where you can earn points towards future treatments and receive special offers. We also have special offers of our own, which you can find on the website, but I want to call special attention to the VIP membership, which gets you the deepest discounts on Botox and fillers, and comes with free services every month, from laser hair removal to dermaplaning, microneedling, IPL, HydraFacial, CoolSculpting, and much more.

Dr. Bob Basu (12:32): Yeah, I couldn't agree with you more, our B exclusive VIP membership program has a monthly membership at different accessible tiers, to best meet your needs, but that is absolutely the best way to take advantage of the biggest value for our med spa services here at Basu Aesthetics and Plastic Surgery. Thank you, Denae, for being with us.

Denae Murphy (12:51): Thank you.

Dr. Bob Basu (12:53): So if you have any questions about our services, check the show notes for links to everything we talked about on this episode, including our website or to Alle or to ASPIRE and to Denae's Instagram. If you want to hear more from Denae about any topic or have a question for me, visit Basuplasticsurgery.com/podcasts. That's B as in boy, A-S-U plasticsurgery.com/podcast. Submit your questions for the podcast.

Announcer (13:21): Basu Aesthetics and Plastic Surgery is located in Northwest Houston in the Towne Lake area of Cypress. If you'd like to be a guest or ask a question for Dr. Basu to answer on the podcast, go to best Basuplasticsurgery.com/podcast. On Instagram, follow Dr. Basu and the team @Basuplasticsurgery. That's B-A-S-U plastic surgery. Behind the Double Doors is a production of The Axis, T-H-E-A-X-I-S.io.