For some people, because of what Dr. Trivedi said about the different muscle and, especially the elevator of the nostril and the labial elevator, sometime the lip reverse the extreme reverses - what we call the gummy smile - but for her, if you’ll smile, you see, small smile, bigger smile, bigger smile, bigger smile, the more she smile, the more you see the gum and the more you see the lip reversing going in. So, it's a very difficult case, because you’ll always be betrayed by this. If you just filler augmentation, whether you do the outline or you want to plump the red part of her lip, the juicy part of the lip, she will be disappointed when she smiles because whatever you do, how much you put in a quiet position, still position, is going to be lovely and we are going to define the outline and maybe the red part, adjusting the lower lip but when she smiles, you will have always this problem reversing. So, you're going to lose one half at least of the lip augmentation. So, the great combination for this lady, which we can't do it today because we don't have it here, will be to combine with few drops, very superficial drops, all on the border Vermillion as Dr. Trivedi said or to the other elevator here to reduce this ascension and reverse of the lip. So, let's keep that in mind, it’s very important.

Now, going back to using hyaluronic acid and, especially the [RA-shid2] which is my new gold standard. I love this product, it has an amazing flexibility. I used to be a great fan for many many years of Tylshael Global to improve the lips, I always say that and I think the new standard for the lips in general is going to be this territory. It has an amazing flexibility, plasticity, easy to mould with the fingers, easy to dissolve if you have any problem, so I think it’s the ideal product to do any sort of lips. So, what's my technique? So, lie down. So, we said we have to improve the outline and the red part of the lip. I use a very simple technique. I've lots of doctors working with me in my different clinics and I always thought about having the simplest technique possible for them to do a good job and standardize the procedure. So, it came to my mind to use a very short needle, a set to gauge four-millimetre needle which allows you to control exactly what you're doing because with this length, you can all inject the outline. I work at the head of the patient, I pinch the lip, I see the outline and usually also, to be very precise, I mark with a pencil the way out of the filler. See here, I knew exactly where the filler is going out, I can be extremely precise. So, then I pinch my lip and I'm going to try to find this virtual canal that you can easily find.

You see, my needle is four millimetres or maybe two millimetres deep exactly, you see. And I can really mould, if I have too hyaluronic acid, I can take it out. See, that's just for the outline. I carry on, pinch again. See, I have a tendency to turn, so because I put the marks exactly, I know exactly where the filler will come out. Same thing, same depth, you see the whitening going along the rim? That's perfect. I pinch always, very gentle, very delicate, simple and easy. Up, you see, it's going on the other side. I don't inject the red part for the moment, I will show you after how to do it, okay? At the moment, I just control the outline, the definition of the lip, I increase it because some people want just the outline, some people want juicy more full lips, so you have to be able to control exactly what you're doing. Same thing, to be more precise. Can you see the outline, the whitening going all along the border? I press.

Question: When you do that, do you do sometimes some local anaesthesia or something?

I never use any local anaesthesia, not even cream.

Question: Not even amila or something like that?

Not even. You can if you want but I pinch the lip and honestly, it's really not painful. At this short needle.

Question: How many spot do you put on your lips? Do you put three by side?

It depends on the way I captured the virtual canal, sometimes it runs all along in one or two dots, it's finished. You see, look, for example, I maybe adjust here. Okay, let's see, that is the outline. Let me add a little loop, sorry, can you sit up please. Smile. I just checked my outline, seems correct.

Okay but now, I'm going to do the outline of the lower lip and then I will plump the lip. The outline of the lower lip, two ways to do it; classic - you can go all along the outline like this, you put your finger in, you see the whitening of this virtual canal and you can go like this. You see, tack, boom all along, you see it goes all along, and that's beautiful. I can do that. I prefer, personally, to carry on my technique, reversing the lip like that, [indistinct]. Okay, now I press like this, I reverse and I'm going to do the outline of the lower lip from here. Lower middle part, you see, one prick and it goes all along, can you see? And I go like this, I press, I push the extra drop outside, that's my favourite technique; I call that the sexy drop in a way. I do just one drop most of the time, that gives me the balance, you see, it's perfect.

Now, you see, I have done some drops here and it's missing on the other side. Normally, I don't do that but I will have to do it to balance it. It's a very old technique for me doing the outline this way. Okay, now it's quite nice. Then you check, ah no, it's a bit imbalanced. I press as you can see, I press, it's malleable. Smile, it's better now. Smile, see grip is a bit thicker here than here, as you can see, so no problem. I can go back, adjust still from the back, it's very simple. See? So much better. I think it's still missing here. All these you came from the fact I start injecting the outline on the other side, so you can combine, you see, injecting directly the outline or starting with a… see? Such a treasurely. Now, if she wants more fuller lips, how should I do? Because technically, I have just improved the outline here, I didn't plump the red part of the lip and let's see already the dynamic of the smile. You see, as I told you, unfortunately, you’re losing a lot of what you've done, see? It's always reversing. See? Look, it's unbelievable, such a pity, okay? So, the patient will be disappointed always, so if you don't do a bit of Botox here and here, you will be in trouble and the patient will be disappointed, this is a very classic case. So, analyse the dynamic of the smile is essential. You see the gum now, it's not right.

So, I can be tempted to make the lip fuller, how do I do?

Question: Until now, you use about one millilitre of product.

Yes, I rarely use more than one millimetre, it’s millilitre, it's exceptional.

Question: And normally, how much do you put in each injection, not more than 0.1 I saw in the video I think?

I don't know, you go with the feeling, I don't know. It can't be so precise, you do what you have to do; sometime you could put very little, sometimes you put a lot, I don't know, it doesn't really matter, what matters is the result. So, just to show you, if I want to plump up these slips here, so always using the same needle, the four-millimetre needle, that's why it's so useful. If you remember, I just used no more than two millimetres, now I can do that. Look at this, I reverse the lip, my thumb, I go tangent, I know exactly where my filler is coming out and inside the red, introduction, can you see it? And I go, boom, do four millimetres in and now you can see the filler going in the red part. And I can mould and sculpt it. Of course, you can put as much as you want, it depends on the lip. Same thing, I reverse tangent, boom, see? It flows, simple, very gentle and on. I’ve done two dots, I'm going to do exactly the same. Reverse tangent, four millimetres because if you go a bit lower, let's say six millimetres, the filler will come here and will make funny lumps, so you have to be very precise; massage, plaster more, sculpting, essential. Same tangent, four-millimetre, boom. Press gentle, that's it. You see, on this one I put all two, so now we have the full lip and I may need to adjust the balance between the upper and lower lip. Wow, you see the juicy lips now? Different, more juicy, yeah? You can see the difference, it's much more juicy. See? Some punishment. Oh, horrible.

Okay, if we don't deal with the muscle, you're going to be punished. Again, you can put as much as you want, [speaks foreign language]. I insist for you to really understand that because, see, in a quiet position, it’s quite sexy, the lips now. I believe it’s nice, because I plump that, maybe I need to put a drop more here. I mean, we are dealing with a very sexy lip now but to show, we have to demonstrate. I give my sexy drop a bit more, same thing. I go even higher now than before. Now, I press the upper part of the lip here, tangent and then lift them a bit closer and I plump. See? Same technique then for the upper lip to be different but I increased the juiciness. Let me see, that's enough. I'm going to dry up, it's enough.

I really showed you, I mean the extreme plumping of the lip is not necessary for every patient, it depends on what the patient wants, okay? Some people would want just a simple definition, highlight their own lips and some people want plump juicy sexy full lips. So, I show you the two extreme and how you can deal with it. The technique is extremely simple, very easy, we just play with a four-millimetre needle, which you hardly can make mistakes with this size of needle. I think it's a nice smile. Okay, it's already better because I plumb the lip, it's already better.

Question: Jean, do we use this needle only for the lip or do you use for other areas as well?

The nose, it’s perfect for the nose.

Question: So, it's 0.4 and…?

Set to gauge by 4, you can find the set to gauge by 6 and set to gauge by 12/13 as the one which are in the box. My favourite are set to gauge by 4. Set to gauge by 6, sometimes you can make mistakes but for the nose, they're absolutely perfect, they’re the best needle to reshape the nose with. Voila, done. Merci beaucoup.