Perfecting Pouts with Heather Weltner, RN

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Creating a picture-perfect pout is one of the most satisfying services an aesthetics provider can deliver. Dermal fillers are quick, generally safe to inject, and the results can range from a subtle refresh to a dramatic plump. Providers and their clients can work together to determine the precise volume desired to ensure every client leaves smiling.

What is lip filler?

Lip filler is a shorthand term for dermal fillers that are approved for use on the lips. Clients seek out fillers to plump, address asymmetry, restore volume loss, and visually hydrate lips. Lip filler surged in popularity when Kylie Jenner embraced the treatment back in 2015. At the time, she said fillers helped her address some insecurities about her appearance and feel more confident.

The most commonly used filler type is hyaluronic acid (HA) gel, a synthetic version of a naturally occurring substance in the body. HA fillers offer a natural-looking appearance and have the benefit of being dissolvable if the client wants to reverse the results. The results from HA fillers last six to nine months and clients can repeat treatment indefinitely.

What are the different types of filler?

Juvéderm® and Restylane® are the top-performing formulas in the hyaluronic filler category. Restylane® is manufactured by Swiss company Galderma, and has been approved by the FDA since 2003. Juvéderm®was developed by U.S. company Allergan, and has been approved since 2006. Both brands offer extensive product lines. Revanesse® Lips™ and Revanesse® Versa™ are newer lines from the company, approved in the U.S. in 2017.

The different products have slightly different formulations to target different areas of the face:

  • Restylane® Silk - lip augmentation or wrinkles around the mouth
  • Restylane® Lyft - cheek augmentation and mid-face contour deficiencies
  • Restylane® - facial wrinkles and folds, lip augmentation, and under-eye hollowing
  • Restylane® Kysse - lip augmentation
  • Restylane® Refyne - nasolabial folds
  • Restylane® Defyne - nasolabial folds
  • Juvéderm® Voluma® XC - cheek and chin augmentation
  • Juvéderm® Vollure® XC, Juvéderm® Ultra Plus XC , and Juvéderm® Ultra XC - mild-to-moderate wrinkles, such as nasolabial folds.
  • Juvéderm® Ultra XC - lip and perioral area augmentation
  • Juvéderm® Volbella® XC - lip augmentation, correction of perioral lines, and under-eye hollowing
  • Revanesse® Lips™ - lip augmentation
  • Revanesse® Versa™ - mild-to-moderate facial wrinkles

Who is a candidate for lip fillers? HA fillers are approved for anyone over the age of 21 (22 for products from Revanesse®) who do not have a history of allergies to the ingredients in the products. Clients who are pregnant, breastfeeding, or immunocompromised should not get fillers. Providers should address client goals, health, and skin condition before deciding which product to use for treatment.

How common are lip fillers? Soft tissue filler is the most popular cosmetic procedure in the United States, according to the American Society for Plastic Surgery. In 2020, more than 3.4 million people visited a provider for fillers—over 2 million of those patients received HA fillers.

Plumped By Heather

Portrait provider, Heather Weltner RN, has been providing aesthetic services to clients since 2019 and has gained a reputation for being a top-level injector. Her approach is to be realistic with her clients, so they get results that are beautiful and appropriate for their anatomy.

Lip filler is one of her most popular services. In fact, you can find her on TikTok as "PlumpedByHeather," a nickname she earned thanks to her skills with lip fillers. Heather explains how she got the nickname: "When my coworkers and myself started noticing my eye for lips, a creative friend of mine actually came up with Plumped By Heather for me and it has just stuck since!"

When Heather meets with a new client, she takes time to talk to them about the procedure. "I spend a lot of time doing a thorough consultation to set realistic goals, make sure they are a good candidate and make sure they are comfortable," Heather explains. "Something I've learned from feedback and reviews is that the number one thing patients appreciate is the time and care spent during the appointment. I always take my time so I can do my best work for clients."

Including the personalized consultation, Heather usually spends 60 minutes with her lip augmentation clients. Comfort is key—both mental and physical. Heather has started offering dental blocks for numbing to make the procedure less painful.

Heather is careful to make treatments about the individual. No two faces are the same, so she makes sure to address the specifics of each client's facial structure.

"I always am realistic with my patients about what is possible with filler based on their anatomy. Everybody is uniquewe can get them as close as possible, but must do it safely," she explains. "For example, female and male lips vary upon the width of the lip you inject. Typically male-born clients are wider past the nose line, and female-born people are within it. However, with some women, their facial balance can handle more filler to the sides, and truly every individual is unique, so I base it on the aesthetic look."

Heather also takes into account a client's history with the treatment, saying, "Clients getting filler for the first time I educate, educate, educate. I am always available for my clients and would honestly prefer them to reach out to me no matter what after the treatment to be safe. I like to make sure they understand the process of healing and potential complications."

She sticks to her philosophy of being safe and realistic when clients return to get their lips refreshed. "Clients that frequent, I set boundaries and will not overfill," she explains. "If a client wants lip filler but doesn't need anymore, you can explore PRF injections with them, which can actually hydrate and give a little bit of volume as well. It is also important to look at the entire face, as sometimes adding chin filler or other facial filler may be more beneficial overall."

One challenge she often sees is clients who have gotten fillers elsewhere and need corrections. Heather is cautious about how to approach those situations, avoiding adding new filler on top of the old, especially if she can see that the old filler has migrated. "I always recommend if there is migration to dissolve and rebuild," she says. "I make sure that I am always being safe."

Heather tries to set her clients up for success by offering suggestions for pre-and post-injection care that reduces pain, swelling, and bruising. "Pre-appointment, I recommend no blood thinners including alcohol 24-48 hours prior to the procedure," Heather explains. "After fillers, I recommend avoiding strenuous exercise for 24 hours and keeping yourself hydrated, which includes your lips by using a lip serum for about two weeks. Immediately after treatment avoid heavy kissing, drinking out of straws, and spicy food."

She also reminds clients bruising and swelling are common side effects. Heather counsels clients to expect to wait two to four weeks for swelling to subside and the filler to settle and reveal the final, desired results. Clients can expect the results to last for six to nine months. Different people metabolize fillers at different rates, so there is no exact schedule for subsequent treatment.

Like any artist, Heather knows the value of working with different materials. She doesn't have a single go-to filler product that she uses. "To be honest, I love them all: My top three would be Juvéderm® Ultra XC, Restylane® Kysse, and recently I have been using a lot more Revanesse® Versa™!"

She has found that she can tailor her filler choice to the needs of her clients. "The product I'm selecting depends on volume loss, age, size of lips, and their goals," she says. "Let's say they had no volume at all. I'd use a softer product like Restylane Kysse® to really build and place more superficially.  For someone that has a larger base to begin with, I’d use a filler with a thicker viscosity like Juvéderm® Ultra Plus."

Adding lip filler services to your practice can build your base of potential repeat clients. As Heather notes, many clients who are interested in lip augmentation are open to other services as well. Stocking a variety of dermal fillers will allow you to provide customized service and address a wide range of client needs.

If you're interested in learning more, speak to a Portrait specialist today.

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