Natalie, RN is an expert injector specializing in facial injections. She has been thoroughly trained by Dr. Grigoryants and is the primary injector at our office. Many women and men in Los Angeles and out of town come to Natalie for injections. She performs:
– Lip augmentation using the technique referred to as the Russian Lip Technique. This lip filler injection technique helps produce more pouty lips, accentuate the cupid’s bow, while maintaining a natural shape. This is a very popular technique requested by many women in Los Angeles.
– Treatment of smile lines and marionette lines.
– Cheek, jawline, and chin augmentation with fillers.
–Botox, Jeuveau, and Dysport injection for wrinkles in the forehead and around the eyes
We use some of the best hyaluronic acid fillers including Versa, Restylane, and Juvederm UltraPlus XC, and Voluma. These are hyaluronic acid-based gel derived from non-animal sources. Different areas of the human body, including the skin, contain hyaluronic acid. We do not use all the available fillers on the market. These fillers differ in their thickness, cross linking, and ability to draw water. So, certain fillers work best in specific areas of the face. Having tried nearly all fillers over the years, we selected these hyaluronic acid fillers for their versatility, best safety profile, and high patient satisfaction.
Hyaluronic acid is a naturally occurring substance in the skin dermis and epidermis. It keeps the dermis hydrated and gives the skin a youthful turgor. As we age, the amount of hyaluronic acid present in the skin is reduced resulting in a decreased skin turgor and elasticity.
Most people tolerate injections well. We apply a strong numbing cream that contains three anesthetics including Lidocaine, Benzocaine, and Tetracaine prior to injections. In addition, the fillers we use contain Lidocaine as well which numbs the area as the filler is injected.
The fillers last months to years depending on the person’s metabolism and area of injection. In the lips and smile lines, the fillers last months to a year. The fillers last up to a year or more in the cheeks, jawline, and chin and several years under the eyes in many patients.
Bruising, swelling, and lumpiness may office and resolve over time. Certain pre-existing facial asymmetries and imperfections may not be correctable with fillers. A very rare complication called embolism may occur when a filler is accidentally injected into a blood vessel resulting in a decreased blood flow. Allergic reaction to lidocaine in the filler is possible in people with allergies to Lidocaine.
Patients should avoid medications and supplements which may increase bleeding and bruising including aspirin, non-steroidal anti-inflammatory medication ( e.g Advil, Motrin, Excedrin, etc), alcohol, fish oil, vitamin E, and herbal supplements 1 week before the appointment.
Many patients in Los Angeles presenting for lip fillers also undergo injections of botox for forehead or periocular wrinkles. In addition, many patients undergo filler injections to augment the chin, cheekbone areas, accentuate the jawline, or decrease the appearance of the smile and marionette lines.
Dermal (facial ) fillers are used to fill facial grooves ( e.g. smile lines or marionette lines) and /or enhance the volume of the chin, cheek areas, jawline, or lips. Botox and like neurotoxins are used for facial wrinkles caused by the muscles of facial expression ( such as muscles of the forehead and around the eyes). Neurotoxins weaken those muscles and the ability of those muscles to cause facial wrinkles.
The amount of filler needed depends on the patient’s starting lip volume and goals. Most patients need one syringe for both lips. In some patients, half a syringe will be sufficient to achieve the desired result.
Lip injections take about 10 minutes to perform. Most patients prefer to have the lips anesthetized using a numbing cream, which is applied for about 15-20 minutes prior to the procedure.
The safety of filler injections has not been studied during pregnancy or breastfeeding. Until more information is available, it would be best to postpone filler injections till after finishing pregnancy and breastfeeding.
For better communication between the patient and the person performing injections, it is important to understand lip anatomy. Basic lip anatomy is illustrated in this photograph of our patient who underwent lip augmentation.
A hyaluronic acid filler was injected in this patient using a Russian Lip technique. The volume of the vermillion border and cupid’s bow were enhanced, and the volume of the vermillion was augmented.
This patient’s lips were injected with one cc of hyaluronic acid filler using the Russian Lip Technique. The definition of the Cupid’s Bow was enhanced in addition to lip volume increase.
This patient underwent lip augmentation using 0.5cc of a hyaluronic acid filler to achieve a subtle enhancement using the Russian Lip Technique.
This patient underwent lip injection with hyaluronic acid filler using the Russian lip technique to produce a pout/bow-shaped lips.
This patient underwent lip filler injection to increase the pout and volume of lips maintaining a natural look. Versa, a hyaluronic acid filler, was used.
In this patient, 2 syringes of hyaluronic acid filler, Versa, were used to augment the lips and the chin.
Russian lip technique (tenting technique) was used to perform lip injection achieving a pouty look.
Lip enhancement using 1 cc of hyaluronic acid filler ( Russian Lip Technique).
One cc of Hyaluronic acid filler was injected using a technique known as a Russian Lip technique to lift the upper lip and augment both lips
This patient previously underwent lip injection elsewhere and requested to have more pouty lips and accentuate the cupid’s bow.
Russian lip technique injection to augment the upper and lower lips using a hyaluronic acid filler.
This patient had flat lips. A hyaluronic acid filler was used to slightly increase the volume and pout of the lips maintaining a natural look.
Lip augmentation using half a syringe of a hyaluronic acid filler. This injection also allowed to slightly lift the upper lip. This technique is sometimes referred to in Los Angeles as a lip flip.
Fillers can be used to decrease the appearance of the smile lines and marionette lines. In addition, a jawline contour can be improve with fillers. Injection of fillers, in the smile and marionette lines to achieve a smoother contour of the face is sometimes referred to as a liquid facelift procedure.
Do you use an injection cannula?
Natalie performs lower lid injections using a cannula technique to minimize the risk for bruising. The risk of bruising using a needle to fill the undereye (tear trough) area can be 30-60%. However, the risk of bruising using an injection cannula is less than 5 %.
As of January 30, 2021, there were three people who developed facial swelling in the areas of prior cosmetic filler injection within a few days of receiving the Moderna COVID vaccine. None of those patients required hospitalization. Their swelling resolved with antihistamines/steroid treatment. This type of swelling in patients with facial fillers is very rare. We recommend that patients wait one month after receiving a COVID vaccine before undergoing facial filler injections. Patient who have facial fillers who not avoid getting a COVID vaccine and should inform their health care provider administering the vaccine that they have facial fillers.
Lip Implants – Dr. Grigoryants offers also permanent lip augmentation. Silicone implants for lip augmentation are available in the United States. They are very soft and provide a natural feel. These implants are inserted through a small incision in the corner of the mouth. Different sizes of implants are available. Samples of these implants will be shown to you by Dr. Grigoryants during your consultation to decide what size would work best for you. We have experienced a very high satisfaction rate with these lip implants.
This patient underwent upper lip augmentation using a soft silicone lip implant. Small (3mm) incision was placed in the corners of the mouth. The small scar cannot be seen. The lip feels smooth to touch. Silicone lip implants offer a permanent solution for lip augmentation.
Upper and lower lip augmentation using silicone lip implants.