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The smile and emotional expression: practical application of a lip and perioral assessment scale

Journal of Dermatology & Cosmetology
Christoph Martschin,1 Van Park,2 Luiz Eduardo Toledo Avelar,3 Fang Wen Tseng,4 Edwina Morgan,5 Danae Chee Zhen Lim,6 Nicola Fallon,7 Tara Telfer,8 Chian-Yaw Hwang9


Background: Lip enhancement continues to be one of the most frequently requested minimally invasive cosmetic treatments. Balancing anatomical considerations and objective measurements with individuals’ differences in aesthetics preferences can present unique challenges.
Objectives: Identify key characteristics that contribute to lip and perioral aesthetics and providing practical insights into the real-world use of the recently published Lip and Perioral Assessment Scale.
Methods: This work comprised four stages. The establishment of an International multidisciplinary collaborative group of eight experts to discuss current clinical practices with respect to lip and perioral enhancement. A practitioner survey to assess the experiences, perceptions, and opinions of a wider group of clinicians (N=40). A hybrid focus group, chaired by two of the experts, to establish considerations best practice approaches to patient assessment in the Asia-Pacific Region. Practical application of a Lip and Perioral Assessment Scale.
Results: Consensus opinion from experienced injectors in the Asia Pacific Region supports the need to consider a wide variety of factors contributing to smile anatomy and aesthetics. Best practices approaches encompass (1) accounting for underlying structures, soft tissues and the impact of aging on smile anatomy, (2) understanding the relative contributions of the teeth and gingiva, lip proportions and skin quality to smile aesthetics and (3) the value of a systematic approach to patient assessment.
Conclusion: Clear communication between patients and injectors is vital to establish achievable goals and realistic expectations. Systematic assessment that accounts for a wider array of variables than lip volume may facilitate a more individually tailored approach.


hyaluronic acid, lip augmentation, perioral aging, perioral assessment, real world experience