Perry are alrighted we can see some fine lines in the upper lip and in the lower lip white cutaneous lip I'd like to address these areas with some more light using a 25 gauge cannula before injecting the vessels that I'm concerned about are the superior labial artery and inferior labial artery so before injecting let's look with ultrasound what we can identify left upper lip we can identify now with color Doppler the superior labial artery we can identify teeth and superior to the superior labial artery we can see orbicularis Oris so I'm placing my probe now in a more lateral position going towards the modiolus and the vessel the superior labial artery is more superficial but as I Advance with my probe in a more medial direction we can see that the superior labial artery a fairly large vessel is located deep to orbicularis RS so what I'd like to do now is just have a look in the cutaneous lip and see whether there are any vessels just superficial to orbicularis auris and the zone is clear while I'm on this side I'm looking now on the lower lip and seen if I can identify with color any vessels because I'll be injecting a small amount of the light in this area and we can see an artery that's pulsating line superficial to orbicularis Horus and that's just inferior to the red Vermillion and another vessel as I'm progressing more medially very tortuous the inferior labial artery and we can see it present in the lower lip okay so let's inject the left hand side what I'd like to do is a technique that I learned from Dr Peter Cullen called the platform technique and place a layer of volite just gently in the cutaneous upper lip to give some support I'm hoping to inject superficial to orbicularis Oris so the aim is 25 gauge cannula coming straight to the filter column not fun and Tiny amount of volite placed as a layer to support the upper lip the platform technique and it's not fun we'll wait for some of the local anesthetic from the ball late to take effect well done well done good job well done well done well done good and now I'm Gonna Come to the lower lip and you're not gonna love me good job well done and you're nearly finished good let's now have a look at the left upper lip and lower lip with ultrasound so let's start with B mode and we can detect the evil light superficial two orbicularis auras let me just double check with color what our vessels are doing we can see on ultrasound that the superior laboratory is intact and has not been impacted by the wall light the wall light is found in on a more superficial plane and we can see increased vascularity in the near field or superficial to orbicularis Oris and that's because an injection has taken place but the vessel is pulsating beautifully let's now look at the lower lip where I've injected and see if we can see the inferior labor Lottery there is a vessel present that we saw before injecting it and it is intact it is coming from inferiorly and making its way up to the lower lip but the volite has been placed in a subcutaneous plane and has not disrupted the flow of the artery left hand side completed
