I would like to treat the perioral region give a little bit of support to the oral commissures and treat the marinettes upper and lower lip what I'd like to do with my ultrasound is identify the facial artery which can be found within one to two centimeters lateral to the oral commissure so let me place my probe at the oracoma shore and let me Place color Doppler on and as you can see we can identify the artery the facial artery and it's found within the modiolus and that is approximately 1.5 centimeters lateral to the oral Commission let's have a look on the opposite side turn towards me and we can see the facial artery and more superficially a branch let me quickly look at the marionettes and see if in this area I can identify any vessels now we can see the depressor angular Iris and line deep to the depressor angular iris is the inferior labial artery there's a Dao the hypoecholic structure and if I rotate my probe you can actually see the inferior label Library deep to it which is medial to the Marinette fold turn this way the depressor angular Oris is hypoechoic and artery is running through it and if I steer my angle of the ultrasound in a direction of the inferior Laboratory I should be able to detect the inferior labial artery and there it is traversing through the Dao to go in a superior Direction but the area that I'd like to inject which is the Marinette doesn't have any vessels let's now have a look at the upper lip and we can see the superior label artery and in the lower lip quite a bit of activity with the vessels and again on the patient's right hand side the superior labial artery always a large tube tortuous running in and out of orbicularis auris and in the lower lip we can see the vessel deep to orbicularis Oris okay now that I know the anatomy let's inject what I'd like to do is give some support to the oral comma Shores so open the mouth slightly that's perfect little Sting coming your way ready one two good job that's it you stay there little skin coming your way again okay ready one ready two and sting good job well done well done and good excellent how was that keep smiling ready one two good job and a break good job good not too bad little stink okay bear with me bear with me bear with me ready one two good job good and relax keep kissing ready one two little sting good job good good and relax good um good job good job good job good ready one ready two and good job you good job good job well done almost there almost there I promise you well done finished I've injected this patient with a total of one ml of one lift using needle I placed 0.05 mils to the left upper lip 0.05 mils to the right upper lip 0.1 mil per oral comma sure I've injected the marinettes I've injected the lower lip and a tiny amount of volume up 0.15 mils per pre-dial sulcus on either side so let's have a look with the ultrasound to see where the product is and what our vessels are doing so I'm on the left hand side I'm looking for foreign we can actually see the vessels are quite happy the artery is present and no compromise in the marionette we can actually see quite clearly the depressor anguliaris and inferior to it the inferior label artery and superficial to it we can also see a branch of the potentially the inferior labial artery all intact
