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Perioral Region
Published in Ali Pirayesh, Dario Bertossi, Izolda Heydenrych, Aesthetic Facial Anatomy Essentials for Injections, 2020
Krishan Mohan Kapoor, Philippe Kestemont, Jay Galvez, André Braz, John J. Martin, Dario Bertossi
The upper lip extends from the subnasale/subnasal point at the nasal base (cranially), to the nasolabial folds (bilaterally), to the lower edge of the vermilion border (caudally). The lower lip extends from its free vermilion edge (cranially), the oral commissures (laterally), and the labiomental crease (inferiorly). At the vermilion-cutaneous junction, a thin, pale line termed “white roll” highlights the color difference between the vermilion and the skin. In the upper central region, the white roll forms a V which, together with paramedian vermilion prominences, forms the Cupid's bow. Two vertical tissue columns (the philtral columns) form a midline depression (philtrum), which extends from lip border to the columella above (Figure 8.1). The labiomental crease passes horizontally in an inverted U shape across the lower lip, separating it from the chin.
Oral Cavity Tumours Including Lip Reconstruction
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Scars within the vermilion usually heal extremely well. Small vermilion defects can often be closed directly. Lateral superficial defects can be allowed to heal by secondary intention, as long as they are not too close to the white roll. Larger vermilion defects that do not involve the white roll require flap reconstruction, either lip (-vermilion) flaps or non-lip (mucosal and tongue) flaps.
Intraoperative Surgical Techniques and Pearls—Special Considerations
Published in Alexander Berlin, Mohs and Cutaneous Surgery, 2014
Matteo C. LoPiccolo, Thomas E. Rohrer
For a full-thickness defect of the lip, the mucosal, muscular, dermal, and epidermal layers should be repaired individually for optimal results (Figure 3.9). A soft, braided, absorbable suture, such as Vicryl, should be used to close the intraoral mucosa, and the knot should be tied internally just beneath the muscular layer. The orbicularis oris is repaired next; it must be fully approximated to restore function to the oral aperture. When closing the cutaneous layer, care must be taken to accurately align the vermilion border to avoid mismatch or notching. This is of the utmost importance. In instances where ink lines become smudged and a scalpel mark has not been placed, the white roll of the lip can guide alignment.7 The dermis and epidermis of the vermilion may be closed with a single layer of suture, and the vertical mattress technique may be used to encourage wound eversion.
Evaluating safety in hyaluronic acid lip injections
Published in Expert Opinion on Drug Safety, 2021
Tyler Safran, Arthur Swift, Sebastian Cotofana, Andreas Nikolis
Within the lips, the OOM is the major structural component. Superficially, the OOM is connected to the skin via a dense meshwork of subdermal fat and fibrous connective tissue which is thicker and more substantial in males and weaker in females. This, along with the stabilizing effect of the hair follicle pilars in males, is one of the structural anatomic explanations for the increased prevalence of peri-oral wrinkles in women compared to men. Deep to the OOM, salivary glands can be identified which are embedded in loose areolar connective tissue and covered by the oral mucosa. During needle and cannula advancement, coming from a lateral port, a distinct space can be identified which is located deep and slightly cranial to the vermilion border (underlying the white roll). This space can serve as a safer gliding plane during cannula advancement but can also be the reason for uncontrolled product spread.
Invited commentary on: comparative study between Fisher anatomical subunit approximation technique and Millard rotation-advancement technique in unilateral cleft lip repair
Published in Alexandria Journal of Medicine, 2021
In order to avoid the drawbacks of the Millard repair, Fisher introduced his anatomical-subunit approximation technique [3]. In this technique, the resulting line of repair ascends the lip along the cleft-side philtral column and curves along the lip-columellar junction to enter the nostril. This aims to achieve symmetry with the non-cleft side whilst placing the scar at the boundaries of the lip subunits. The nostril sill is aligned such that the nostrils form equal circumference, and the avoidance of a transverse incision at this level aims to prevent nostril stenosis. The heights of the lip elements are matched using a small triangle of lateral lip tissue just above the white roll, as well as taking advantage of the Rose-Thompson effect, wherein length is gained by opening the angles of the repair.
The Effect of a Single Dose of Dark Chocolate on Cardiovascular Parameters and Their Reactivity to Mental Stress
Published in Journal of the American College of Nutrition, 2020
Valeria Regecova, Jana Jurkovicova, Jana Babjakova, Iveta Bernatova
Then, the probands consumed dark (Dark) or milk (Milk) chocolate at a dose of 1 g/kg of body weight with a standardized breakfast, which consisted of a 60 g white roll and filtered tap water (4 mL/kg of body weight) over 10 minutes.