Toward a clinical framework for crosslinked hyaluronic acid lip augmentation

Biomaterial design, dynamic anatomy, and injection strategy.

Authors

  • Kamila Salomão Galdino Paranaense University (UNIPAR), Umuarama, Paraná, Brazil; Postgraduate Specialist in Orofacial Harmonization, UniDomBosco University Center, Curitiba, Paraná, Brazil

DOI:

https://doi.org/10.67463/9xe9x994

Keywords:

hyaluronic acid, lip augmentation, injectable biomaterials, anatomy, rheology, vascular safety

Abstract

Background: Lip augmentation with crosslinked hyaluronic acid is often framed as a volumizing procedure; however, clinical performance is shaped by material properties, tissue mechanics, vascular anatomy, and injection strategy.

Objective: This review synthesizes selected literature into a clinically applicable framework for product selection and conservative treatment planning in lip augmentation.

Methods: The discussion was organized around biomaterial design, dynamic tissue behavior, vascular safety, and pharmacobiological reversibility. A de-identified illustrative case was retained only to contextualize the framework and was not used as confirmatory evidence.

Results: Across the literature, outcomes appear to depend less on injected volume alone than on the fit among gel properties, anatomical precision, tissue mobility, and preparedness for complication management. Lip-specific rheology, structure-property relationships, ultrasound-informed safety, and responsiveness to hyaluronidase emerge as key determinants of predictable performance. The evidence base remains limited by product heterogeneity, uneven lip-specific data, and insufficiently standardized follow-up. In the illustrative case, conservative subunit-based treatment with 1.0 mL of crosslinked hyaluronic acid improved contour definition, projection, and upper-to-lower lip proportion at 15 days without observed vascular compromise.

Conclusion: Current evidence supports a conservative, anatomy-aware, biomaterial-centered approach to lip augmentation while underscoring the need for stronger comparative studies and more standardized outcome assessment.

Author Biography

  • Kamila Salomão Galdino, Paranaense University (UNIPAR), Umuarama, Paraná, Brazil; Postgraduate Specialist in Orofacial Harmonization, UniDomBosco University Center, Curitiba, Paraná, Brazil

    Dentist graduated from Paranaense University (UNIPAR), with postgraduate training in Endodontics and clinical interests in dental traumatology, particularly tooth avulsion, replantation, and associated endodontic management. She also completed four years of medical education at Universidad Privada del Este, Paraguay, which contributed to an interdisciplinary and patient-centered clinical perspective. Her professional interests include Orofacial Harmonization, injectable biomaterials, facial aesthetics, and technology, with emphasis on safety, ethics, predictability, and harmonized clinical outcomes.



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Published

2026-03-31

Issue

Section

Review Articles

How to Cite

1.
Galdino KS. Toward a clinical framework for crosslinked hyaluronic acid lip augmentation: Biomaterial design, dynamic anatomy, and injection strategy. J Digit Health Adv Biomater [Internet]. 2026 Mar. 31 [cited 2026 Jul. 2];1(1):25–32. Available from: https://test.journal.jdhab.org/index.php/jhab/article/view/article3-galdino-ha-lip-augmentation