As seen in Fig. 1 Sophie had developed a “noodle” from a previous treatment a year ago in Liverpool. 

In this instance, Teoysal kiss had been used. A noodle is the term given to a long thickened strand of filler which has become hardened in the superficial plane of the lip. This distorts not only the patient’s lip shape but also their smile as the obstruction interferes with the natural dynamic of the lip.

After careful assessment by Dr Esho it was felt using hylase to dissolve the noodle at intervals was the correct way to go about this reconstruction.

Surgical removal was also an option however the aim was to reduce further scarring.

Fig. 2 shows the patient’s lips post-hylase – no noodle but a lot of volume lost especially in the upper lip.

Part of this will recover but using an amalian medium filler with Dr Esho’s own bespoke vectoring technique has rebuilt the body of the lip as seen in Fig. 3 giving a signature natural less is more finish.