# Innovative Classification of M‐Shaped Lips for Enhanced Refill Outcomes: A Case Series

## TL;DR

This paper introduces a new classification system for M-shaped lips to improve safety and results in lip filler treatments.

## Contribution

The first classification system for M-shaped lips to guide cosmetic filler treatments is proposed.

## Key findings

- Personalized treatments based on the classification system achieved improved lip symmetry and volume.
- No significant complications like filler migration or vascular issues were observed in treated patients.

## Abstract

Lips are crucial to facial aesthetics, with fuller lips often deemed more attractive. This preference has led to increased demand for non‐surgical lip augmentation using dermal fillers. However, there is a gap in the literature regarding the identification and management of a particular anatomical variant colloquially known as “M‐shaped lips”, characterized by a central “M” configuration of the upper lip. This anatomical variant presents unique complexities. This study presents the first classification system for M‐shaped lips to guide safer, more predictable treatments.

To introduce the first classification system for M‐shaped lips, improving diagnostic accuracy, treatment strategies, and minimizing complications in cosmetic lip augmentation.

A case series of nine patients aged 20–45 with M‐shaped lips seeking cosmetic augmentation were treated with Aliaxin LV, a hyaluronic acid filler, in multiple sessions. The proposed classification system was based on the angle between the vertical and horizontal midlines of the lips, including three grades: mild (≤ 15°), moderate (16°–25°), and severe (> 25°). Injection techniques and filler volumes were tailored according to patient classification using needles and cannulas for precise placement.

The classification system facilitated personalized treatments, resulting in satisfactory aesthetic outcomes without significant complications. All the patients showed improved lip symmetry and volume, with no instances of filler migration or vascular complications.

The findings suggest that this classification system can significantly improve cosmetic results and reduce risks in treatment. Larger studies with more diverse populations and extended follow‐up are needed to validate these findings.