What can be done for the silicone in my lips?
Using silicone as a lip filler is now understood to be an outdated idea. Unfortunately, unscrupulous individuals continue to push this damaging treatment on the public. While many well-meaning individuals had high hopes that silicone would serve as a safe and effective means to contour and fill the lip, it has proven otherwise. Unfortunately, today many of those who underwent silicone treatment suffer from disfigurement of the shape of their lips, lumps that are present, and abnormalities as a result of their treatment. If you are one of these individuals, you may ask if there is hope to save you from this predicament.
There’s good news and bad news; it would be a disservice to not be straightforward about this. Silicone in the lips is essentially irreversible. Very little of the material can be removed. If you hear otherwise, and someone promises a miraculous fix, you are, to be kind, having your leg pulled. At worst, you may be at risk of some one prey on your predicament. Silicone is a long-lasting, permanent material when used as a filler. Its side effects are just as long-lasting.
Unlike hyaluronic acid fillers, which can be reversed with an enzyme injection if there are unwanted side-effects, there is no such process for silicone oil. Granulomas, lumps, and nodules commonly caused by silicone oil injection can be helped by well-planned surgical intervention. Dr. Steinsapir uses a 5-step approach in providing help to address these disfiguring contour abnormalities along the edge of the lips. First, he does a detailed consultation. It is important that your surgeon carefully listen to your concerns and understands you objectives in having filler in the first place. Second, he educates you to understand how the body reacts to this filler. Third, some individuals who come for consultation have active inflammation from the silicone oil and benefit from 5-FU injections to help quiet the inflammation. This may not be effective when no inflammation is present. Steps 4 and 5 are surgical. Individual granulomas can be excised. This needs to be done to avoid new contour issues and scars. Finally, the overall volume of the lip can be improved by very precise liposuction using micro-cannulas. We have found the combination of removing the worst abnormalities, followed by shaping with liposuction, to be most efficacious in improving upon old silicone treatments.
Dr. Steinsapir has found that the best course of action for you will always depend on your particular facial concerns, a physical examination that includes an overview of your medical history, and a personalized consultation. In this way he can individualize your treatment plan to best address your concerns and unique issues. Dr. Steinsapir is considered a world leader in facial cosmetic procedures, including fillers, minimally invasive treatments with fast recovery times and natural results, fixing previous surgeries and treatments, and overall facial balance. He regularly helps people dissatisfied with a former procedure to achieve better results. We invite you to schedule a consultation with Dr. Steinsapir, who can answer your questions, provide hope, and help you plan a solution that’s catered to you. You deserve the best and don’t have to wait any longer for improvement.
About Dr. Steinsapir
Dr. Steinsapir is a board certified eye surgeon and dual fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.
Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician or surgeon and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.
Feeling Pressure to Look Feminine
With an abundance of fashion magazines like Cosmopolitan, Vogue, and Elle there is a lot of pressure to look a certain way in order to be considered “feminine;” full pouty lips, large eyes, flawless skin, and high, full cheeks are the aesthetic standard these days. The internet has only become a tool to fuel this obsession with female perfection, but the reality is, makeup and Photoshop go a long way in making starlets and models meet the modern standards of beauty. Nevertheless, the desire by women to meet the ideal is strong, and it doesn’t always require major surgery to achieve. More often than not, it’s the little touches that make the big difference and starting small can preserve a more natural look and prevent you from looking like you’ve had major surgery.
Lips
Your lips are one of the first parts of your face to appear aged. With a loss of volume and an increase of lines around the the mouth makeup has a tendency to exacerbate the problem by feathering. Full soft lips are not just a sign of beauty, but also a sign of youth. Fortunately, your lips are one of the simplest fixes without the need for surgery. Fillers can provide a very natural solution to lips that are thin or losing volume.
With so many fillers available on the market today – Restylane®, Radiesse, Perlane, Juvederm, Artefill, Sculptra, Matridex, and even silicone oil – it can be easy to feel overwhelmed by the options. However, not all of these fillers should be used as lip fillers under normal circumstances. Hyaluronic acid fillers like Restylane, Juvederm, and Perlane are much more suitable for lip augmentation than permanent and semi-permanent fillers. This is because they are much more forgiving, do not tend to lump, and can be simply and easily adjusted with the enzyme hyaluronidase.
Dr. Steinsapir prefers the use of Restylane as the best filler for lip volume deficiencies. This is because the lips are very sensitive and irregularities can arise. Fortunately, Restylane doesn’t tend to form bumps, and an experienced physician specialist can skillfully place Restylane for natural looks and long-term benefits.
Under Eye Fill
Dark circles under your eyes, or even a hollowness above your cheekbones is easily improved using a similar method as with the lips. Dr. Steinsapir also prefers Restylane to reduce the appearance of dark circles because it can be easily adjusted. Despite what the old wives tales say about dark circles and getting enough rest, persistent dark circles are actually the result of your lower eyelid muscle showing through the delicate and thin skin of your lower lid area. When there is no subcutaneous fat between the skin and the muscle, the area appears dark and sunken.
The treatment requires a skillful hand but once placed and adjusted, the treatment is completely natural and can’t be detected by others. No wonder this has become the most popular eye dark circles treatment.
It is critical that the injecting physician assess how you do after the treatment because a certain percentage of treatments require an adjustment. Dr. Steinsapir explains that everyone holds a slightly different amount of water in the tissues and small areas of fullness can spoil an otherwise great result. For this reason, he encourages his patients to follow up about a week after treatment to assess how the service has settled.
Microdroplet BOTOX® and Dysport®
Of course, forehead wrinkles and brow lines are considered unfeminine, even among the older generations of stars like Diane Keaton, Susan Sarandon, and Jane Fonda. Despite all of these women being over 60, all their photographs show them with smooth foreheads and full cheeks despite their features showing other signs of aging. Maintaining a youthful appearance is a large part of looking feminine because it’s these features in women that are signs of femininity.
Unlike standard treatment methods, Microdroplet™ BOTOX® and Dysport create brow lift without forehead paralysis. Microdroplet™ BOTOX® works with greater precision with your facial muscles. The care and interest Dr. Steinsapir has shown in inventing this treatment demonstrates his dedication to achieving a beautiful, more youthful appearance without impeding the ability to express emotion.
Standard injection methods tend to freeze the forehead. The forehead can’t move and the eyebrows drop like stones. What looks good is a gently lifted eyebrow, no crows feet lines or brow pinch, and a forehead with reduced lines that is still able to move. Imagine a BOTOX® or Dysport® treatment that allows you to have natural expressions!
Chemical Peel
Flawless skin has always been the ideal for beauty and as we all age, men and women alike, our skin develops flaws and spots that may not have been there when we were young. But cosmetic products are not marketed to men so there is even more pressure on women to maintain clear, beautiful skin.
There are many types of chemical peels available and they treat many types of concerns, so it can be difficult to figure out which chemical peel is right for you. But the chemical peel is truly an art form with versatile abilities depending on your needs, so it’s vital to understand that for a successful face peel with profound results, you’ll need an expert in performing facial peels who has extensive treatment experience and understands how to combine science and aesthetic planning for the best results possible.
Chemical peels can effectively treat facial concerns like aging skin, fine wrinkles, dark spots, acne, creases, loss of elasticity in the skin, and other concerns. This frequently makes the chemical peel an excellent alternative to surgery that removes excess skin for the lower eyelid. A chemical peel in the eyelid region is a minimally invasive procedure that preserves your natural features while rejuvenating your appearance.
Pigmentation is always an important consideration to any chemical peel. The range in skin colors and complexions is complex, so this is something to consider with your doctor on an individual basis. Fortunately there are many people who can and do benefit from chemical peels. Your doctor can tell you more about skin-types as classified by the Fitzpatrick scale, and let you know what that means for you and your candidacy for a chemical peel. A chemical peel can also help improve concerns with irregular pigmentation.
About Dr. Steinsapir
Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.
Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.
Are the Current Fillers Better Than Collagen?
Collagen was the original facial filler and, for much time, it was the only viable filler available. It was offered as Zyderm I, Zyderm II, and Zyplast. The Zyderm benefits did not last very long, and the Zyplast effects only lasted a couple months. While these proved to be great products for treating problems in facial deficiencies like the edge of the lips, their relatively short life span made them a solution essentially only viable for the wealthy who could afford frequent treatment. Today collagen products have largely been replaced by the hyaluronic acid fillers called Restylane, Perlane, and Juvederm. Since both of these types of facial fillers can successfully improve the facial contours, let’s examine the hyaluronic fillers further before drawing any conclusions.
What Is the Difference between Collagen and Hyaluronic Acid Fillers?
Collagen is a naturally occurring protein that works as the primary building block to hold together our tissues. As the original injectable facial filler, it’s typically derived from bovine, porcine, or human materials. In the example of bovine-derived collagen, the collagen is extracted from cows raised in a controlled environment free of disease and closely monitored. Allergan, Inc. creates Zyderm and Zyplast from a highly purified collagen taken from a closed bovine herd, ensuring that their product is safe and high quality. You do need to obtain an allergy test before receiving bovine collagen filler because there is a three to eight percent chance that of an allergic reaction. The other collagen fillers like Cosmoplast and Cosmoderm come from cultured human cells, and you do not need an allergy test before treatment. These later products have replaced the original bovine Zyderm and Zyplast products. Finally, Evolence is the newer collagen product that is derived from porcine and has a longer life than other forms of collagen.
While the amount of time that collagen lasts depends on the individual, it generally does not last nearly as long as the hyaluronic acids. Both collagen and hyaluronic acid injections are effective in treating concerns like fine lines, deep wrinkles, crow’s feet, brow wrinkles, and frown lines. Hyaluronic acid is found naturally in the human body as well, and it is an important part of the processes that regulate cell renewal and growth. When we put hyaluronic acid into the body, it is non-immunogenic, meaning that it is not seen as a foreign substance by the body. Therefore, while it is possible you could be allergic to a hyaluronic acid filler, the chances are minimal and unlike collagen products usually no allergy tests are recommended before treatment. Furthermore, hyaluronic acid fillers last longer, and they are easily and comfortably adjusted with the enzyme hyaluronidase.
Is Collagen or Hyaluronic Acid Better?
The filler that’s right for you will depend on many individual circumstances. Your doctor will consider your goals, the site(s) of treatment, your health and medical background, and many other factors when helping you to choose the best treatment plan for you. For example, if you are getting a lip filler, both collagen and hyaluronic acid fillers can work well, with the results of hyaluronic fillers like Restylane lasting longer and being more easily adjustable. If you are seeking a filler for under eye hollows, then under eye Restylane is usually the best choice. If you have nasolabial folds, Juvederm may be a suitable filler. The top choice will really depend on your consultation with a qualified cosmetic surgeon who specializes in cosmetic facial fillers, although in most cases the modern hyaluronic acids will be recommended.
Seek Advice from a Doctor Who Cares
Dr. Steinsapir specializes in minimally invasive facial cosmetic procedures and is a physician consultant to Medicis, Inc., who distributes Restylane and Perlane. He has developed a highly effective undereye treatment method called DeepFill Restylane, which is widely used by other cosmetic surgeons and world-acclaimed. As a board certified ophthalmologist, fellowship trained in both cosmetic and eye plastic surgery, Dr. Steinsapir strives for natural results that achieve complete facial balance and fast healing times. To speak with a doctor who listens, and to learn more about how a facial filler might help you, contact us today to set up your risk-free consultation with Dr. Steinsapir.
Men and lip fillers
Men’s lips are often neglected. This is too bad, because a natural fullness in the lips is very handsome. If you are a man seeking cosmetic improvement for your face, take care not to overlook the value of lips. Many men who have lost lip volume over time or who have naturally thin lips fail to consider lip fillers as a treatment option. Yet when we analyze what is going on in the face and what treatments are going to have the most impact, restoring the lip volume is of critical importance. If you have thin lips or lip lines, consider how lip fillers may benefit you.
Attaining Masculine Lips
Strangely, when we think of full or beautiful lips, we usually think only of women. It is of course true that full and natural lips give striking compliments to a woman’s face, but women are not the only ones who look best with well-formed lips. If you look at fashion magazines, you’ll see that the men have lips that are every bit as strong as the women’s. This is because of the simple truth that men’s lips are important. The big difference of course is that men do not wear lipstick to call further attention to the lips. But just as young women have full lips that gradually deflate over time, the same is true for men. Restoring the volume deficiency with lip augmentation can work wonders in refining your features and making you look younger.
Men and Lip Fillers
Because so many men who want facial improvement don’t even consider the possibility that men usually look best with naturally full lips, they sometimes displace a problem of lip deficiency to other features that may or may not benefit from cosmetic treatment. For example, if you notice that something about the lower half of your face is “off,” you might assume that you need a facelift or a better-defined jaw. Perhaps you could use these treatments; we’ll leave that up to your cosmetic surgeon and you to determine. The point here is that it’s important not to overlook any possibilities.
Restylane is almost always the most suitable facial filler for lips. The lips are very sensitive and the skin here tends to show any irregularities, but Restylane rarely forms bumps. This is why Restylane is great for treating sensitive areas like the lips as well as under eye hollows. Since Restylane is a hyaluronic filler, any dissatisfying results can easily be changed by your doctor. The flexibility of Restylane makes your lip augmentation a very low-risk procedure that is both safe and adjustable.
Expert Treatment for Optimum Results
Placing a lip filler is both a medical procedure and an art form. Your doctor should have extensive experience in Restylane lip treatment as well as artistic vision and an intricate understanding of facial anatomy. If you are interested in learning more about how lip filling can help you, or just want to find out if you’re a good candidate for a lip filler, we invite you to consult with Dr. Steinsapir.
Dr. Steinsapir is a cosmetic surgeon in Beverly Hills and Los Angeles who specializes in minimally invasive cosmetic procedures that give you fast recovery time and natural results. He is a leading expert in Restylane, and has served as a physician consultant to Medicis, Inc., Restylane’s distributor. In fact, his practice is one of few in the world that makes Restylane for dark circles and lips a major area of specialization. Please contact us today to find out how Dr. Steinsapir’s experience and care can help you achieve your desired look.
I am thinking of getting lip filler but I am afraid of getting my lips overdone.
Lip augmentation is a great option for those with thinning lips, aging lips, lip lines, or volume deficiencies. Lip fillers have the ability to change your appearance from aging and ordinary to youthful and sensual. It’s surprising what a difference full lips can make on the face, which is why so many people overlook the important role their lips play when they consider how to improve their appearance. Don’t forget that we use our lips to smile, speak, kiss, eat, and express ourselves. The full lips associated with youth and beauty can make a great difference in how others perceive us and how we feel about ourselves. Both men and women can benefit from lip fillers, provided that both the individual and the doctor determine that this is a suitable treatment option.
Lip Filler Before and After Photo
One major reason great candidates for lip fillers hesitate to seek treatment is because they worry about getting their lips overfilled. Thanks to media hypes, sitcoms, and a few publicized incidents of poor judgment, this is a common concern. The truth is that with just a bit of foresight and planning, you needn’t worry about overdoing your lip filler treatment. There are many fillers available, and the ones best for the lips are very forgiving, enabling your doctor to easily adjust the treatment should you be unhappy with your results.
How Can I Avoid Overdoing My Lips?
Seeking nonsurgical cosmetic treatment for the lips should be an extremely rewarding, low-risk experience as long as you do some research first and choose your doctor with care. First, let’s look at some filler options.
With so many fillers available on the market today – Restylane, Radiesse, Perlane, Juvederm, Artefill, Sculptra, Matridex, and even silicone oil, to name a few – that have all been used as lip fillers, it can be easy to feel overwhelmed by the options. However, not all of these fillers should be used as lip fillers under normal circumstances. Hyaluronic acid fillers like Restylane, Juvederm, and Perlane are much more suitable for lip augmentation than permanent and semi-permanent fillers. This is because they are much more forgiving, do not tend to lump, and can be simply and easily adjusted with the enzyme hyaluronidase. Should you be dissatisfied with your treatment for any reason, experience an irregularity, or simply change your mind about what kinds of goals you have for your appearance, this enzyme can be injected to modify your treatment.
We have found that Restylane is usually the best fillers for lip volume deficiencies. This is because the lips are very sensitive and can irregularities that may arise from treatment. Fortunately, Restylane doesn’t tend to form bumps, and an experienced physician specialist can skillfully place Restylane for natural looks and long-term benefits.
I think I’ve already had too much lip augmentation.
Resolving this issue of course depends on the nature of the problem and the type of filler you received. If you were treated with something like silicone oil, there is both good and bad news: this is a permanent filler. If you like your results, that’s great, and you can expect them to last basically forwever. If you don’t, well, it is virtually impossible to improve the lip. Receiving treatment with a long-term filler is somewhat of a gamble because the long-term fillers have been shown to be less reliable than a filler like Restylane, and if you are discontent with your outcome then it’s harder to reverse.
If you feel you’ve had too much of a hyaluronic filler, adjustment will be very easy. You can usually return to your original doctor to resolve the problem, unless the relationship has deteriorated or you are not confident in your original doctor’s skill level in regards to lip treatment. In such cases, you should seek a second opinion.
If you were treated with a long-term filler like Sculptra or Matridex, treatment will be more challenging. You may be able to a receive a saline injection to try to break up the filler. In some cases excision is indicated as an appropriate treatment. This will depend on the severity, location, and nature of your irregularity or other concern.
It’s possible that you are early from your treatment and simply experiencing some normal swelling. Give yourself time to heal. Wait a couple of weeks to let the swelling settle before evaluating whether or not your lip treatment was excessive. If you have a bruise, you are likely experiencing swelling and need to let things settle down a bit before deciding to seek an adjustment.
How do I prevent a problem with my lip filler?
With some basic understanding of lip fillers and a carefully chosen cosmetic surgeon in Los Angeles to perform your nonsurgical cosmetic treatment lip filler, you really don’t need to worry about regretting your treatment decision. Weigh your options with potential doctors and be sure to ask many questions about what filler he or she recommends, and how easy it is to modify treatment in the off-chance that you’re dissatisfied with it. For example, you can feel great about a Restylane lip filler treatment because it has a strong history of working well as an ideal lip filler. The benefits of Restylane can last for over a year, yet you needn’t worry that you’ll be stuck with results you don’t like because Restylane is both modifiable and not permanent.
Even more important than exactly what filler goes into your lips is the doctor you choose. Find a cosmetic doctor with whom you are comfortable. Your doctor should specialize in facial cosmetic surgery and nonsurgical facial treatment and be extremely knowledgeable about facial fillers. You should feel at ease around your doctor and confident in his or her abilities. How can you be confident? Look into your doctor’s credentials, areas of specialization, experience record, and unretouched before and after photos. What your doctor says should make sense to you. Further, your doctor should personally perform all of your treatments without passing this job to an assistant or “physician extender.”
Dr. Steinsapir is a cosmetic surgeon in Beverly Hills who specializes in minimally invasive treatments and is an expert in facial fillers. In fact, he has served as a physician consultant to Medicis, Inc., who distributes Restylane and Perlane. He is widely considered a leader in facial fillers because of his innovative methods like Deepfill Restylane, extensive experience, and practical artistic skill. He is widely respected and a Clinical Associate Professor at UCLA in oculofacial surgery. Please call us today for a consultation to find out how Dr. Steinsapir’s lip filling techniques can refresh your appearance.
Should I have lip filler or BOTOX for my lip lines?
Those who have very thin lips, asymmetrical lips, or irregularities in their lips such as lip lines, bumps, or wrinkles can benefit from lip treatment. There are safe, effective options available for those seeking improvement in the lips. Your treatment will depend upon the nature of the problem, but usually Restylane works the best.
What about BOTOX?
We have found that BOTOX in the lips is usually not ideal. This is because BOTOX relaxes overactive muscles, which makes it great for areas like the forehead where muscles are often too tense, but not in the lips. There are many important muscles around the mouth that don’t respond optimally to BOTOX. Since hyper-contracted muscles around the lips are usually not a concern, it doesn’t make sense to use a muscle relaxant in this area. There are a few people with “gummy smiles” who may benefit from having their lip elevators relaxed in this area, but generally this is not the issue we see very often.
Expression of emotion is very important in the face. This means that BOTOX treatment is great for some things – for example, if you have forehead wrinkles that make you look continually angry, BOTOX can restore your relaxed face to a position of emotional neutrality, giving you a clean palette from which to express yourself. This also means that BOTOX should not be placed into an area that is already aptly expressing emotion. Most people have properly functioning muscles around the lips, which is why we usually recommend using a filler for lip lines treatment.
Lip lines BOTOX may not be the preferred option in most cases, but there are many other benefits of BOTOX application. BOTOX is a precise treatment that can be applied exactly where it is needed and only there, so you don’t have to worry about BOTOX paralysis or a treatment in your cheeks migrating to your lips. If you’ve already received BOTOX lip injections and would prefer an alternative to BOTOX, you don’t need to worry because the effects will wear off in time. As long as you see an experienced physician for your cosmetic facial treatment, you can anticipate many BOTOX benefits as experienced injectors will individualize treatment for what is best for you.
Great Lip Filler Options
The lips can usually be treated in minimally invasive ways without using lip plastic surgery, although surgical procedures are useful in some situations. One nonsurgical procedure that works great is Restylane lip enhancement. From our experience, our opinion is that Radiesse and Perlane aren’t the optimal lip products, as Restylane is more forgiving and effective.
Restylane is ideal because it creates great results while maintaining the flexibility that more permanent treatments don’t give you. Restylane is now available as Restylane-L, which contains a numbing medicine for increase lip treatment comfort. If you have any issue with Restylane in lips, your doctor can easily modify, lessen, or erase the treatment by injecting the enzyme hyaluronidase. This is a safe and simple outpatient procedure. Flexibility is essential in lip treatment because of the delicate nature of the lips’ skin and contour. Restylane usually does the job well the first time, but in case it doesn’t, you can relax knowing that Restylane will not cause any irreversible problems.
Improving existing lip problems
Sadly, some have lips that are not pretty due to prior work by well meaning physicians, surgeons, and, yes, lay injectors. These lips may have been damaged by silicone oil, fat transfer, and mystery fillers, or just plain funky surgery and lip edge implants. Well, help is available for these forlorn lips. Many can be vastly improved with artistic application of Restylane to fill in and correct what is missing. Lips that have been damaged by accident or an unfortunate treatment experience can find help in Restylane.
Who can treat my lips?
Think of a meeting with a potential cosmetic surgeon like an interview. Assess the experience and qualifications of each individual doctor, make sure it is a currently licensed physician or surgeon, and don’t forget to assess your own comfort level too. The stuff you hear should make sense, and you should feel confident about the treatment options you discuss together. We’re not telling you to interrogate the doctors you meet, but to make sure you communicate well, have all your questions answered, and feel good about the doctor’s ability to help you. Like any good interviewer, be open to return questions and speak with honesty and frankness.
If you are looking for Los Angeles lip injections or other solutions for lip lines, we invite you to a no-risk consultation with Dr. Steinsapir. Dr. Steinsapir specializes in cosmetic facial treatments and is equipped with top-notch medical offices in Beverly Hills and at UCLA. His repertoire of experience uniquely qualifies him to perform sensitive, detail-oriented treatments. Call us today to learn about how lip treatment options can be customized to your unique needs.
