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Making Those Lip Lines Go Away
The development of upper lip lines and wrinkles is very troubling for most women as it is a sign of aging. Lip wrinkles are impossible to cureand any patient undergoing treatments should view the expected results more as improvement rather than elimination. Injectable fillers, Botox, and laser resurfacing are the mainstays of treatment today.
The development of lines and wrinkles on the lips is one of the signs of aging in a woman. Like brown spots on the back of the hands, there is very little that one can to do to prevent them. Smoking, and even drinking bottled water, have been implicated as causes, but many women have them and they have done neither.For fair-skinned women with thin skin and thin lines, there may be little one can do to stop them from appearing.
As a general principle, wrinkles form on the face perpendicular to the direction of action of the underlying muscle movement. For example, horizontal forehead wrinkles are the result of ther vertically-oriented and moving frontalis muscle which extends from the brows upward into the scalp. Since the mouth’s main muscle (like the eyes) is a sphincter or encircling muscle which lies parallel (horizontal) to the upper and lower lip (except at the corners), it is no surprise that the lips (particularly the upper) develops vertical wrinkles in some people. The other factor that highly contributes to lip wrinkles is the thickness of your skin and the size of your lips. (which is interrelated) The thicker your skin, the less likely you will ever develop them. You rarely see lip wrinkles in people with thicker skin such as African-Americans and people of Middle Eastern descents for example. (and they have larger lips to begin with....as their skin is thicker)
Treatment of lip wrinkles is a challenging problem. I tell patients to think of it as improvement as there is no complete cure in most cases. For small and fine lines that are mainly located at the junction of the skin and the lip, an injectable filler can make a nice improvement...provided you find it acceptable to have a larger lip size. (whichever you desire) When the lip wrinkles are deeper and run higher into the upper lip, the concept of skin resurfacing comes into play. Usually this means laser resurfacing and it is just a question of how deep to go and how much recovery does the patient want. When the lip lines and wrinkles are more severe, I usually use a combination of making the lip bigger with injectable fillers and resurfacing the skin with a laser. This is done in the office under local anesthesia unless the patient is having other facial procedures which requires a trip to the operating room with the use of deeper anesthesia. Current proponents for fractional (fraxel) laser treatments feel that it offers better results than traditional laser resurfacing but that has not yet been clinically proven. In the more severe cases, a small amount of Botox to help reduce the amount of muscle movement can also be helpful when done with fillers or laser resurfacing but you must be careful to not use to much lest you make your smile have an unnatural appearance.
Other methods of upper lip resurfacing for lip wrinkles is currently being evaluated. One method is to combine laser resurfacing with the use of sandpaper (yes I said sandpaper), known as laserbrasion. With laserbrasion, a combination of upper skin removal is done first with the laser and the deeper skin areas are taken down with sandpaper. The concept here is that the use of sandpaper causes less trauma (no heat) and will heal faster without the prolonged redness. And it is just as effective as the laser but safer and with less complications than if one used traditional dermabrasion. The other method is known as percutaneous collagen induction therapy. (PCIT) Known aerating your lawn, a small wheel with fine needles is run over the upper lip, cutting many fine holes into the deeper portions of the skin. As this heals it causes the skin to thicken which helps reduce the amount of visible wrinkling.
Upper lip wrinkles in some women are unavoidable and can be very troubling. Injectable lip fillers, laser resurfacing, and Botox can help but there is no permanent cure. The alternative treatments of fractional laser treatments, laserbrasion, and collagen induction therapy are interesting but it is too early to know if they will offer better results.