Why do I have smokers lines if I've never smoked? Because those pesky vertical lines (peri oral lines) around the mouth are not a result of smoking. While tobacco use does kill collagen and cause premature aging, the real reason for the development of these lines is the contraction of the Orbicularus Oris muscle. The action of the O. Oris muscle is to cinch the mouth closed, creating vertical lines in the skin around the mouth. What determines the severity and permanence of those lines is the overall skin quality and thickness.
There are several options for treatment of peri oral lines. Filling in the area with volume using dermal filler is very effective. I use a layering technique with a deeper filler for volume loss over the entire upper lip and a different filler injected much more superficially, directly into the lines. Often times a small amount must also be added the body of the lip to keep the contour of the lip natural and balanced. A limited amount of dermal filler can be injected into this area before causing an unnatural appearance to the upper lip.
Botox can also be effective by preventing the cinching activity of the O. Oris muscle. Doses of 4-8 units are average and patients are counseled that they may not be able to drink out of a straw or spit mouthwash. Some people find that they don't like the feeling of Botox in that area and opt to skip this treatment. Medium depth chemical peels can sometimes cause a very mild improvement in lip lines by exfoliating the area, making the skin crease less, but the result is not very long lasting.
Deeper resurfacing can also be achieved using deep peels and ablative lasers, which are more effective but require more downtime and there are additional risks involved. Lastly, collagen induction therapy is one of the most effective ways to treat peri oral lines. This can be done using microneedling and/or fractional laser technologies. These treatments are usually done in a series of 6, about a month apart. Down time typically involves some redness/inflammation for 24-72 hours followed by some minor dryness.
We have found that treating peri oral lines with multiple modalities is usually the most effective approach with the most long lasting and natural result. We do apply numbing cream, but please keep in mind that the upper lip is extremely sensitive, so you will want to consider your typical tolerance to skin treatments.
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If you want to treat unwanted fine lines and wrinkles, Jennifer King, MD and our team of highly-trained aestheticians can use a range of treatments to reduce the signs of aging. Schedule an appointment today and realize your full beauty.