How to Treat Lines, Folds, and Wrinkles Around the Mouth and Lips


how can I treat lines around my mouth
there are three common types of lines around the mouth area that occur with
facial aging that patients and our practice often expressed concern about
one vertical lip lines or wrinkles above the lips to nasolabial folds also called
parentheses lines that appear at the outer part of the mouth and taper into
the nose area and three mesolabial folds which become more visible on the outer
lower corners of the mouth often refer to as marionette lines these lines and
folds are due to tissue changes associated with facial aging such as a
decrease in facial volume from loss of bone fat and soft tissue as well as a
reduction in skin thickness and quality I’ll talk about how I help my patients
with these lines around the mouth in my practice I’m dr. Amiya Prasad I’m a
board-certified cosmetic surgeon and fellowship trained oculofacial plastic
and reconstructive surgeon I’ve been in practice in Manhattan and Long Island
for over 20 years helping my patients with changes seen with facial aging is a
core focus in my practice with particular emphasis on the lips and the
area around the mouth referred to as the perioral area vertical lip lines is a
term which refers generally to lines which appear above the upper lip these
lines result from several contributing causes this means that each cause should
be approached to get the most effective outcome deep lines that appear when the
lips are puckered are caused by the activity of a muscle called the
orbicularis Oris muscle the appearance of these deep creases can
be improved by strategically reducing muscle activity using a neurotoxin like
Botox as the activity of the muscle decreases the depth of the creases
improve with consistent use of a neurotoxin over time the skin continues
to be less creased with movement and the lines become less prominent a neurotoxin
like Botox takes about three days to take effect and full effects are seen
about two weeks I routinely see my patients at that time to evaluate the
results and see if any enhancement is needed The effect of Botox or any
neurotoxin decreases over several months so patients come in on an average of
about every four months vertical lip lines can also be due to volume loss of
fat and soft tissue beneath the skin volume loss due to aging causes loss of
projection above the lip resulting in lines increases to be more visible by
placing a hyaluronic acid filler like Restylane or Juvederm for a volumizing
effect the skin is lifted slightly making the lines and creases appear more
smooth filler application can be performed in a few minutes and can last
between 6 and 12 months vertical lip lines can also be caused by diminishing
skin quality the skin can lose collagen and elasticity due to aging to stimulate
collagen and tighten the skin treatment like laser resurfacing or radiofrequency
heating can be employed to induce a controlled injury response the body
reacts to this controlled injury by producing collagen to heal this area the
collagen response can also help smooth and skin and thereby improve the
vertical lip lines the nasolabial folds or parentheses
lines appear to deepen due to volume loss associated with aging the
nasolabial fold can be improved indirectly by adding volume to the cheek
as well as to the mid-face I add volume to these areas using a technique called
structural volumizing also called the y lift where thicker
hyaluronic acid fillers are placed at the bone level which is below the muscle
layer this method restores volume where volume loss is most significant which is
at the bone level unlike commonly practiced filler placement which is just
below the skin deeper placement prevents filler from shifting thereby avoiding
the doughy less youthful appearance seen commonly with traditional filler
placement techniques in addition this structural volumizing technique also has
a lifting effect that further softens the appearance of the nasolabial folds
this Structural Volumizing technique came naturally to me as a surgeon with
extensive experience in performing facial implant surgery and facial
fracture repair so instead of placing silicone implants on top of the bone I
place long lasting injectable fillers using thicker hyaluronic acid fillers
like Juvederm Ultra Plus and Juvederm voluma the results of this procedure can
last one to two years the lines and fold to start at the corners of the mouth and
go downward are called mesolabial folds also known as marionette lines these
folds are also due to volume loss caused by aging and are often treated at the
same time as nasolabial folds we treat these lines with hyaluronic acid fillers
like Juvederm Ultra Plus and Juvederm voluma one particular advance
of hyaluronic acid fillers is the ease of reversal that is they can be
dissolved with the enzyme hyaluronidase if someone is dissatisfied with their
results this is an important differentiation because for this area we
can also consider a filler like radius which is made up of calcium
hydroxyapatite a material similar to bone which is also a long-lasting filler
however radius cannot be dissolved we further addressed the mesolabial fault
by adding volume and contour to the jaw line also at the bone level with
Structural Volumizing the jaw line up to the chin tends to lose its continual
contour and definition with age and this can also affect the appearance of the
mouth by adding filler to the jaw line all the way to the chin to make the
contour more continuous and defined the volume correction can also improve the
appearance of mesolabial these filler treatments take minutes to
perform and patients can see improvement immediately there may be a little
temporary swelling after treatment but this is generally minimal and resolves
quickly I regularly see cosmetic filler patients two weeks after treatment to
see how the filler has settled and if any additional enhancement is needed
patients can even have this type of treatment done shortly before an
important event like a wedding in my opinion filler placement is to be
treated as seriously as surgery once you’ve entered below the skin in my mind
the procedure is invasive fillers are often applied by non physicians and
doctors who don’t perform surgery as I mentioned earlier I feel that my
experience as a surgeon has been very useful in how I place fillers
particularly at the level allowing my patients to have
consistently satisfying outcomes with minimal swelling and rarely experiencing
any bruising I hope you found this information helpful thank you for your
question you