Vertical lines around the lips represent changes brought about by loss of volume in the skin and tissue beneath, as well as the constant muscle action which creases the skin. Treatment of these lines may involve replacing volume, such as with dermal fillers like Restylane, or by decreasing muscle action with botulinum toxin. At times both remedies are used together.
Botulinum toxin is most frequently used in the upper face, but has been utilized for lip creases in small doses. When placed carefully botulinum toxin can help reduce these lines for months at a time. At times the effect may not be equal, leading to a crooked smile or difficulty with speech or drinking liquids.





