My primary age problems are wrinkles above the mouth (below the nose area). The second problem is the line or deep wrinkle that comes on each side of my mouth and heads downward. I call it the "Charley McCarty look". It gives me a sad look.
Can Radiesse Fix Big and Small Wrinkles on the Lip Area?
Doctor Answers 8
Radiesse is an excellent filler to use deep in the dermis layer for facial folds. I prefer to use Juveaderm or Restylane for the lines above the lip. Both of these products are placed in your lip area closer to the surface and have a clear appearance. The smooth consistency of of injectable gels helps to instantly restore your skins volume and smooth away facial wrinkles and folds. Deeper lines above the lip can also be greatly improved by having an Erbium resurfacing procedure. This procedure is done in my practice under anesthesia as opposed to local but provides a more lasting appearance of lines around the lip.
Use Juvederom or Restylane for lip lines, not Radiesse
Radiesse, as will other fillers, will always be looking to extend the indications for its use in the face. In my opinion, it is not a product to be used close to the skin surface and as such should not be used in lip lines. Used deeper in the upper nasolabial fold, it is great but I would stick with the HA fillers Juvederm and Restylane for lip lines.
Radiesse in the upper lip
I am really not a fan of radiesse in the upper lip, even though we use a great deal of it for other facial sites. The reason is that the lip is very active, which caused problems when radiesse was first used to plump up the red lip. In about 16% of cases, firm nodules resulted. So radiesse was not suggested for use in the lip. Second, radiesse is injected just below the skin, or order to lift up and provide structure to folds. Unlike the hyaluronic acid fillers restylane and juvederm which can go into specific layers of the skin, radiesse must go deeper. So it is not as good as other choices for small, superficial lines. Third, there is very little subcutaneous fat in the upper cutaneous (white) lip, which means that lumps and irregularities show more readily. So injections in this plane with radiesse are more difficult to predict than other sites.
I have seen patients with injections in the nasolabial fold, where the product dissects into the upper cutaneous lip during the injection process. Very small amount, but still enough to leave visible thickening.
Finally, you should know that the injection trainers/educators are currently suggesting this as a new application for radiesse. That might be why you heard about this in the first place. As someone else described, it's supposed to give precise strength and foundation to the white lip to offset volume loss and that puckered, wrinkled look. As much as I love radiesse, there are better products to use here. Stick with restylane or juvederm.
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Radiesse is a great filler for deep non-muscle driven lines such as the nasolabial fold. It can also be used to to fill in the melo-labial fold (Charles McCarty Look). Radiesse is a white, thick filler so it can show through the skin if it is used in fine lines around the mouth.
The lines around the mouth are best treated with a finer filling material found in Juvaderm or Restylane.
Fillers for smile creases, marionette lines and upper lip wrinkles
More physicians are starting to inject the cutaneous upper lip (not the red [vermillion]) lip with fillers by injecting them horizontally to build up the lip if it is thin and to diminish the vertical creases. The hyaluronic acids such as Juvederm and Restylane are used in the vermillion and the border of the red lip as Radiesse might causes bumps when injected into these areas. The vertical lip lines are a function of chronic pursing of the underlying muscle, smoking, genetics and a change in mouth size due to a change in the placement or size of the teeth.
The marionette lines that you are describing beneath the smile folds, running from the corners of the lips down to the jaw between the cheek and chin, can respond very well to Radiesse or the hyaluronic acids.
Radiesse for Nasolabial Folds, Juvederm for Lips
Radiesse is specifically to be avoided in the upper lip. The activity of the muscle that moves your mouth tends to bunch up the Radiesse into small noticeable lumps/ bumps. Given the long lasting effect of Radiesse, and the availability of better fillers for the lips (Restylane, Juvederm), most experienced injectors won't inject Radiesse in this area.
On the other hand, the beauty of Radiesse is that it lasts a long time in the nasolabial fold (junction between cheek and lip area) and does not have the same problem of contour irregularities. This has been my filler of choice for over 6 years
Radiesse for wrinkles
Radiesse is appropriate for the large/deep wrinkles on the sides of the mouth, but not for the lines above the mouth. My concern would be the development of lumps/nodules with Radiesse if it is injected too superficially. I would stick with the hyaluronic acid fillers (Restylane or Juvederm) for the wrinkles above the mouth.
Lip lines and perioral lines
A combination of Radiesse and Restylane may be of great help to you.
The best results for lip lines is achieved with CO2 laser resurfacing, including The Deep FX.
The laser will also improve your perioral lines if you are a candidate, skin color wise, and you are ready for the healing time.
Discuss your options with a BOARD CERTIFIED PLASTIC SURGEON.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.