Botox Cosmetic for Lip Lines

I have smokers lines, and my sister-in-law had Restylane to treat this and it looks good. I went to a consultation and the doctor suggested Botox. I didn’t think Botox was for the lips?

Doctor Answers (11)

Botox for smoker's lines or upper lip "bar codes"

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Hi Anon,

Botox in very small doses is effective at treating fine to moderate upper lip lines. One (1) unit in each quadrant of the lip, four (4) units total, is all that is needed.

For the deeper (bar code) lines, an ablative laser is best; see Fraxel re:pair. Restylane and Juvederm when used correctly are also effective adjunctively.

Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Botox for lip lines - Proceed with caution

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Botox is a wonderful modality to utilize for lip lines; however, you must understand what you are getting into.

When injecting Botox in the forehead or glabella, it is okay is one is unable to contract these muscles; however, only a small amount of Botox should be injected around the mouth at any given time in order to prevent oral dysharmony or affect one's pucker too much. This may mean that you will require more frequent injections to maintain this result.

Sanjay Grover, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 121 reviews

Botox for lip lines

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I strongly agree that you proceed with caution when it comes to Botox in the lips.

This is a treatment that is loved by some and hated by others.

Lines of the lips are due to several factors which include loss of volume, loss of bony & dental structure, loss of elasticity and repetitive use. Botox only treats the last of these and therefore multiple approaches may be required for optimal results.

I have had to injecte anywhere from 4-8 units in the upper lip and 2-4 in the lower lip. I always start with a low dose and proceed from there.

I often combine fillers, resurfacing (dermabrasion or laser), collagen induction ( skin needling), and boney supplementation with either dental appliances or deep fillers.

I hope this helps!

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 51 reviews

Botox in Lip Lines

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While it is possible to use small quantities of botox to treat fine lines, it patient selection is key, and the procedure should only be performed by an experienced and expert injector.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 20 reviews

Botox Cosmetic can be used to treat lip lines

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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.

Ira D. Papel, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

Consider all your options.

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Although very tiny amounts of BOTOX® from an extremely experienced injector could be beneficial for your lip lines, they may not be the best choice. Most of the time, a simple resurfacing treatment (laser therapy or chemical peels) can make a big difference for the fine wrinkles around the mouth area, while dermal fillers are popular for deeper lines. In fact, it’s not uncommon to combine these—sometimes with BOTOX® also—for a comprehensive approach that typically yields more impressive results overall.

Wrinkles around the mouth and lips

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Belotero injections, followed by RR Retinoid Repair Cream and laser skin resurfacing can help reduce wrinkles around the mouth and lips.

Raffy Karamanoukian MD FACS

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 56 reviews

Botox treatment for lip lines

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Lip lines are extremely bothersome to my patients, especially because they are often referred to as "smoker's lines". The best way to combat these vertical wrinkles is with combination therapy. Botox often works great in dilute and small doses in combination with dermal fillers such as Juvederm Ultra or Restylane. If the lines are deep, a fractional laser device can also be quite helpful.

Miriam Hanson, MD
Austin Dermatologist

Botox Cosmetic for lip lines

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I like to combine SMALL doses of Botox with a short acting filler (Restylane). This gives me the better resultant effects of 2 modalities. 

Botox for lip lines

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 Very conservative injections of Botox to the upper lips will help minimize the muscle action that produces lip lines.  If you are a smoker, you may need more than Botox for an acceptable outcome.  It is important to stay conservative because you need lip function to remain reasonably intact.

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.