I am only 45 and I hate the way my mouth and peri-oral area are aging. I feel like this area of my face makes me look 10 years older. My neck and jawline are still fairly decent so I'm not sure if its time for a facelift already or would a liquid facelift have a worthwhile effect on this area? Please advise, I'd like to take as many years off as possible in one procedure. Thanks!
Facelift or Fillers? (photo)
Doctor Answers (15)
Central lower 1/3rd of the face is often the first zone to age
Lilangelmommy: The perioral area is the 2nd most frequent area I treat, (after the upper 1/3rd/brow). Your photos demonstrate good jaw and neck definition but also deflation of your cheeks, tension around the upper lipstick "bleed lines" and the beginning of a left mandibular jowl. Liquid facelift usually means the use of collagen stimulatory fillers (Sculptra, Radiesse) and both of these would be suitable for correcting the vertical lines or "fish gill" deformity, which many slender women in their 40's note. Last century, a woman had to choose between optimizing either her face or her body, however now that the range of fillers has expanded, you can have both. It has been estimated that you will need a bottle of Sculptra for each decade to produce full effect, however first you need to find a consultant to discuss your aesthetic objectives. Sculptra's collagen stimulatory effects are slower to build but more sustained. Radiesse gives almost instantaneous gratification, however less persistence. The static radial lip lines confer a stern appearance, so the use of micro doses of Botox and Belotero would go a long way to softening and prettying your lips.
Facelift or Fillers?
You may certainly benefit from a facelift, but for someone like yourself with more concentrated wrinkles around the mouth, I would recommend a combination Pixel and fillers. Pixel is a fractionated carbon dioxide laser that can help you achieve reduced wrinkles, create tighter skin and lead to a more even complexion with several days of downtime, depending on the amount of improvement desired. We often add the Erbium laser at the same time to lessen or eliminate the peri-oral wrinkles and recreate the lip line. Typically, only one treatment is necessary and results can be achieved with much less downtime than a traditional facelift procedure. Fillers would help restore some of the volume you lost in the lower half of your face, which is part of the natural process of aging. Of course, you would need an in-person evaluation by a physician to determine which procedure is right for you with the price being dependent on multiple factors including the type(s) of procedure(s) recommended, number of lasers needed, the size of the treatment area and the amount of improvement desired.
The aging mouth...Lift v. Peel v. Volume...What to do?? Ask Dr Ellen
I can actually feel your pain, as I am in the same boat! It's so frustrating to see your mouth slip away at a faster rate than the rest of you and it seems that there should be a simple solution to fix the problem without getting into a lot of surgery, etc. And there are some remedies, so keep reading...
Here is my take on the perioral area: Aging is a 3 Dimensional Problem-
1. volume/soft tissue loss contributes to loss of lip projection and shape, our lips acquire a flatter appearance and the lip skin becomes more adherent to the underlying muscle
2 bone loss contributes to a more retrusive, prune- like or sucked in shape of the mouth. The maxilla and mandible start to lose stock and are less able to support the soft tissue.
3. loss of skin elasticity leads to drooping of the lips corners, a longer distance from the nostril to the free edge of the lip and more rigidity of the skin so that the vertical lines are more fixed and tight.
So you can see, there is not one simple answer to address this 3 dimensional problem. And, as you can imagine, lifting from the sides won't be successful in directly correcting the lip/perioral region.
Based on what I've described of the aging process above, here are some tips that will help in the short term to soften the look of your lips and restore some of the femininity:
1. add a little volume to your lips with a hyaluronic acid product- restore shape, add projection in cupid's bow
2. I like to use a very small amount of Botox in both the upper and lower lip as well as the depressor muscle (pulls down the angle of the mouth) to reduce the muscle tightness a little bit. This will soften the vertical ilnes and give the illusion of more lip volume and projection.
2. microdermabrasion for the perioral area and chemical peel will soften the skin, make it more supple and pliable and able to retain moisture.
Regrettably, there is no 'silver bullet' for the perioral area and it requires a fair amount of attention to retain a soft feminine look. However, it is a delicate region and proper care will go a long way to keeping a youthful appearance.
Thanks for asking! Dr Ellen
ps: in the future fat transfers could be combined with a face lift to add volume as well
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Facelift or fillers?
From your pictures, I see three issues that cause aging to your mouth and lower cheek area. First, there are some vertical lines on your upper and lower lips. Second, there is an area on the sides of your cheeks where there is some volume loss. Third, there is an area on both sides of your face, between the mouth and the area with the loss of volume on your cheeks, that has a bit of a protrusion. A facelift, by itself, would only help with the third issue. The vertical lines on your lips could potentially be helped with Botox or fillers, or a chemical peel or laser peel. The volume loss on your cheeks could be helped with fillers, and generally filling that area would improve the area with the slight protrusion in front of it.
Facelift and fillers
The patient clearly is volume depleted. Doing a facelift would only make you more bony-appearing and look skeletonized. Alternatively, if a surgical approach were desired, fat grafting would be the option. I do not think face lifting is an option if you want to look rejuvenated. In your case the ideal product to inject is Sculptra. This will give you volume as well as some skin thickening and has good longevity and if done properly can give a nice lift and rejuvenation. In addition, Botox can be used on the neckbands to improve areas of the neck. Ultherapy also can be helpful on the neck as a non-invasive treatment.
Facelifts VS Fillers
Fraxel Re:pair or the CO2 laser can reduce the lines in the peri-oral and mouth area. Facelifts are essentially ineffective for improving peri-oral lines. Restylane or Belotero are effective injection treatments for fine lines around the lips.
Facelift or Fillers around mouth?
Hey there! You are correct that you really are not a candidate for a facelift yet, and fillers are likely your best bet. Hyaluronic acid fillers like Restylane and Juvederm are very good at adding volume to the lips, marionette lines and nasolabial folds. We also use them to add volume to the cheeks, which is sometimes called a "liquid facelift." Laser resurfacing around your mouth would be helpful also for some tightening and smoothing of the fine lines. Erbium or CO2 laser works the best in my experience. The combination of volume addition and lasers is quite powerful.
Would A Liquid Facelift Correct The Aging Around My Mouth?
For your upper and lower lips, a liquid facelift to include fillers in your lips, usually Restylane, in the white rolled border between the red and white lip, Perlane to fill the body of the lips, and Belotero in the wrinkles (ritids) of the upper and lower lips.
The wrinkles on either side of your mouth and onto the cheeks are due to a loss of collagen in the skin and also excessive skin. Here, you will be best served by a standard lower facelift with the injectibles done at the same time. A deep Supra SMAS facelift with SMAS plication will give you the best stretch on your loose skin and to get rid of the wrinkles on your cheeks.
Starting approximately six weeks after your facelift, I would recommend a series of 3 Sculptra injections to give collagen back to the aging skin around your mouth and cheeks.
You have a long distance between your lower lip and your chin, and your chin is beginning to sag which will lead to an unfortunate appearance known as a witch's chin. This can be corrected once again by a liquid facelift using Radiesse or one of the HAs. These fillers or a small chin implant will give the optical illusion of decreasing the height of what appears to be a very long face.
As you can see, you need a combination of injectibles and surgery, and this can best be done by a Board Certified plastic surgeon who is a member of the American Society for Aesthetic Plastic Surgery.
Should you get fillers or a facelift?
From your photos I can see that you are slender and that has led to the loss of fullness in your cheeks, resulting in vertical lines. If you rely on the use of fillers you will need to use quite a large volume and repeat this treatment every couple of years. I have used a simple rule of thumb for advising women like you what to do. Fillers are expensive and if you need to use more than 3-4cc per year then you are better off "saving your pennies" for a surgical lift. In your case, I would suggest a limited lift to tighten the lower cheeks and eliminate the jowls. This would be your best investment and the results should look good for about 10-15 years. The lines around your lips are a little trickier and should be approached with caution. You might need a combination of treatments such as fillers, Botox and dermabrasion (it is a little difficult to be exact with the limited detail in your photos). My best advice is to be careful not to have too much filler in the lips because that may end up looking puffy and unattractive.
Diana L. Elias MD
Facelift for area around mouth
From your photos it appears that you have a lot of aging in the cheeks as well as around the mouth. Ther is certainly loss of volume in the lips, especially the upper lip with a lot of lines in that area. Your neck is still quite good except for a slight laxity in the submental area. I would perform a short scar 2 layer facelift which would improve the cheeks and jowls as well as tighten the neck some. This does not reach the area aound the mouth since if we pulled tightly enough to reach that area it would look funny. I would perform a CO2 laser resurfacing of the perioral area at the same time as the mini lift. I use the Lumenis Encore Ultrapulse Total FX laser as it goes the deepest but still has the fast healing of fractional lasers. This give the most permanent solution but you may also want later adjunctive procedures such as Juvederm (or similar) fillers around the lips. I do not think a totally non surgical approach will be best for you but will certainly help. Good luck!
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.
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