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9 Months later and the line has shown no signs of disappearing, now what? (Photo)

I posted 9 months ago about a horizontal line above my upper lip, underneath my nose, following lip injections of juverderm. I have tried to wait it out hoping this would eventually go away. It hasn't. What are my options now? I would have thought all the filler would be gone by now, or at least diminished somewhat. There doesn't seem to be any filler left in my lips...but the line has not gone away, any suggestions?

Doctor Answers (5)

9 Months later and the line has shown no signs of disappearing, now what?

As seen posted photo the horizontal line and gummy smile might improve with a BOTOX injection. Or even a surgical release of the muscles in the upper lip...

Miami Plastic Surgeon
4.5 out of 5 stars 62 reviews

Line above lip

To completely give a good option as to what may be done to assist you a physical exam is an absolute necessity.  It appears that you may either have an overdeveloped perioral muscle or the skin overlying the perioral muscle is scarred down to the muscle itself.  The treatment for either situation is very different.  Botox may be used for the overdeveloped muscle but surgical release is required for the attached skin.  Filler would do little good for either situation.

Ernesto Hayn, MD
West Palm Beach Plastic Surgeon


The line above your lip is likely caused by movement and although it may soften a little with filler it will not go away completely. At times, Botox can be used, if being administered by an experienced injector to try and modify the movement to diminish the appearance of this line. You must be aware that you may not like the end result as the upper lip may drop slightly and the overall shape of your smile will change. My best is advice is to take baby steps and try the filler first. If you are not happy with that or the filler doesn’t last very long, due to movement, you can always add a little Botox the next time.

Sheetal Sapra, MD
Ontario Dermatologic Surgeon
5.0 out of 5 stars 1 review

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Crease in upper lip

I do agree that it is possible Botox in the upper lip muscle would help soften the crease, and additionally reduce the prominence of your gums when you smile.  I would like to see a picture of your upper lip at rest to see what it looks like since the filler. 

Karen Stolman, MD
Salt Lake City Dermatologic Surgeon
5.0 out of 5 stars 7 reviews


It look like you have over active muscle in the upper lip and perhaps botox may help soften that line by diminishing the activity, but an exam in person is critical.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

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.