What can I do about lip wrinkles and thin lips after weight loss and smoking cessation at 50 years old? (photo)

Question

50 year old that is a former smoker, but didn't get the lip wrinkles until I lost some weight! I've never been happy with my thin lips but couple that with the vertices lip lines it is really aging me! What should I do?

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Michael P. Morrissette, DDS, FACS · Answer

First, patients who have never smoked develop smokers lines of the upper lip. It is a common problem for women and aging. Second, there are multiple approaches to improving the appearance of your lips. The length of your lip ( the distance between the tip of your nose and pink of your lip ) appears excessive (greater than 13 mm). If that is the case, I would recommend a lip lift procedure to shorten that distance. This procedure alone will decrease the wrinkles, however, a permanent reduction in wrinkles can accomplished with resurfacing. I prefer to resurface the skin with a CO2 laser or chemical peel ( TCA or phenol). I think that fillers will not provide the results you are seeking. In addition, any result with fillers is temporary.

Catherine Winslow, MD · Answer

Hello!You have a number of issues contributing to the wrinkles. You have loss of volume in the lips -especially the lower- and the junction of pink/white lip (vermillion). Loss of volume is best treated with fillers. Fillers can be used to improve the depth of the lipstick lines as well. It is not uncommon to have the muscle under the skin contribute to the "lipstick lines" of the upper lip and small amounts of Botox will improve this. Finally your skin has lost collagen and elasticity; resurfacing would greatly improve the quality of skin and end results. Lasers or dermabrasion for more aggressive treatment would be optimal. I would recommend a consultation with an experienced facial plastic surgeon to discuss your options. Good luck and stay safe!

Philip S. Schoenfeld, MD, FACS · Answer

There are a few ways to tackle the issues with your lips that you are unhappy with.  You are going to need filler for lip augmentation and for the deep lip lines.  You will also need Botox in the upper lip to prevent the orbicularis oris (lip muscle) from contracting and making these lines even deeper.  Microneedling, radiofrequency microneedling, or perhaps ablative laser to the perioral region would also help but the lines are deep.  Finally, you are also a candidate for a lip lift procedure for a variety of reasons that filler will not address.

Melissa Young Szalay, MD · Answer

Your concerns are related to a few contributing factors. With weight loss, results are typically great everywhere except in the face, where fat actually is valuable to maintain a youthful appearance.  Also, in general, with aging, we loss volume in the face, including the lips.  Restoring volume to the lips can be done with dermal filler.  Choice of filler is up to your treating provider, but in general we like to choose a softer, more malleable filler that can move with your lips for natural results.  In terms of the vertical lines around your lips, these can also be treated with a soft filler, but care needs to be taken not to add too much volume here or it can create a "monkey" look.  For these resting lines (not only around your mouth but also the chin), I would recommend microneedling and/or platelet-rich plasma (PRP) injections to helps stimulate collagen and elastin production, which helps "heal" the skin and improve resting lines and wrinkles.  Finally, a professional level skin care program is a must!  I remind my clients that I can do great things for them in my studio, but they can optimize their results by doing a customized skin care routine every day.
Best, Dr. Melissa

Robert L. Kraft, MD, FACS · Answer

The deeper grooves in the jowls can be corrected with filler and this would also be useful in the areas surrounding your lips. The finer lines would be treated with laser. They may be improved but not eradicated.

Robert T. Buchanan, MD (retired) · Answer

What you have is classic aging of the lips. Of course, your weight loss didn't help as loss of the fatty tissue of the lips is one of the signs of aging. The upper lip is, in youth, about a third smaller then the lower. It also has the vermillion border as the most prominent part. The lower lip central vermillion is its most prominent part. As we age the upper lip becomes straight and even convex. The lower recedes and becomes smaller than the upper. All this is from loss of the supporting fat. Because the skin has also lost its thickness and elasticity, the muscles of the lips create the distinctive lines like what you have. The reason these are called "smoker's lines" is because they appear earlier in smokers. Treatment involves use of Retin-A (tretinoin) and Obagi's ELASTIderm to thicken the lip's skin and add elastic tissue and then injection with a hyaluronic acid filler. Frequently you do not even have to fill the lines. They may disappear just by adding volume to the lips. If not, then use of a filler like Juvederm Volbella can improve them further. By combining the filler with skin care, the body uses some of the filler to make its own collagen so you do not have to do as much the next time. Make sure you see an expert in rejuvenation, not someone who mostly treats younger people.

What can I do about lip wrinkles and thin lips after weight loss and smoking cessation at 50 years old? (photo)

Answers (7)

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