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I find that Botox works very well for the lips, specifically the uppers, to soften lines. Sometimes however, if the lines are very well defined or have been there for a long time, volume is needed instead of, or in addition to the Botox. I usually start VERY conservatively, so as not to interfere with function- smiling, eating and speaking are more important. Because of this, I find that the results last usually less than the typical 3-4 months that we see on other parts of the face.
Depending on what condition of the lips you want, Botox may be of assistance in providing an appearance you desire. It will only last about three, maybe four months around the mouth at the most. As an off-label procedure, botox can be injected carefully and with only 1 to 2 units per site on the skin-colored upper and lower lip to help smoothen the vertical creases into which lipstick "bleeds". There may be a flattening of the lip and issues such as not being able to smile enough to show your upper teeth, and difficulty pronouncing certain letters, singing, orating, and playing a wind instrument. The other aspect of perioral aesthetic improvement that Botox can accomplish, is by injecting the muscles that pull down on the corner of the lip (the DAO, depressor anguli oris), the corner of the mouth which curves down in many people as they age and gives a sad appearance, can lift up more horizontally. The DAO must be injected in the safer regions as doctors who have injected too high up near the corner of the mouth have found that unwanted relaxation of adjacent muscles have caused asymmetry of the mouth and problems smiling, which are temporary and come back to normal, but can take what seems like an endless four months, or so.
Many of our female patients are fans of this technique inasmuch as the outcomes are subtle, the dosing is cost-effective, and there only a few viable options for treating this very strong muscle. Most will find benefit in combination treatments of Botox/Dysport, dermal fillers, laser resurfacing, and good skin care. The only downside with this treatment is a short duration being that the strong muscle action degrades the product much quicker than other areas. Most will report a 9 week duration that may improve with time as the patient consistently works on this area.
If you want fuller lips then you want a filler such as Juvederm. Botox can be used to help reduce wrinkles above the lips, but there are other more proven methods for this area - such as laser treatments and other dermal fillers.
Botox is used to relax muscles, not add volume. In some cases lip lines caused by muscle action ("puckering") can be improved by treatment with botulinum toxins such as Botox, Dysport, or Xeomin. These products also can produce eversion of the lips. With injection of higher doses, difficulty smiling or "puckering" can result. Injectable fillers such as Juvederm and Restylane may be used to improve the appearance of lines caused by volume loss in the lips and laser skin resurfacing procedures are used to treat wrinkled lip skin. Sometimes botulinum toxins, fillers, and lasers are all needed to obtain best outcomes.
