Is filler appropriate for a “deep wrinkle”? (Photos)

Question

I recently completed a cycle of Accutane, which, of course left my skin very dry because my lips were extremely dry while on the medication, I was often biting the inside of my cheek, and eventually, I developed this kind of crease on the side of my mouth. I don’t know if filler would be the right approach here, because volume is not the issue. I will eventually get laser to treat my acne scars, and maybe that would help with this crease. But I have to wait 6-12 months for laser. I’m 49. Would you use filler to fix this?

Anna Chacon, MD, FAAD · Answer

Hi,

Thank you for sharing the context and photos—it really helps to understand the situation. From what you’ve described, the crease on the side of your mouth is more of a skin crease from repeated trauma and dryness rather than true volume loss. In these cases, filler may not always be the ideal solution, because it primarily addresses areas where there is a loss of underlying support or fat. Using filler in a crease caused by scar tissue or repeated biting can sometimes make the area feel firmer or uneven without fully smoothing it.

Alternative approaches that could help include:

Laser resurfacing (as you mentioned), which can improve skin texture, stimulate collagen, and soften creases—though timing is important since your skin may need to stabilize post-Accutane.
Microneedling with or without PRP can also help improve the thickness and elasticity of the skin over time.
Topical retinoids or peptides in the meantime can support collagen production and improve skin resilience.

In short, filler can sometimes help, but for a crease that isn’t related to volume loss, targeting skin quality and collagen stimulation first tends to give more natural, lasting results.

Camille Cash, MD · Answer

Lasers should be helpful in softening the appearance of the crease that bothers you.  You are correct that you will need to wait 6-12 months after completing Accutane to have that done to allow the skin to heal.  You are also correct in noting that this is a texture/laxity issue so lasers would be the better choice.

Is filler appropriate for a “deep wrinkle”? (Photos)

Answers (2)

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