I have smokers mouth due to weight loss. Should I skip the Pelleve and go straight to a filler?

Doctor Answers 4

Fillers have more immediate but temporary result, while heat treatments take longer for results, but also last longer

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Thank you for your question. You did not submit a photo, but ask you if weight loss can result in smoker’s mouth, and should you skip Pelleve and go straight to fillers for treatment.

I can give you some guidance on how we approach this area around the lips often referred to as smoker’s lines in our practice. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve been in practice in Manhattan and Long Island for over 20 years. Our practice offers a full range of solutions from non-surgical skincare products, injectables, the full line of radiofrequency and laser technologies, and advanced cosmetic surgery. If you have this type of problem, I have a series of options we would discuss to optimize the results for you.

When you think about what your issue is, and you state it’s related to weight loss, you have to make a distinction: what do fillers do, and what does technology like Pelleve do? Pelleve is a radiofrequency technology that generates heat into the skin, specifically the dermis or the backbone of the skin. The dermis is very important for the elastic nature of the skin and for support. When the dermis gets weaker, it collapses and you get lines. Pelleve radio-frequency generates heat at a critical temperature to stimulate collagen formation. With fillers, typically hyaluronic acid fillers, are placed intradermally, very close to or just below the dermis, as well as into the deeper tissues.

In the mouth area, there may be some elements related to weight loss, but I suspect there are also some elements related to genetic facial aging. If you want add volume at multiple levels, fillers allow that more immediately. The difference with Pelleve or laser treatment, both ablative and non-ablative laser, is you are treating, then waiting for results. You are waiting for the induction of collagen which means at least a month to see some results.

In my practice, I try to counsel my patients about the physiology of what they see. Very often, people focus on lines, but lines are a reflection of what’s going on underneath. You have to think how the mouth and lips look overall, and their relationship to the rest of the face. We offer solutions that include a laser treatment method from the inside of the lips, and add heat from the inside called 4D rejuvenation. We have methods with injectable fillers, non-ablative lasers, ablative laser treatments like fractional CO2 laser, and platelet-rich plasma (PRP) that uses your own blood to stimulate collagen, so we have a lot of different options. This is not a black and white type of question where it’s one or the other, and often synergy is best in a combination approach.

I recommend you meet with a doctor, maybe a few doctors, to learn about your options with what you want to achieve. Often people want to see a line get erased, but a line can’t usually be completely erased, but it can be improved. When you think more globally and artistically, then you can find a solution to enhance the overall look. For example, when person comes in saying they have a problem with the nasolabial folds, and that their lips are small, we do a procedure called structural volumizing where we can add volume to the cheeks, jawlines, and around the mouth, but without going directly into the lines around the mouth or lips, but the whole area can look better. So there is an art, and it is not about chasing the individual elements, but seeing the whole rather than just the sum of the parts. I hope that was helpful, I wish you the best of luck and thank you for your question.


New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Smokers mouth / weight loss

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Hello, I have seen Radio Frequency and Fillers treated to that area for lines .  Pelleve' is a great treatment that takes a few times and depending on your depth of lines , you might want to go the filler route.  Its hard to say without seeing your lines.

Best of luck to you.

Georges Kaado, MD
Virginia Beach Physician
5.0 out of 5 stars 11 reviews

Pelleve and Filler

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Pelleve is a wonderful treatment to do with filler. The “smoker’s mouth” you mention will probably benefit most from the filler. However, weight loss usually means skin laxity, which the Pelleve will help with.P

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Pelleve or filler

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There isn't any reason you can't have both! In fact it's a good idea to have both.  Lots of offices are doing Pelleve first and then doing filler.  Pelleve helps tighten the skin and reduce wrinkles.  This will enable your doctor to use less filler and possibly prolong your results.  Good luck to you.

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