Perioral lines - best treatment?

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Without photos and more information a specific recommendation is not possible. Usually fillers such as Belotero Balance or Volbella, work very well for the perioral vertical lines and fine wrinkles. These treatments injected properly usually last a year or longer. If the wrinkling is more significant, a deep resurfacing procedure may be a good option. I personally recommend a deep chemical peel (phenol-croton oil), if you can find an experienced doctor. Lasers have a tendency to produce a hypo-pigmentation if the deep lines are treated. Please consult with an experienced facial plastic surgeon to discuss your options.

There are numerous treatments for perioral lines and depending on how many, how deep and etched they are would determine which method or methods would be best.  For early fine lines superficial fillers with or without Botox are usually fine.  The newest are Restylane Silk, Volbella, Belotero and soon Restylane Fine. For deeper lines more robust fillers like Juvederm, Restylane and Radiesse are best, but now PDO threads are also being used to give significant improvement.  Energy based treatments such as Thermi Smooth, Ulthera and Fractional lasers are more permanent and lasting treatments alone or in combination with fillers.  Finally, in skilled hands, Dermabrasion is a very successful long duration solution. 

Fillers would be the best treatment for these perioral lines.  Without a photo I am assuming that they are deep and could be filled with Voluma or Juvederm.  Superficial lines can be treated with Fraxel, chemical peels, PRP and Microneedling.  Please consult a board certified dermatologist for the best cosmetic results.  Best, Dr. Green

Laser treatment is possible, but if the lines are v deep performing this procedure JUST around the mouth area will result in what we call the 'milk mo'- white areas on the upper lip. Not a good look. If you have a look at my before and after pictures, you can see how Specialist treat lines in this area- namely a blend . This means we do treat the entire face as it gives a more natural look. Peels such as old fashioned phenol peels can give good results, however with the event of lasers, the later is more precise with less chance of skin colour changes. Dr Davin Lim. Brisbane. Australia.