Had Botox injections on top of my upper lip for "smokers wrinkles". It has been more than 3 weeks and absolutely no change?

Im 39 & this was my 1st time for Botox. I did it above my upper lip for the "smokers lines", they aren't deep/bad but definitely noticeable to me. Dr did 6 injections. I took pictures before & throughout since now more than 3 weeks since & theres absolutely no change. I felt some numbness but even that has diminished. My question is why? I know the Botox is diluted, could it be it was overly done? Or that the dr didn't do it properly? I have read depending on severity 2-4 should be sufficient.

Doctor Answers 15

Botox for the lips

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Thank you for your question Mellymel16. Botox is a purified protein used to address wrinkles associated with facial expression. In the lower face a small amount of Botox can be used around the lips which will provide a slight pout and may improve the wrinkles above and below the lip a subtle amount. It is important that a small amount is used because over-treatment can lead to issues with speaking, eating, and breathing. Botox is usually an adjunct treatment to others such as fillers and fractional laser resurfacing for smokers lines. Please consult with a doctor for specific recommendations. Good luck!

Treatment For Smoker Lines

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I would use dermal fillers such as Belotero or Restylane Silk for
smoker lines as these are superficial fillers. I would recommend an
Erbium type laser resurfacing for deeper lines. This should be done in the hands of a Board Certified Plastic Surgeon or Dermatologist with expertise in this area.


Rod J. Rohrich, MD
Dallas Plastic Surgeon

Botox for upper lip lines

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Botox when given alone rarely improves upper lines much. There is a wide variability in how people respond to Botox in the lip. Some get very weak with a small amount, and some seem to have no effect unless a large amount is given. The number of injections used does not tell how much Botox was given. I prefer to start with a small amount of Botox and give more the next time if the effect was limited.

My normal approach is to give Botox in small amount on either side of the lip lines where the muscle is that is causing the lines. If you have the patient purse their lips, you can see how the muscle is responsible for the lines. I then wait at least two weeks, see the patient back, and then usually inject filler directly into the remaining lines. If you have deeply "etched" linesin the lip, it is not possible to clear them completely, but they can be significantly improved.

Thank you for your question.

Best Wishes

David J. Kiener, MD
Sacramento Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Botox in upper lip

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Injecting Botox in the upper lip is tricky because there is a thin line between giving too much and paralyzing the muscles to the point of affecting speech or not giving enough and not noticing any result. So, you need this done by an experienced injector. But it is always better to go conservative and you can add more if needed. 

Andrew Pichler, MD
Sacramento Facial Plastic Surgeon

Botox and smoker's lines

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Depending on the severity for your smoker's lines, you may need a combination of Botox and fillers.  You can only place small amounts of Botox in your lips, because too much would cause problems with speaking, eating and drinking.  It is best to discuss your results with your doctor and see what your options are.   Good luck!

Jennifer Trent, MD, FAAD
Sarasota Dermatologic Surgeon
5.0 out of 5 stars 5 reviews

Had Botox injections on top of my upper lip for "smoker's wrinkles." It has been more than 3 weeks and absolutely no change?

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Thank you for your question. Botox injections in the upper lip to correct "smoker's wrinkles" is a widely recommended treatment. That being said, you may want to consider combination of Botox and a filler such as hyaluronic acid, to give a more satisfying correction. I wish you the best of luck.

Botox for smoker's lines

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The area around the mouth can be very tricky when injecting Botox and my guess is that your doctor proceeded with caution. Some people respond to tiny amounts while others need more product to get a good result. You might need more injected for a good result so I would suggest that you go back and discuss this with your doctor.

Jo Herzog, MD
Birmingham Dermatologist
4.8 out of 5 stars 20 reviews

Lip Lines -- Lasers, Microneedling/PRP, Botox, Fillers

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Botox rarely works for this condition.  Fillers and lasers with microneedling are the best options and will take a series of treatments for improvement.  Please see an expert.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Botox for above lip lines

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Botox works by relaxing muscle/preventing muscle fiber contraction. This reduces the appearance of lines in most cases but since Botox doesn't "fill a dent" it will often not completely eliminate the line. To eliminate the line you need collagen growth-i.e. replace the collagen that has been lost which is what created the line to begin with. Popular collagen induction procedures include things like microneedling facials with or without platelet rich plasma (The so-called Vampire Facial) and Ultherapy smoothing treatments (micro-focused ultrasound).
Lisa Vuich, MD

Lisa Vuich, MD
Nashua Physician
4.7 out of 5 stars 11 reviews

Botox to Upper Lip for Fine Vertical Lines

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Thank you for your question.  Sorry to hear that you are having some concerns about your postprocedure appearance.  It is difficult to comment on your results without seeing your before and after photographs.  I find that Botox to the upper lip works well to soften very fine vertical lip lines.  Moderate to severe vertical upper lip lines are very challenging to treat.  Often a combination of Botox and fillers works best.  Please be sure to see an experienced injector for an in-person reevaluation to fully address your concerns and to determine the best course of action.  Best wishes! 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.