I have severe wrinkles around my mouth area. What's the best treatment? (Photo)

I was wondering what would be the best procedure to deal with the severe wrinkles around my mouth areas. I was considering facial resurfacing but know a couple people who have had that done for acne and were not happy with the results. Plus the 'aftercare' sounds scary.

Doctor Answers 4

How to remove lip wrinkles

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In all honesty a combined approach is needed to treat Perry oral wrinkles around the lips.

The most effective results are seen with a combination of Botox, filler injections and laser resurfacing.

I prefer a technique called combined laser resurfacing using both non-ablative and ablative fractional Erbium laser treatments.

The benefit of the erbium laser over the CO2 laser is that there is less risk of pigment loss and a much quicker and easier recovery.  In addition I prefer the erbium 4 spot treatments and one area of the face on the whole face is not being treated.

I have severe wrinkles around my mouth area. What's the best treatment?

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Deeply etched lines and wrinkles around the mouth (peri-oral area) can be effectively treated with the CO2 laser.  Simplistically speaking, there are two types of treatments with the CO2 laser: fractional CO2 and full CO2.

The full CO2 laser treatment will provide the greatest amount of smoothing to the deepest lines and wrinkles.  The recovery often sounds "scary" but the results are fantastic.  Persistent redness to pinkness for 2-3 months is common but can easily be covered with make-up after 8-10 days.  Fractional CO2 laser technology can be used but the results are less (but good) and the downtime is significantly less.

Botox and fillers can be used as a supplement but the costs of doing these treatments alone long term can be significant when compared to CO2 laser treatments.

I hope this helps.

Timothy R. Miller, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 74 reviews

Laser Treatment For Perioral Lines

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Dear Ckiesch~

Thank you for sharing your photos. You would get the best results with an aggressive laser resurfacing procedure with a CO2 laser, which would be done under anesthesia with about 1-2 weeks downtime.

If you are not ready to undergo a laser procedure, you could consider starting with Botox and fillers. A few units of Botox would help with lines that are present when you purse your lips. Superficially placed filler such as Belotero would help camouflage the deeper creases that are present even when you are not moving your lips. These treatments would not get rid of all the lines but you should get some benefit from them.

Best wishes,
Amy Hsu

Amy K. Hsu, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

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Laser Resurfacing for Mouth Lines

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Hi CK.  You need a heavy laser resurfacing procedure.  We would perform 2-3 fractional resurfacing procedures with a depth of up to 1000 microns (1 millimeter)  approximately 1 month apart each with about 7 days of recovery.  In addition, we would use dental blocks to numb the area before treatment.

The recovery would be a bit difficult, but if you want to remove those lines you need a serious procedure.  It's likely that your friends that had laser resurfacing had a very superficial (not very deep) procedure.  The bigger the issue, the deeper the resurfacing needs to go to address it.  

We would use the Sciton Profractional 11% or 22% coverage with 2-3 passes and up to 1000 microns.  Repeat for three procedures for best outcome.  Good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

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