What is causing these wrinkle like lumps/folds around my mouth at age 25? (photo)

Question

I have these wrinkle lumps/fold around my lips that get even worse when I smile. I was wondering if it is possibly perioral mounds or deep nasolabial folds? I know my face isn't symmetrical. I suffer with tmj and am looking into botox for jaw reduction as my lower face has gotten much wider over the past few years. But what can be done about the area around my mouth? Details: 25 years old/non smoker/not overweight/previous juvederm lip injections a year ago but the problem was there already.

Jason Emer, MD · Answer

It is likely you are going through some aging, which is a combination of genetics and sun.  I suggest you see a facial contouring speciliast, you will need fillers, laser, radiofrequency/ultrasound treatments in combination to help texture/tone, improve volume, and crepe skin.  Best, Dr. Emer.

Heidi A. Waldorf, MD · Answer

Those 'lumps/folds' on either side of your mouth are created by loss of volume (fat) most likely in your cheeks, but also the sides of your face and chin.  With less support, the skin literally folds there.  You're young, you've likely lost less fullness of the upper and lower cutaneous lip (the skin above and below the lip itself) and you've added structure to the lip with juvederm already, so instead of it just folding downward, it seems to stand up like a lump.  Your TMJ is likely aggravating the condition by squaring off your jaw and tightening all the surrounding musculature.Replenishing the volume of the cheeks, lateral face and chin will help lift and soften the folds.  Depending on your medical history, this can be done using sculptra, radiesse or a hyaluronic acid filler like voluma or perlane.  Depending on the texture of your skin - including whether or not you have had sun damage already - you may also consider a tightening procedure like Thermage, which has the benefit of no pain and no downtime; or a fractionated resurfacing procedure that can improve texture while also tightening, like Fraxel Restore or Dual.  Id recommend waiting until after filler for those since volume is clearly an issue.Remember that while botulinum toxin for TMJ can definitely improve your symptoms and soften the appearance of your jaw, you will likely notice some change in your ability to smile and chew temporarily.  Your face will also look longer and more narrow so you may need more filler for width until you get back to a new baseline.

Hratch Karamanoukian, MD, FACS · Answer

Thank you for your question and for posting pictures.I believe Radiesse, Restylane or Juvederm can help soften these nasolabial lines and mild marionette lines. We prefer Radiesse for these lines in our practice and the product depends on the physician who is injecting, unless you have a preference. You should have a good outcome with this and you should request a cannula technique to reduce bruising or hematoma. Best,Dr. Karamanoukian

What is causing these wrinkle like lumps/folds around my mouth at age 25? (photo)

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What is causing these wrinkle like lumps/folds around my mouth at age 25? (photo)

Answers (3)

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