I am very saddened by the lines around my mouth that are pulling my face down. (Photo)

Hello. I am very saddened by the lines around my mouth that are pulling my face down. They have become very prominent in the last few months. Would you suggest a filler or Botox? Also my neck has suddenly become wrinkled too. I am 49.

Doctor Answers 8

Fillers vs Ultherapy and other devices.

Often a combination approach gives the best results. Your skin seems to be great in the fact that you have little in the way of sun damage. Devices like Ultherapy can give you a lift, however in cases like yours I often combine this treatment with fillers that stimulate collagen such as Radiesse. I then use an HA based filler such as Juvederm for contouring and fine work. Video shows one of my methods for reduction lines around the mouth. All the best, Dr Davin Lim. Brisbane. Australia. 

Brisbane Dermatologist
4.7 out of 5 stars 77 reviews

Eliminate Fine Lines & Wrinkles

Wrinkles can be unsightly and are a common concern I treat amongst individuals of all ages and ethnicity. For your case, I can suggest some potential procedures that will diminish the appearance of these wrinkles and even reduce the rate of recurrence.

Botox vs. Fillers: Increasingly popular amongst youthful audiences due to what some are calling "preventative botox", these methods have the potential to actually decrease your chances of needing further corrective procedures in the future. Botox Cosmetic is a brand of neuromodulator (other brands include Dysport® and Xeomin®). These treatments work by causing facial muscles to relax temporarily. Unlike Botox, fillers don’t relax facial muscles, but instead work to fill creases and “plump” the skin.

Lasers: Fractional resurfacing lasers offer significant skin improvements with little to no downtime. Compared to traditional resurfacing lasers that target the entire skin surface, fractional devices only target small areas of the skin (in your case - under the eyes).

Platelet Rich Plasma Injections (PRP): In my opinion, this is one of the most unique procedures available in that we use the patients own blood to reverse the signs of aging. For PRP injections, we draw blood from the patient and use a process known as centrifugation to pull the plasma and platelets from the blood. The concentrated plasma is then reintroduced to the patients 'problem areas' via injection directly to the site. Not only does the gelatin-like mixture fill the fine lines and wrinkles, but the plasma also stimulates stem cells while reactivating collagen production to give the skin a youthful, plump look. Results are immediate and actually continue to smooth the skin for lasting improvement. PRP is great for younger candidates due to increased chance of acceptance/absorption of the plasma.

In any case, ask your doctor about the options available to you as there are a great deal of procedures that can assist in the dissipation of wrinkles and fine lines.

In good health,

Dr. Berger

Andre Berger, MD
Beverly Hills Physician
5.0 out of 5 stars 9 reviews

Turn a Frown Upside Down

There are many treatments for lines around the mouth. Fractional co2 laser or fractional RF treatments are usually best to this area in combination with fillers and/or botox. For neck wrinkles, a combination approach including volume/fillers/fat, face/neck lifting or skin tightening, ultherapy, and lasers can be used. I suggest you see a cosmetic dermatologist with experience in lasers and fillers. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews

Wrinkle Options

You have several options that can help with your concerns.  I would recommend the injection of a filler like Radiesse.  You could also use a undergo an noninvasive skin skin tightening procedure like Ulthera.  Finally, you could consider a surgical approach to the correction of your wrinkles.  Hope this helps.  And please consult with a board certified cosmetic surgeon.

Soft lift face

thanks for your question . You are a very good candidate for filler injection but I would also suggest non surgical face lift devices like RF , laser or ultrasound. I recommend you to see an expert physician for consult

Reza Akef, MD
Toronto Physician
5.0 out of 5 stars 2 reviews

Lower Face Rejuvenation

Hi and thank you for your question!

The lines around the mouth will require a filler. A small amount of Botox or Dysport in the jowl area will also help, but the majority of the change will happen from the filler to the marionette area. I would also suggest considering some non-surgical facial tightening and lifting with Ultherapy. The would help contour, define and lift the lower face and neck. I think you would be very happy with a combination of the Ultherapy and filler.


Dr. Grant Stevens

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 147 reviews

Tightening Sagging Skin

Based on your photos, you are a great candidate for dermal filler; with careful placement your lines could be filled and the lower face lifted. The amount of time filler will last does depend somewhat on which filler is used, something we would determine during our consultation, however you can typically expect to get around 4-6 months. The procedure is easily tolerated and involves no downtime. In terms of your neck, we offer an incredible neck and face tightening treatment called 3D laser. 3D is a collagen-building powerhouse which combines the power of two lasers, Collagenesis and Vbeam, to tighten the skin on two different levels for an overall three-dimensional tightening effect. Building collagen helps to tighten the skin, giving it a more youthful, smoother appearance. This procedure is best when done in a series of three spaced about 4 weeks apart and involves minimal discomfort and no downtime. I believe the combination of fillers and laser would provide you with a tighter, lifted and more youthful appearance you would be very happy with.

Dennis Gross, MD
New York Dermatologist
4.4 out of 5 stars 5 reviews

Wrinkle Management

Thank you for your inquiry and for providing pictures. Regarding the lines around your mouth, they can easily be treated with fillers such as Juvederm, Belotero, Emervel and Perlane. All these hyaluronic acid products, will smooth out your skin and wipe away wrinkles. Botox may help with the wrinkles on your neck but a consultation and assessment will be necessary before determining what treatments is best. Always be sure to consult with a board certified plastic surgeon. Regards,

Omar Fouda Neel, MD, FRCSC, FACS
Montreal Plastic Surgeon
4.9 out of 5 stars 24 reviews

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.