Smokers lines filler over scarring? (Photo)

Question

Hi , I’m 53 and have noticed one side of my lip pulls in more than other. I have a few small scars above lip and this is why. Would smokers line filler or lip filler be best to sort this out. Or Botox ? I like the idea of filler as it lasts longer, but worried the scarring would make it look odd. Thank you

Juan Guillermo Breton, MD · Answer

I would not only treat the lines by iltself, because I have to build up structure, so I would use a lowe G" filler to give your lips just a little plump and to mantain the shape, then i would do a blend between an HA based filler called skinbooster, a very low G" filler and botox (but in a differente dilution), because usually what patients complaint about more when they have botox on the lips to correct and/or treat smokers lines, is that the y dont smile the same. With the blend you wouldnt have an issue with that and usually it last quite for some time, maybe 8 - 12 months

Brandon Richland, MD · Answer

Hello, and thank you for your question. If one side of your lip is smaller than the other, I would recommend focusing on either lip filler or using neurotoxin for a lip flip. Lip filler will last longer and there are specific techniques that can be used to lengthen the height of the lip. You could also fill in the smokers lines as this would create a very uniform result. If you decide to choose neurotoxin for your lips, this helps to flip the top lip outward but can only last about 6-8 weeks. I would recommend scheduling a consult with a provider who specializes in dermal filler and neurotoxins to determine which treatment option is best!

Anna Chacon, MD, FAAD · Answer

Both dermal fillers and Botox can be effective in addressing smoker's lines and lip asymmetry. The choice between these treatments often depends on the specific characteristics of the lines and the overall facial anatomy.Dermal fillers, like Juvederm or Restylane, can add volume to the lips and smooth out wrinkles. They can also be used to correct asymmetry. However, the presence of scars can sometimes affect the outcome, and this is something that needs to be evaluated in person by a professional.Botox, on the other hand, works by relaxing the muscles around the mouth, which can help reduce the appearance of smoker's lines. It's a slightly different approach and might be an option if the lines are primarily caused by muscle movement.The best way to determine the most suitable treatment for your specific case would be to schedule a consultation with Dr. Anna Chacon a board-certified dermatologist, who can evaluate your lips and scars in person and discuss the possible treatment options with you.

Anil R. Shah, MD · Answer

Hello intuitive563136! My name is Jessica, I am a physician assistant, and one of the providers at Shah Facial Plastics. Thank you for your question. Based on your concerns, I recommend combining treatment with dermal filler and lasers. I highly recommend scheduling an in-person consultation in order to better assess your areas of concern and discuss an appropriate treatment plan to help achieve your aesthetic goals. Our office phone number is: (312) 944-0117. I hope this helps and best of luck!

Nelson Lee Novick, MD · Answer

There are two components to most facial wrinkles; the dynamic component, i.e. the movement of the muscles below the skin that lead to scrunching and pleating of the skin above and a static component, i.e. the creases etched into the skin after years of repeated movement of the muscles of facial expression. To address this, a neuromodulator, such as Dysport, Botox or Xeomin, when injected properly, can quiet the underlying muscle--i.e. address the underlying cause of the wrinkles (in this case the smoker's lines) and following that an appropriate filler can be used to elevate and smooth the creases that have been etched in after years of daily muscular movement.  You would be wise to make sure to consult with an experienced board certified cosmetic dermatologist injector. Hope this helps and best of luck.

Nadja Haub, MD · Answer

Hi there,
I am sorry to hear that you have a small amount of scarring on top of the left side of your lip. Looking at your photos, the tiny scars on top of your lip appear to affect your lips' shape. 
As these little scars appear to be the cause for this, I would suggest to try and smooth the scars first, and then try some lip filler. 
Treatment options for the scars include microneedling or laser. Both treatments induce very tiny micro-injuries to the skin close to the scars. These little injuries will heal and renew the skin in that area. This can soften the scars. 
After that, I would treat the area with dermal filler. First, I would shape your lips and maybe inject more dermal filler into the left side of the lip to improve its shape. 
Following this, I often mix the dermal filler with a small amount of Botox to further relax the muscle on top of the lip. 
I use a small cannula to inject the dermal filler/Botox mix. The cannula will be gently inserted close to the corners of the mouth into the area on top of the lip. After that, I gently wriggle the cannula under the skin on top of the lip. This process loosens the wrinkly skin and creates a small space right under the skin. This is where I inject the dermal filler and Botox mix. 
The treatment takes half an hour, and results last between 12 to 18 months.

Connie Hiers, MD, FACS · Answer

With your deep lines, you will need more than filler. I would suggest starting with plasma pen or CO2 laser to treat your deep lines.  You may need up to 3 treatments. Whatever if left then can be filled with filler if needed.

Berlin Beauty Medical Aesthetics · Answer

Botox, microneedling, and dermal fillers can be used individually or in combination to address smoker's lines, which are fine lines and wrinkles that commonly appear around the mouth due to repeated lip pursing and smoking. The choice of treatment or combination of treatments will depend on the severity of the lines and the desired results. Here's how each treatment can be used:
Botox can be strategically injected into the muscles around the mouth to relax them and reduce the appearance of fine lines. This helps prevent further deepening of these lines.The effect of Botox typically lasts for a few months, and follow-up treatments are needed to maintain the results.
Microneedling is a minimally invasive procedure that uses tiny needles to create micro-injuries in the skin. This stimulates the production of collagen and elastin, which can help improve the texture and appearance of the skin. Microneedling can be used to treat fine lines and wrinkles, including smoker's lines, by encouraging the skin to regenerate and become smoother. Multiple sessions are often required for optimal results, and there may be some downtime.
Dermal fillers can be used to address smoker's lines by filling in the lines and adding volume to the area around the mouth. Hyaluronic acid-based fillers are commonly used for this purpose. They can be injected into the lines to plump and smooth the skin.
Combination treatment in this case works best. Hope this helps!!.....Lena

Mats Hagstrom, MD (license on probation) · Answer

Find lip wrinkles are difficult to treat. Filler can either be done right in the dermal junction or deeper in the lip together overall lip volume. When injecting into each individual wrinkle filler tends to give the lip a bulky, unnatural appearance. Standard lip augmentation helps slightly, but doesn’t really treat define wrinkles 
Botox is a bit of a balancing act getting enough tocsin to give result versus the patient living with partially paralyzed lips.
Skin resurfacing works fairly well in other areas but tends to not do the trick around the mouth. This includes CO2 laser and chemical peels even deep, ablative treatments seem to not given lasting results.
The best approach is prevention with daily sunscreen, starting at early age.
For actual treatment, the best is probably a combination of fillers and Botox since no single treatment is going to give a curative effect.
Best,
Mats Hagstrom, MD

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