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Thank you for your question and for sharing your concerns with us. Lip lines can be a very challenging concern to address, however there are a number of options that can help improve these lines. Often, the more different modalities you use the more impact you can have on the lines and still appear very natural:1) Botox and Dysport: Can be used to weaken the amount of pursing that your lip muscles can do, and hence limits how much deeper the lines can get. This treatment is repeated every 2-3 months2) Restylane Silk or Juvederm: thinh dermal filler's are a great way to directly address the fine lines. This is repeated every 6-9 months3) Ultherapy: Helps to create a little more dermal thickening. Can be done as a series to help build on the results. Should be done before fillers. 4) Profound: Micro needling radiofrequency can be used to help build collagen and elastin in the deeper skin tissue.5) Fractionated CO2: Can be to used to smooth the superficial fine lines and create a smoother look.It is important to choose which modalities would be helpful for you. It is also important to find a plastic surgeon or dermatologist with experience to help with your assessment and develop a plan that can help address your concerns.
Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery. Best,Dr. Karamanoukian Realself100 Surgeon
Botox can be used off-label to carefully inject tiny (1 - 2 units) of Botox per site in the two differenet sites of each upper lip, and the same of the lower lip. Superficial, thin, non-viscous fillers can be injected into the individual lip lines but I have been successful injtecing dilute fillers such as Restylane and Juvederm, diluted with lidocaine anesthetic, horizontally under the lip lines to make them less visible. This is done carefully with very small aliquots of filler per site, so as not to thicken the lip.
The best treatment for lip wrinkles is to add volume to the lips and resurface. For volume, hyaluronic acid fillers work best for temporary filling. We prefer autologous fat-fascial grafts ILiveFill) for lip augmentation over fat injection in our practice, but both are widely used for a more permanent result. Botox can be effective in very small amounts, but remember that the lip is functional, and too much Botox can literally make patients drool or interfere with speech. For resurfacing, there is a range of options from fractional lasers to fully ablative lasers, with variable settings of each depending on the patient's recovery time and needed results.
I read your concern: Upper lip wrinkles may be softened by a well performed Injectable Filler treatment provided they're visible and deep when you're not pursing your lips. Delicate wrinkles that are not visible at rest are not well suited for fillers. This may be a tricky area to improve as the injection should be intradermal, or into the skin. If you have several treatments where the filler is placed deep to the wrinkled skin, you can get a full, unattractive appearance of your upper lip. The expertise of your doctor is important if you're looking to reduce the appearance of the "bar-code" on your upper lip. My personal preference in this area is to use Silikon-1000, an off-label filler for permanent results. Hope this helps. Dr. Joseph
