Guidance for long philtrum and “smoker’s lines” (photo)

Question

Age 55 never a smoker but have a lot of lines and a very long philtrum. I also have a giant “five head” but that’s a separate issue.

Gary M. Horndeski, MD · Answer

You are an excellent candidate for a lip lift. A lip lift does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners. The lines around the mouth of the upper lip will also be improved. Another thing to consider is a circumoral dermabrasion.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Zoran Potparic, MD · Answer

It is very likely that lip lift would create nice improvement in your case. Regarding deep lines, which are result of skin changes as well as volume loss in the lips, options like fillers or fat grafting should be explored. Good luck.

Nelson Lee Novick, MD · Answer

The use of microdroplets of Botox appropriately placed immediately above the vermilion border of the upper lip can help to diminish the underlying muscular action of the muscles surrounding the mouth that are responsible for the so-called "smoker's lines" (aka "lipstick bleeding lines). It will also create a non-surgical lip lift which will secondarily help to shorten the appearance of the elongated philtrum.
The use of a low viscosity, cohesive, malleable HA filler can the be used to elevate and smooth the etching of the overlying "fabric" of the skin that has already occurred. Finally, the same HA filler can be threaded along the upper vermilion to further enhance the lip lift effect and further diminish the appearance of the elongated philtral columns. 
You would be wise to make sure to consult an experienced, board certified cosmetic dermatologist filler and Botox injection expert. Best of luck.

Anna Chacon, MD, FAAD · Answer

Thank you for reaching out with your concerns. Addressing lines around the mouth and a long philtrum can be effectively managed with a combination of cosmetic treatments. Here are some options you might consider:

Dermal Fillers: Hyaluronic acid fillers can help smooth out "smoker’s lines" around the lips and can also provide subtle volume to the area, which may help in reducing the appearance of a long philtrum.

Botox: Small amounts of Botox can be used to relax the muscles around the mouth, which can reduce the appearance of fine lines.

Laser Resurfacing: Fractional lasers or CO2 lasers can improve skin texture and reduce lines by promoting collagen production.

Microneedling: This procedure can also stimulate collagen production and improve the appearance of fine lines and skin texture.

Lip Lift: For a more permanent solution to a long philtrum, a surgical lip lift can shorten the length of the philtrum by repositioning the upper lip.

It's important to consult with a board-certified dermatologist or plastic surgeon who can provide a personalized assessment and recommend the best treatment plan based on your specific needs and goals.

Guidance for long philtrum and “smoker’s lines” (photo)

Answers (4)

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