After Three Laser Facials, Still See Fine Lines Around my Mouth

Lines around the mouth are called "Smoker's lines" in many parts of the country, but in Utah where we have the lowest incidence of smoking in the nation, we call them "Whistle lines".  These lines form in response to repeated contraction of the circular muscle surrounding the mouth called the orbicularis oris.  These lines can be very difficult to treat, especially when deep.  A superficial laser, the kind you probably received, is just not aggressive enough to rid yourself of these lines.  Usually you will need one, two or even three different approaches.  The first is a resurfacing treatment.  This needs to be aggressive and deep.  Options include:


Deep Erbium:YAG laser, not the superficial or even the fractionated kind, but the real deal

Dermabrasion

Deep chemical peel like a Baker's (Phenol mixed with Crotton oil and water) peel


If that doesn't do it.  Then you fill the volume deficiency.  Options include a Facelift with SMAS harvest and implantation of SMAS into the lips (not really an option for a 33 year old), Restylane or Surgisil soft silicone lip implants.  Sometimes this would include a second resurfacing treatment.  Botox is rarely an option as the results are unpredictable and with mouth motion can make you look like you've had a stroke, so be careful.  Obviously, the more aggressive the treatment, the more adverse effects you can have and the longer recovery.  So, have a long discussion about expectations with your surgeon. 

Lines around the mouth are a common concern for which I see patients in my clinic in Pensacola, Florida.  They are certainly able to be improved with laser resurfacing but it often takes a fairly deep resurfacing of this area which may require an extended downtime.  If you do not have the downtime available (approximately 2 weeks), you will benefit from a series of peels of less depth to achieve improvement of the lines.

I do not like to use neurotoxins such as Botox, Dysport or Xeomin to treat lip lines but I have been able to achieve significant improvement with Belotero, one of the latest hyaluronic acid fillers which is able to be placed very superficial in the skin.

Best Regards,

Jacque P. LeBeau, MD

LeBeau Clinic Facial Plastic & Reconstructive Surgery