33 - How to tighten skin around mouth (surgical or non surgical)? (Photos)

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

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. For tightening skin around the mouth, I would recommend Morpheus8, a cutting-edge treatment that combines microneedling with radiofrequency energy. This treatment works by stimulating collagen production deep within the skin, helping to tighten and lift sagging areas, including around the mouth. The heat from the radiofrequency energy encourages the skin to contract and regenerate, leading to smoother, firmer skin over time. Morpheus8 is particularly effective for treating fine lines, wrinkles, and mild to moderate skin laxity, and it can be a great option for those looking for a non-invasive solution to address concerns around the mouth. It’s safe for most skin types and requires minimal downtime, making it a popular choice for those looking for a subtle yet noticeable improvement in skin tone and texture.

This problem is quite a common one and fortunately, in most cases, can be easily remedied in the hands of an experienced, board certified cosmetic dermatologist filler injection expert. The problem is so common that I literally treat this almost daily in my practice.
Typically, the use of a small amount of a robust HA lifting filler injected properly can serve to elevate the depressions at the angles of the mouth and straighten them. In expert hands this should take no more than about five minutes to perform with immediate results and typically little to no significant downtime.
Hope this helps and best of luck.

Thank you for sharing your photos. At 33, it’s very common to start noticing early changes around the mouth—this area has thinner skin and is one of the first places where volume loss and skin laxity become visible. The creases you’re seeing and the slight inward turn at the corners of the mouth can be addressed with several approaches, both non-surgical and surgical, depending on how subtle or dramatic you want the improvement to be.

Here are the most effective options:

1. Hyaluronic Acid Fillers (Most Common & Effective First Step)

Early volume loss around the mouth often creates the appearance of deeper creases and inward-turning corners.
Strategically placed fillers can:

Reinflate areas that have hollowed subtly

Smooth out the folds around the mouth

Support the corners so they sit more upright and slightly outward

Improve balance and restore a more open, relaxed mouth shape

This is usually the most natural-looking approach at your age.

2. Skin Tightening Treatments (Non-surgical)

These help firm the skin and reduce early laxity:

• Radiofrequency (RF microneedling)
Promotes collagen remodeling and helps tighten crepey skin around the mouth.

• Ultrasound-based tightening (Ultherapy-type treatments)
Targets deeper layers to gently lift and firm over time.

These won’t replace volume but can noticeably smooth the skin’s texture.

3. Laser Resurfacing

Fractional or ablative lasers can:

Reduce fine lines directly around the lips

Improve skin texture

Tighten the superficial layers

This is helpful if you’re noticing fine etched lines in addition to creasing.

4. Corner Lip Lift (Surgical Option)

If the inward turn of the mouth corners is more structural rather than volume-related, a small surgical corner lift can reposition them slightly upward/outward.
It’s a more permanent option but typically reserved for specific cases since you’re still young.

5. Lip Support (Filler Technique)

Sometimes the area looks tighter or pulled inward simply because the lips have lost subtle support. A conservative, well-placed filler can:

Recreate natural curvature

Prevent the corners from collapsing inward

Improve overall balance of the lower face

My Overall Thoughts for You

Based on what I see, this looks like a combination of early volume loss and mild skin laxity—very common and very treatable. Most patients in your age group start with fillers plus a collagen-stimulating treatment like RF microneedling for the most natural and balanced result.

These approaches can help soften creases, subtly open the corners, and make the mouth look refreshed without changing your natural features.

You may want to look into a Botox lip flip. This treatment uses neuromodulators like Botox to "flip" the outer corners of the lip. The treatment is done in the office and final results are seen after two weeks. The results last approximately three to four months. Other options include filler or Morpheus8. This treatment uses RF technology combined with microneedling to improve overall skin tone and texture.