Botox for smoker’s lines? (Photo)

Question

I have mild smoker’s lines (however Not from smoking) on my upper lip which has also lost volume. One Dr recommended Botox, where another said even a small amount of Botox in the upper lip can cause issues with mouth movement. I am not a candidate for laser. I’d love to hear if the best result does come from botox, or filler, and if filler, which one specifically, and I’d like to add in a bit of volume- very little. Thanks in advance!

Caner Kacmaz, MD · Answer

The best option to eliminate the smoker's lines would be filler in combination with Botox.. Botox will soften the muscles that cause the expression responsible for smokers lines.

Nick Slenkovich, MD · Answer

Hello, I’m Lauren, the aesthetic injector at Colorado Plastic Surgery Center. Smoker's lines are common concerns for patients. If you’re looking to add just a small amount of volume and address those lines, filler would be ideal. Juvederm Volbella is a common filler that is used in the area you are describing. This filler is more subtle, giving you a natural enhancement. In addition,  Botox can be used in moderation to smooth out lines, and it could complement the filler treatment very well and achieve a balanced result. However, it’s always best to consult with a skilled provider who can assess your unique needs and goals. They can recommend a personalized treatment plan just for you.

Nima Shemirani, MD · Answer

Hi @Molly Mae. I recommend a combination treatment of botox, filler, and a chemical peel.

Best of luck,

Dr.  Nima

Vu Ho, MD · Answer

There are a few options for you! You can do botox in this area although you want to make sure to to go to an advanced injector because there is risk of injecting into certain muscles that can negatively affect your smile/facial expressions. There is also an option to inject small amount of filler into the lines. Adding volume to the lips can also help lessen the appearance of these lines. Using a product like restylane kysse would allow the injector to fill in both the 'smokers lines' and use the same syringe to add some volume to the lips. Keep in mind if you are wanting both areas to be treated, you may require more than 1 syringe.
Best of luck!

Brandon Richland, MD · Answer

Hi, thank you for your question. Botox can be a great option to help treat smokers lines, also called a “lip flip”. Anywhere from 4-6 units can be injected above the lip to help soften the vertical lines by making the top lip evert (flip upward). This can give the appearance of a fuller top lip as well. Downsides to a lip flip include decreased or inability to pucker lips (drink out of a straw), speech difficulty, and sometimes drooling can occur. If you happen to get a lip flip, it often only lasts 6-8 weeks unlike traditional botox, which can last 3-4 months.Filler is also a great option for smokers lines. Filler can be placed in the lines to help soften the appearance. There are several types of filler that can be placed in general, but for smokers lines, you would want a softer filler. Filler can last anywhere from 6-12 months, depending on type of product and placement of product. Only a practitioner can determine which filler is appropriate for you, therefore, I would recommended scheduling a consult and discuss the pros and cons to Botox vs filler.

Eric M. Joseph, MD · Answer

The problem with botox in the upper lip is that it can affect your ability to articulate and to use a straw. Lines like yours may be corrected with microdroplet Silikon-1000, depending on your examination. The other option for decreasing fine lines and wrinkles is Morpheus 8. I hope this helps! Sincerely, Dr Joseph

Jason Emer, MD · Answer

​Fillers such as Restylane Silk, Belotero, or Juvederm can work well to treat lines around the mouth, but the best first option is laser resurfacing or deep peels to induce collagen production. Superficial radiofrequency devices and microneedling can help as well and are less invasive. I suggest going to an experienced cosmetic dermatologist with expertise in lasers and fillers. Best, Dr. Emer​

Nelson Lee Novick, MD · Answer

First, it is important to understand how wrinkles form. Repetitive action of the muscles below the skin, such as those around the mouth involved with kissing, puckering, whistling, drinking through a straw, etc., eventually lead to permanent creasing and etching of the overlying skin even when these muscles are at rest. So, in order to optimally treat skin wrinkles, ideally both the underlying muscle movements (the dynamic component) that initially leads to their formation, as well as the static (at rest) component should be treated. Accordingly microdroplets of Botox injected at the appropriate locations along the upper lip to address the dynamic component accompanied by the use of a low viscosity, cohesive malleable HA filler placed very superficially to directly elevate and smooth the lines (the static component) would be the best way to go. This treatment plan is certainly nothing new; I have personally been using this approach for over thirty years with gratifying results. You would wise to make sure to consult with an experienced, board certified cosmetic dermatologist injector. Hope this helps and best of luck.

Sara Salas, MD · Answer

Smoker's lines are a normal sign of aging, even if you never smoked at all. It is caused by loss of volume in the lips. Therefore smokers lines are a consequence. If we treat the loss of volume on your lips with hyaluronic acid we could definitively fade away the smokers lines.

As for botox, if applied by trained practitioner, the possibility of having mobility problems is close to 0. 
Botox and fillers around the area are a great option for you!

Camille Cash, MD · Answer

Fillers should give you a nice improvement if you are uncomfortable with the risks from using Botox.  Another option is chemical peels.  Medical grade skin care products like Transform MD can help as well.

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