Smoked 35 years, quit in 2010. What is a permanent solution for my vertical lines? (Photo)

Now I am over 50 vertical lines are so bad. I understand I have to do fillers to see where I need to be but what is a permanent solution? I have tried the implants still feel like I am dueling all the time, I removed them after about a year and a half.

Doctor Answers 13

Laser Rejuvenation for Perioral Lines

Thank you for sharing your question and photos. While there is not permanent solution to these lines, they can be greatly reduced with a variety of cosmetic treatments. I would recommend a full field resurfacing laser to this area (called the “perioral region”), which will greatly soften these lines and make them less noticeable. The downtime associated with this procedure is more extensive than other lasers, however the results are outstanding. Alternatively, you could do a series of less aggressive lasers, such as the Sciton Halo, if you do not have the appropriate downtime. After you have healed form the laser, I would also recommend injecting a hyaluronic acid filler such as Restylane into each individual line. Botox is also an option to prevent future lines from developing, however it must be injected skillfully and in the proper place. I strongly recommend scheduling an in-person consultation with a board-certified specialist  who is experienced with lasers and injectables to get a better sense of which treatments are right for you. 


Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

Lip lines

These lines can be treated with a variety of products and lasers. The most complete treatment is laser resurfacing. In my practice, I use an erbium laser in conjunction with fractional resurfacing to achieve the most dramatic results. Expect some downtime, but the results are worth it! Good luck, Dr. M

Jared Mallalieu, DO
Annapolis General Surgeon
5.0 out of 5 stars 8 reviews

Smoked 35 years, quit in 2010. What is a permanent solution for my vertical lines

I think the vertical lip lines can be improved with many different options, such as fillers or lasers. I do not know of anything that will give you a permanent fix to the problem though. Your skin will continue to age and the lines will come back in time.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 26 reviews

Smoked 35 years, quit in 2010. What is a permanent solution for my vertical lines?

There is no such thing as a permanent solution. Even though you have quit smoking, everyday activity such as talking, pursing to kiss or drinking through straws, as well as general aging can always increase the look of lips lines. Some people choose fillers to help smooth out the look, while others lean more towards some sort of resurfacing technique. A deeper laser, such as CO2 would help to resurface the upper lip to diminish the lines. Other treatments such as the Rejuvapen/Dermapen would work well too, but would more than likely require several treatments. 

Lawrence Bundrick, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 6 reviews

Lip Aging -- fillers, lasers, radiofrequency, microneedling/PRP

There is no permanent cure for lip lines, these are genetic, due to aging, and other factors like smoking and talking.  I suggest lasers and microneedling along with fillers to get the best initial improvement and long term collagen production.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 167 reviews

Smoker's lines around the mouth.

Congratulations on being a non-smoker after that many years.  That's the best thing you could do for yourself.Remember that treatment of wrinkles aims at smoothing the wrinkles that you see when your lips are in repose and not pursed or "kissing."  Fillers can be very beneficial (though temporary) and provide a pretty easy solution but more aggressive treament would include a fractionated CO2 laser peel (Active FX by Lumenis).Discuss options with your plastic surgeon, facial p.s or dermatologist to formulate a plan.  Remember to stay out of the sun and never return to smoking!  Best wishes. Jon A Perlman MD FACS  Certified, American Board of Plastic Surgery  Extreme Makeover Surgeon ABC TV Best of Los Angeles Award 2015, 2016  Beverly Hills, Ca 

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Smoked 35 years, quit in 2010. What is a permanent solution for my vertical lines? (Photo)

The goal of lasers, dermabrasion or deep peels is to  remove the upper layer of the skin,  which then heals in smoother than before. Fractionated lasers have proved to be very disappointing for wrinkles.  I have found that the best treatment for lip wrinkles  is simple dermabrasion. This does not require a 100 000 dollar machine that the doctor needs to pay for.   I think that it is a convenient myth that minimal procedures somehow magically produces a result which you see months later. In order to get a result that can be seen in person you need to apply a certain amount of force to the skin.  The old CO2 lasers which were very powerful did this as well as peels and dermabrasion. In my 30 years of trying everything, dermabrasion has worked the best and has the least side effects.... the side effects specifically are scarring which is rare and loss of skin pigment which is almost universal and MUCH more common and profound with deep peels and the old co2 laser than with dermabrasion.Regardless of the treatment you lips will not look like a baby's bottom, there will be residual wrinkles and the upper lip almost always does better than the lower lip.  
Ps What implants did you have? .

Val Lambros, MD, FACS
Newport Beach Plastic Surgeon
5.0 out of 5 stars 8 reviews

Smoker's lines

Dear Donna Louisville:  Smoker's lines can be treated with a resurfacing procedure, which requires at least a week of downtime for healing and redness that needs to be covered with makeup for a variable period of time afterward. This gives more immediate results but can be associated with scarring if not performed carefully. Alternatively you might consider having #Ultherapy, after which there is no downtime but with which results become visible in the months after treatment.All the best,  Dr. Clark

Sheryl D. Clark, MD
New York Dermatologist
5.0 out of 5 stars 7 reviews

"vertical lines" around mouth

I have gotten great results to improve the lines around the mouth by combining skin resurfacing treatments with possible botox or fillers. Botox can be used very conservatively to relax the lines around the mouth, while fillers can be used to fill in the hollows. The best treatment is a good skin resurfacing treatment, such as a fractional co2 treatment to make new skin. I usually start with conservative botox & fractional co2 skin treatments. Fillers can be added later if needed. Good luck. Best, Dr H 

Sanaz Harirchian, MD
Houston Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Vertical lip lines

Hi, your problem is a common one, even for individuals who never smoked. With age the lip volume shrinks and the skin contracts resulting in the vertical lines. The orbicularis muscle activity exacerbates this even more. The solution is often multi-layered, requiring replacement of volume with fillers, reducing muscle activity with Botox, and treating the skin surface itself. Every surgeon has their individual approaches. I personally find injecting fillers or fat, followed by skin resurfacing to be the most effective. There is no "permanent" solution as your face continues to age with time. You need touch ups over the years. I wish you the best!

Arnold Almonte, DO
Roseville Plastic Surgeon
4.8 out of 5 stars 28 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.