Filler, Sculptra or facelift for large wrinkles around my mouth? (Photos)

Thank you for sharing your photos and your concerns. From what you describe, it sounds like the lines around your mouth are dynamic and volume-related, meaning they become less noticeable when you lift your cheeks. This usually points to volume loss in the midface rather than true “sagging” that would require surgery.

Here’s a breakdown of your options:

Cheek filler: Adding volume to the cheeks can often lift the midface slightly and soften deep nasolabial folds. This is usually a quick and effective non-surgical solution for lines like yours.

Sculptra: This works by stimulating collagen over time, gradually restoring volume. It’s great for subtle, long-lasting improvement but takes multiple sessions and several months to see the full effect.

Mini facelift: This is generally reserved for more significant sagging, especially if the jowls or jawline are affected. At 44, if your main concern is midface volume loss rather than laxity, you may not need surgery yet.

In many cases, a combination of cheek filler and possibly targeted nasolabial filler can give you noticeable improvement without surgery. Sculptra is an option if you prefer a slower, natural collagen-building approach.

The good news is that at your age, these lines are very treatable with minimally invasive options, so surgery is usually not the first step.