What is better for multiple lip lines; chemical peels/dermabrasion or fillers?

Question

I am 59 and have noticeable vertical lip lines. Botox did nothing. Read that artefill would be the best filler to use but also read plastic surgeon blogs that stated peels/dermabrasion was the best way for long lasting good results

Young R. Cho, MD, PhD · Answer

Thank you for your question and for sharing your concerns with us. Lip lines can be a very challenging concern to address, however there are a number of options that can help improve these lines. Often, the more different modalities you use the more impact you can have on the lines and still appear very natural:1) Botox and Dysport:   Can be used to weaken the amount of pursing that your lip muscles can do, and hence limits how much deeper the lines can get.  This treatment is repeated every 2-3 months2) Restylane Silk or Juvederm:  thinh dermal filler's are a great way to directly address the fine lines. This is repeated every 6-9 months3) Ultherapy:   Helps to create a little more dermal thickening. Can be done as a series to help build on the results. Should be done before fillers. 4) Profound:   Micro needling radiofrequency can be used to help build collagen and elastin in the deeper skin tissue.5) Fractionated CO2:  Can be to used to smooth the superficial fine lines and create a smoother look.It is important to choose which modalities would be helpful for you.  It is also important to find a plastic surgeon or dermatologist with experience to help with your assessment and develop a plan that can help address your concerns.

Dhaval M. Patel, MD · Answer

Thank you for your question!  I advise you to have a consultation with a board certified plastic surgeon, to discuss all of your options!  I would personally recommend looking into some laser treatments around your mouth.  Best of luck!Dr Dhaval PatelDouble Board Certified Plastic SurgeonChicagoHoffman EstatesOak Brook

Nelson Lee Novick, MD · Answer

In general, a medium depth chemical peel would be needed to help improve vertical lipstick bleeding lines. This kind of peel can be effective, but like true dermabrasion, is an aggressive procedure that involves prolonged healing and real downtime and the risk of permanent hypo or hyperpigmentation and even scarring. I have been treating vertical lip lines with fillers sor more than three decades, since the early days of the use of the original collagen filler, Zyderm I. Today, we are fortunate to have more sophisticated hyaluronic acid fillers, such as Belotero Balance, which I would use for this purpose in my Upper East Side Manhattan office and Teosyal Redensity II (which I would use in my Israel satellite facility where a far greater number of regulatory agency approved fillers are available). Both have little to no tendency to give rise to the unwanted, bluish Tyndall Effect when injected superficially within the delicate tissue around the mouth.I would not use a permanent filler, such as Artefill, silicone or Bioalcamid, as these have been associated with the early and late (as many as twenty years later) formation of disfiguring nodules and granulomas that are very difficult to treat. Furthermore, unlike with the use of temporary or semipermanent fillers, permanent fillers cannot be dissolved or easily removed and in my opinion would be a poor and risky choice, particularly for this region.Fractional microneedle resurfacing, about which you can learn more in the archives of Realself, can serrver an additional procedure following the use of an injectable filler to promote new native collagen synthesis (neocollagenesis), which can even further smooth and prolong the effects of filler treatment.

J. Jason Wendel, MD, FACS · Answer

Thank you for your question. Pictures would be helpfulFor a predictable and controlled result, a deep laser resurfacing around the mouth may be beneficial.

To be sure, see two or more experienced, licensed
and certified providers for a complete evaluation to make sure you are a good
candidate and that it is safe for you to have the procedure.

I hope this helps.

Steven Wallach, MD · Answer

Lip lines can be treated with dermabrasion and lasers.  Some filler may help as well. I prefer not to use something like artefill which are permanent.

Lewis M. Feder, MD · Answer

Only a combination procedure will truly address this problem.   I  find for my patients  doing a chemodermabrasion offers supurb results.    Don't waste your money on Botox or chem peels for this as they are ineffective     Fillers are useless

Stephen M. Davis, MD, FACS · Answer

Thanks for writing,I believe one of the causes of these lines is chronically pursing the lips. The perfect example is smoking. However these lines can also be caused by drinking from straws, pop bottles, water bottles, whistling etc. what ever causes someone to always purse their lips. So the first thing to do is decide what you are doing to cause this. All the treatments you talked about help but if the root cause continues, did you really solve the problem?In my hands the best, yet most aggressive treatment is CO2 laser resurfacing. This is a very controlled thermal injury and some skin tightening at the same time. The down time is somewhat longer and there can be redness for some time. All the other things help, but aren't as effective. I hope this helpsStephen M. Davis, MD, FACSGreen Hills Plastic Surgery

Mitchell Schwartz, MD - Account Suspended · Answer

A hyaluronic acid
filler such as Juvederm, Restylane, or Belotero is the usually the best option for correcting vertical wrinkle lines. They can also be used to define the vermilion borders and to elevate
and lift the corners of the mouth. Please
remember, your results depend upon the skill and experience of your physician
injector to give you a natural, flattering result.

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