How Many cc’s of Volbella would I need for upper lip lines? There are approximately 5-6 lines. (photo)

I recommend getting a formal evaluation with a facial sculpting expert. These fillers, (Volbella, Restylane, Juvederm) are good to create a symmetrical and full lip. PDO Nova threads can also be used to improve shape and also provide lift. Fat or implants are a permanent alternative.  Best, Dr. Emer

It is important to realize that most facial and neck wrinkles are formed from the repetitive motion of the muscles of facial expression (i.e. the dynamic component) and following years of this repetitive, daily motion, the development of permanent etched-in creases (i.e. the static component). By analogy, if you fold a piece of paper tightly even one time, you will create a prominent "etched-in" crease along the fold line that even with ironing is unlikely to be completely erased. Therefore, when treating areas, such as in this case the so-called vertical "bar code" ("lipstick bleeding") lines, it is usually not sufficient to simply fill the lines with a filler, since the continued overactivity of muscles around the mouth are likely to mechanically lead to quick breakdown of the injected product and a very short period of benefit. It would be best therefore to inject Botox (or Dysport or Xeomin) in order to quiet the underlying muscular activity that has led to this problem and then to fill the remaining lines that have already formed. This may be done in the same treatment session, which I ordinarily do, or may be divided into two separate treatment sessions. I find Belotero Balance in my NY practice to be the most beneficial for this purpose, since it is a smooth, cohesive filler that possesses little to no tendency to give rise to the unwanted bluish/gray Tyndall Effect when injected very superficially, as must ordinarily be done to smooth bar code creases. It is likely to require no more than about 0.5 cc from what I can tell from the photo. In my Israel satellite office, where a far greater number of regulatory agency approved fillers are available, I typically choose Teosyal Redensity II. It is difficult to say from the photo provided, but if there is also general photodamage and blotchiness of the skin surrounding the mouth, then a series of superfical peels or microneedling alone or combined with low strength TCA can be extremely helpful for improving overall tone and texture. Be sure to consult with a board certified aesthetic physician and ask to see his/her personal before and after photos before agreeing to proceed. Best of luck.