What treatment is best for perioral "smokers lines" and acne scars around mouth? FX Fraxel/lower face lift? Best for me? (Photo)

Doctor Answers 4

Treatment of smoker's lines and acne scars

For smoker's lines I recommend a combination approach.  Most patients need all 3 of the following, while others may need only 1-2 for optimal results.
  1. Neuromodulator (Botox, Dysport) to relax the muscles that purse the lips - done before laser to help prevent re-etching of lines in newly resurfaced skin.
  2. Laser resurfacting (Full-field Erbium or fractionated CO2)
  3. Filler (e.g. Restylane Silk, Belotero)

For acne scarring it is important to consider the type of scars - rolling, boxcar, pitted.  A combination approach is often indicated and may include:
  1. Subcision to release fibrous bands that tether the scars
  2. Laser or radiofrequency device (e.g. fractionated CO2, Infini RF, non-ablative fractionated 1540)
  3. Filler (e.g. Restylane)
You will need to consult with your physician to see what your unique needs may be. 
Best of luck!

Greenwood Village Dermatologic Surgeon
5.0 out of 5 stars 6 reviews


Fraxel is a laser skin rejuvenation treatment that resurfaces your outer skin, erasing imperfections. It also encourages the production of collagen, a protein found in connective tissue.The result is clearly visible lines, folds and wrinkles. Fraxel laser skin rejuvenation is a non-invasive technique that affects only about 20 percent of the facial skin exposed to it. The most common side effects of Fraxel laser treatment are swelling and skin redness, which should subside within a couple of days. Other temporary side effects may include minor itching, dry skin, peeling or flaking, and a bronzed skin appearance. The risk of infection or scarring is very limited.

Elliot M. Heller, MD
New York Facial Plastic Surgeon
4.6 out of 5 stars 93 reviews

Lines around the mouth an scars

Typically these lines are some of the most difficult to treat.  I can't tell from the photos if you need a lower face lift.  An in office consultation is the only way to assess this situation.  However, a combination of fillers, Fraxel, and topical skin care are generally needed in these areas.  Please consult a board certified dermatologist for the best cosmetic results. 

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 74 reviews

Treatment of acne scarring and smokers lines -- fractional co2 laser with prp and microneedling, then fillers like bellafill etc

I suggest speaking to a dermatologist who specializes in scarring and lasers.  You need a combination approach to get the best results for these conditions.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 191 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.