What is the best way to get rid of deep lines on upper lip vermilion area? I have tried fillers & dermal fat grafting (Photos)

Hello! You have really nice, youthful fullness of your lips and also excellent demarcation of the vermillion border (the transition line from lip to skin). There are usually two ways to remove excess skin that can give the appearance of wrinkling - either add volume to improve fullness (which you've tried) or remove some skin to better drape around the tissue that is present. A third open is resurfacing, such as peels or laser, but we generally do not recommend this on the lips. So I would recommend considering a small upper lip reduction. This would remove part of the inner-most aspect of the upper lip (the mucosa) so that there is less excess skin on the upper lip to allow for wrinkling. It would result in decreasing the height of your upper lip a little bit, but it should not change the overall lip fullness or the crisp line of the vermillion border. It would be best to have a surgeon perform an exam in person who preferably is familiar with lip reduction procedures to see if they agree or have any other thoughts/ideas. Hope that helps!All the best,Dr. Victoria Aimé