I have wrinkles above my upper lip. I've tried Botox but it isn't working. Is there another solution?

Repeated, daily motion of the muscles around the mouth with time eventually can lead to deep vertical creases around the mouth--much like a crease line forms in a blank sheet of paper after it is formed. And just as simply stopping the folding of the paper will not erase the crease previously created by folding, Botox, which works on quieting muscular movement, will simply slow the process, but generally has little effect of creases that are now present at rest. To effectively treat deeper "bar code" lines around the mouth, BOTH Botox to diminish the relentless muscular creasing (the dynamic component) AND filler to treat the creases that have already been created (the static component) are generally required. So, it would seem that filler would be the next step. Just be sure to consult with an experienced, board certified dermatologist. Hope this helps.

Hello chi910, thank you for your question! These upper lip wrinkles are so common and can be extremely stubborn. Using botox or another neuromodulator to restrict the movement causing the lines is an important first step, but if the lines are deep there will be more pieces to the puzzle.

In our office, step 2 alongside botox is to treat the skin itself. This would be through high-quality skincare (we like Defenage), microneedling or RF-microneedling (such as SylfirmX, Morpheus, Scarlet), and other resurfacing modalities such as Plasmage and Clear & Brilliant to tighten & rejuvenate the skin and allow for new collagen growth in those grooves.

Lastly, filler can be a wonderful addition to the treatment plan, if both product and patient are selected carefully. For deep lines resistant to or still lingering after other treatments, a filler with a little bit of structure like Versa or Juvederm Ultra can make a nice difference. For super fine lines, SkinVive injectable hydrator helps to plump the skin without adding additional volume, thus smoothing out the skin in those areas.

I hope this helps, best of luck in your search!

Best,
Genie Alexander, RN BSN for Dr. Anna Petropoulos, MD FRCS at Center for Classic Beauty, Danvers & Boston, MA.

A combination approach would give the most improvement. Deep wrinkles and smile lines can be improved with a combination of Botox and/or fillers for the lines themselves and to build anatomical support with Sculptra for collagen building. Ultherapy is a great skin tightening device, but works best in combination with other treatments like J Plasma, RF treatments, lasers, microneedling/PRP, salt facials, Cosmelan for skin tightening and improve skin tone. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

Thank you for posting your question. Dermal fillers may be a great solution for lip lines and wrinkles that can also be used in combination with Botox for more dramatic results. Volbella is a Juvederm filler that adds volume and smooths out lines and wrinkles around the lips caused by aging, smoking, or sun damage. Laser resurfacing or RF microneedling are also options for treating this area. It is always best to seek an in-person consultation with a board-certified facial plastic surgeon that can provide detailed guidance and treatment options customized for your needs.

Fine lines in the perioral area are a very common concern for a lot of patients. Some of these lines are indentations in the skin which can be addressed with fillers. I’d recommend switching up from botox to dysport with a combination of fine fillers to soften up those lines. Nonetheless, I would recommend you to complete multiple in office consultations with board certified facial plastic surgeons to discuss your ideal outcome. This way, they can assess your face in person and determine the best treatment for you. Best of luck! Kian Karimi MD, FACS

There are various treatments for the upper lip lines. Depending on the situation you may benefit from a thinner filler. Sometimes lasers are indicated for resurfacing. I encourage you to begin by visiting with a expert injector to determine what is recommended for you.