What should I do about my smokers lines? I've had fillers and they haven't helped. (photo)

I tell my patients that this is a difficult, and often frustrating, area to treat.  I like combining Botox, filler and some sort of treatment that stimulates collagen production.  These treatments include Ulthera or microneedling, both of which nicely stimulate collagen and help with lines.Your muscles in this area are very strong because you smoked, which is why lines are now there.  Relaxing the muscles with Botox helps to soften those lines.  However, only small amounts of Botox can be used in this area, which is why additional treatment methods are usually needed.  Once the muscles are relaxed, a very thin filler such as Volbella can be injected directly into the lines to further decrease them.  If a combination of Botox and fillers don't get the results you want, then I recommend stimulating collagen production with either the Ulthera or a series of microneedling treatments.Best of luck to you. 

Thanks for your question. This is one of the hardest areas to treat and requires a multi-modal approach. Even then you need to be realistic about expectations. I typically combine fillers, botox (if the issue involves dynamic line production) and microneedling. Again, it's important to temper expectations but the good news is that using this combination, a significant improvement can oftentimes be achieved.

Smokers lines can be genetic so don't beat yourself up about it, although it is great that you quit! I personally dont find fillers effective for this, I use a dissovable PDO suture called NovaThread which works for most of my patients. If you bruise easy than you probably will bruise from most injections that's just something you need to plan for. Eat pineapple (anti-inflamation) and Arnica tablets before and after injections to help minimize. Good luck

Thank you for your question and posting your pictures. Smoker's lines are very difficult to treat. Options include fillers, micro-needling (series) with or without PRP, micro-needling with an RF device such as Fractora, and neuromodulators such as Dysport or Botox. More recently J-Plasma has become available. This one time treatment uses a combination of cold helium gas and RF energy to create a plasma that resurfaces the skin and dramatically tightens the skin. It is the most effective treatment I have seen for smoker's lines. Further, with healthy lifestyle choices the results will last for years. It does come with some significant downtime and is more expensive but the results appear as good, if not better, than a face lift. In addition to treating wrinkles and imprinted lines, the J-Plasma procedure will remove pigment irregularities, bags under the eyes, and drooping eyelids, while lifting and reshaping your face to a more youthful appearance.I hope this was helpful - Dr. Moore.