Fillers do help the lines, but all can cause bruising. Unfortunately, there is more bruising with hyaluronic acid fillers, such as Juvederm and Restylane, than the former collagen fillers. A new filler which is thinner than Evolence, a collagen from pigs, may soon be approved by the FDA and this may give you good results with less bruising than the hyaluronic acids. Taking Arnica montana, an herb, which can help minimize bruising, is recommended by some physicians and their patients who bruise easily can start it a day before the procedure and take it for the day of and a day after as well. Avoid aspirin, ibuprofen, advil, alleve, vitamin E, fish oil, garlic, ginseng, ginko biloba as these medicines and products contribute to more bruising. Aspirin should be avoided for up to two weeks prior to the procedure if possible, and a few days for the non-steroidal antiinflammatory agents such as advil, Avoid the herbs for one to two weeks prior to the procedure. Ice immediately after the procedure might lessen some bruising. Don’t exercise that day or the day after if you are prone to bruising. Some people don’t mind the bruising and don’t need to stop their aspirin or exercise regimen. You, however, might find it helpful to do this. Laser resurfacing and a small dose of Botox could help the lip lines, but there is a risk of scarring with the former and drooping with the latter. Lines often come back despite the laser resurfacing although they might be better than they were before the procedure.
Radiesse is for deeper injestion
Radiesse is a thicker filler and is not to be used in the lips or near the lip line. If it is injected in this area there is a risk that there can be hard lumps or visible white bumps. Radiesse is a very nice filler for providing volume to other areas of the face.
Any injection carries with it a risk of bruising. You may have heard that one filler has less bruising than another but in reality that is not true. All fillers have the same risk of bruising. Fair skinned people tend to bruise more easily, and it can take 2 weeks for bruising to go away completely. Do not take any aspirin, ibuprofen or vitamins that are not medically necessary for 2 weeks prior to your treatment. This will minimize your chances of bruising.
For the vertical lines along the upper lip, you may need Restylane or Juvederm or collagen. The choice is determined based on the thickness and position of the wrinkles. Sometimes fillers are not the appropriate treatment for these lines, and we also use laser resurfacing or Botox to help reduce their appearance.
Radiesse for lip wrinkles
Radiesse should not be used for superficial or deep wrinkles around the mouth. It is a thick ,long term filler which is best used for melolabial folds (between upper lip and chin) and marionette lines (between the lower lip and chin and cheek) and to fill in sunken cheeks and temples.
Other fillers may work better for wrinkles around the mouth.
Prevelle silk (Hyaluronic acid), Evolence (Porcine Collagen) may work quite well.
But in my experience, by far the most effective method for treating these wrinkles is the traditional CO2 Laser Resurfacing. One treatment suffices. Unfortunately there will be 7-8 days down time. I usually treat the lower lids at the same time.
As to the new, fractionated CO2 Laser resurfacing, 2 or 3 or even more treatments may be necessary. The marks of this treatment can be covered with makeup. Thus, even though technically there is domn time, in many cases no time is lost from work.
For all of the above procedures, a treatment with 4 units of Botox prior to the first procedure would greatly enhance the results.
Wrinkles of the upper lip
I would consider a resurfacing procedure (laser or chemical)to address the fine lines around the mouth. There is, however, some down-time associated with such a procedure (approximately 7 days). The procedure would be even more effective if you were to have a few units of Botox injected to the lip 2-4 weeks prior to your resurfacing procedure. Good luck.
Upper Lip Wrinkles, What is the Best Treatment for Those Pesky Buggers?
Fractionated CO2 (either Fraxel re:pair or Deep FX) is a great treatment choice to treat your upper lip vertical lines.
Stay away from Radiesse in the lips as it has been reported to cause lumps and bumps in the lips that are difficult to treat.
Good luck and be well.
Juvederm is, in my opinion, the best filler option for lines around the mouth and to plump the lips. Radiesse causes lumps. Be sure you are off all aspirin, ibuprofen, fish oil, and vitamin E for 2 weeks prior to injection. I have found Bruise Relief (at most CVS) to reduce the frequency, severity and duration of bruising after filler. (Disclosure: after finding how well it worked in my practice, I did a study and am now a compensated consultant)
The other way to go is fractional CO2. I have been using Deep FX for over one year and find it dramatically helps lines and wrinkles but there is 7 days of downtime. The results last several years.
Best treatment is to resurface upper lip for lip wrinkles
For the optimal results for upper lip lines with a prolonged results, CO2 laser is what I recommend. The Fraxel re:pair is excellent for this. You can see an example in my pictures.
Just doing this area is very easy. No pain med, no sedation, topical and blocks will make you extremely comfortable. About 5 days of healing time are needed. Sometimes a second treatment will be needed.
Another option is fillers and Botox. I do inject Radiesse horizontally very lightly along the area above the lip which helps somewhat, but not in the lip or directly into the lip lines. HA's can be injected into these lines, but sometimes can be seen. In the future, Evolence Breeze will be great for this.
Fillers and skin resurfacing
Radiesse is a good filler for nasolabial folds, i would not inject it in the lips for fear of lumps. You will also have a lot more bruising with the radiesse. I would recommend a combination of resurfacing with laser or peel inaddition to a hyaluronic acid filler.For the bruising, we give arnica BEFORE the injection day. Best of luck!