How Safe is Botox when Applied to the Upper Lip for Smoker's Lines?

If you just want to get rid of wrinkles then Botox may help. Very few units are required. If too much is administered incorrectly, the movement of the lips will be affected and the result will look abnormal and you'll have difficulty moving your lips.

Upper lip veritcal creases are caused by multiple factors, different for every patient.  Smoking, chronic sundamage, dentition and age contribute to the lines.  Some lines have been present for so many decades that elimination of the muscle activity below the skin, which had caused the skin to "accordion" and create these lines, won't make the lines go away.  Often these stubborn lines can benefit by using Botox pre resurfacing  as an off-label indication to minimze the active pursing of the lip muscles so there is less creasing of the skin during the healing of the new skin.  The optimal resurfacing may be dermabrasion (sanding), Plasma Portrait resurfacing, Carbon dioxide laser ablative or non-ablative (Fraxel Repair), deep chemical peel, or a series of non-ablative Fraxel Restore lasers (erbium). Fillers also have been used. Some of my patients having Botox as a prelude to fillers or resurfacing did so well that they didn't need the secondary procedures.  The skin is not fragile in this location and Botox can work well. It is as said previously, is an off-label indication.  There is a risk of elongating or flattening the upper lip, asymmetry (lack of balance from side to side, e.g. a crooked smile) and difficulty eating and speaking correctly, singing difficulty and even dribbling. Very few units (1 - 2 units the most) per site injected, and maybe 4 - 6 units for the upper lip total would be used.  The lower lip can be treated similarly. You need to see an experienced physician for this treatment.

Generally, smoker’s lines are treated with dermal filler like Restylane or Juvederm not Botox. Smoker’s lines appear due to a loss of volume in the area, so using fillers will restore the volume and decrease the appearance of the unwanted lines. In some cases, Botox can be used as well to treat the lines, but you should see an experienced injector to see what is best for your situation.

 

Hello.  Botox for smoker's lines is very effective and safe when used properly for smoker's lines.  The risk would be overuse of the product which may cause a marked change in the sensitivity of the lip as well as changes in the shape of the mouth or smile.

Because we do not use a lot of Botox in this area, 6-8 units is maximum and we start at 4, we typically combine the Botox with Restylane.  Botox relaxes the muscles that "purse" or tighten the upper lip and Restylane fills the lines and provides volume.  The two together work very nicely although because of the conservative amount of product we use, the results typically last between 6-10 weeks.  

Results of this treatment can be seen in the before and after pictures link below.

However, this is less than an ideal treatment.  The smoker's lines are there because of loss of lip volume particularly at the junction of the white and red lip rolls.  This is best treated with filler volume.  Also too much BOTOX will cause incompetency of the orbicularis oris, the muscle the purses the lips.  This is not ideal.

Botox in the upper lip is dangerous as it can cause change in your smile, speech and expressions. The fine lines which are referred to as 'Smokers Lines' do respond to the Botox but the precise dosage can be hard to accomplish at times. You are better off getting Juvederm or Restylane in that area to fill up the lip skin and iron out the wrinkles.

Regards

Dr. J

 

Disclaimer: This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

 

 

Neuromodulator injections in the upper lip can help to soften the "smoker's wrinkles" around the mouth.  It is a balancing act to achieve a good effect without affecting the movement of the lip too much.  You should seek out an injector who is familiar with injecting in this area and start conservatively.  You can always reinject in a couple of weeks if needed.  If too much is injected and it negatively affects lip function, there is nothing to do but let it wear off.

In experienced hands, Botox can work very well to soften lip lines.  Depending on the patient, a combination of Botox, fillers and laser treatments will give the best result.  Hopefully, you have stopped smoking.

Injecting Botox to the upper lip is considered an "off label" use of Botox.  It is very safe if the Botox is delivered in tiny amounts, strategically and symmetrically placed.  If too much Botox is injected, it may become difficult to sip from a straw, whistle, or say certain words that start with the letter "P" or "B", etc.  This is the reason it is best to seek attention from a board-certified dermatologist or plastic surgeon.

Botox, or other muscle relaxers like Dysport and the new Xeomin, are one part of the treatment of smokers' upper lip lines.  Part of the lines comes from the wear and tear of the puckering of the lips during smoking.  Slightly relaxing the muscles helps reduce the intensity of that wear and tear, which helps to slow down the worsening of the lines.  But, the lines also need to be filled in to look better; that is usually done with either Restylane or Juvederm.  Plus, the lines are usually etched into the surface of the skin, so patients usually will benefit from some type of laser resurfacing.   

There's no miracle for improving these lines, but an experienced physician who is skilled with all three types of treatment can usually help a great deal.  And most important, for the sake of your health as well as your looks, stop smoking.