Vertical lip lines on 38 year old. What can I do about this? (Photo)

My best guess for the lack of success in treating these clearly motion-related vertical upper lip lines with Botox and with filler would be that incorrect choices of techniques were used. With the filler, rather than solely attempting to fill and elevate each individual vertical line, as was likely done, a cohesive resilient filler capable of resisting the muscular motion would need to fanned superficially throughout the upper white lip region beneath and at ninety and forty -five degree angles to the vertical lines. Additionally, if necessary, microdroplets of Botox can be injected in slightly different areas to where injected for the "lip flip" technique in order to quiet the overactivity of the muscle responsible for the problem. Make sure to consult with an experienced, board certified cosmetic dermatologist. Best of luck.

​Fillers such as Restylane Silk, Belotero, or Juvederm can work well to treat lines around the mouth, but the best first option is laser resurfacing or deep peels to induce collagen production. Superficial radiofrequency devices and microneedling can help as well and are less invasive. I suggest going to an experienced cosmetic dermatologist with expertise in lasers and fillers. Best, Dr. Emer​

Thank you for sharing your question. As the lines appear to form with animation attempts I would recommend Botox treatments to help soften the lines while avoiding other behaviors such as straw use. Hope this helps.

You will likely have a better outcome with a combination of treatments. Botox with fillers can help soften the dyanmic muscle activity as well as decrease the prominence of the lines. See an expert injector for treatment.

A combination of hyaluronic acid filler and Botox will give you better result. This combination will provide better results than just hyaluronic acid filler you have tried previously.

In general, try to reduce "pursing" movements like sipping from straws or smoking etc. If the lines mainly occur with animation as you've said, then Botox should be sufficient. If the lines are present at rest, you'll want to add a fine filler as well. Sometimes microneedling and laser resurfacing or deep chemical peels can also be helpful. Most importantly for best results and safety, see your local cosmetic dermatologist.

Dermal fillers such as Juvederm Volbella or Restylane Silk, which are hyaluronic-based and the thinnest in their respective families are two of the options to non-surgically correct vertical lines around the mouth, more commonly known as "smoker's or lipstick lines." To correct these lines, small amounts of dermal fillers are injected into precise locations and along the lines and lip border. Because these lines are pesky and they are more prominent when using either smoking, using straws or continuously pursing the lips along with fillers, small amount of Botox are injected around the mouth to relax the muscles. Topical creams that contain retinoids can gently resurface collagen in the deep layers of the skin, derma-rolling stimulates the production of new collagen to soften fine lines and improve skin texture and fractional ablative and non-ablative lasers can cause microzones of collagen repair which resurface vertical lip lines.