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.

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.

​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​