I would like to reduce the puckering above my upper lip also fill the lines and enhance the upper and lower lip?

Thank you for sharing your question. The vertical fine lines that you are noticing around the mouth are very common but can be challenging to treat. A small amount of Botox properly placed can prevent the muscle movement that causes the vertical lines. A hyaluronic acid filler such as Restylane or Belotero can be used to inject small amounts of filler into each line, which lasts about 6 months before needing to be repeated. For a long term solution, I have had excellent success using and erbium yag resurfacing laser to improve the appearance of lines around the mouth. While this option does have more downtime associated with it, the results are by far the most impressive and long lasting. I recommend consulting with a board-certified specialist who can further discuss these treatments with you and make specific suggestions based on an in-person evaluation. 

Using a small amount of botox around the lips can help relax the muscle thus reducing puckering.I usually start by restoring volume first before I use botox because one the volume to the lip area in restored there usually isn't a need for botox.

I would recommend a combination of treatments for the perioral lip lines associated with puckering. Botox and filler together work very well and complement one another. Only a small amount of Botox, usually 6 units, is needed around the lips. I would use Restylane Silk or Volbella (once it is available) for the fine lines on the upper lip. The filler can be used to enhance the lip line (vermillion border) and to give some volume to the lip itself. I would also use a procedure to induce some collagen formation which will improve the texture of the skin and help with softening of the lines. Options include fractionated resurfacing laser such as Fraxel, radiofrequency treatment such as Sublative, or microneedling such as SkinPen. Please consult a board certified dermatologist or plastic surgeon experienced in aesthetic injectables. Best wishes.

Fillers such as restylane silk, belotero, or juvederm can work well to treat lines above and around the mouth, but the best first option is laser resurfacing or deep peels to induce collagen production. Radiofrequency devices such as Intensif, viva and microneedling/PRP help as well and are less invasive.  I suggest going to a well trained cosmetic dermatologist with expertise in lasers and fillers.  Best, Dr. Emer. 

Thanks for your query. For puckering above your lips fillers would be more helpful than Botox as they instantly take away the fine lines. Hope it helps.All The Best