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

Question

what would you recommend ? I was thinking Volbella and Botox ( botox first ? ) the lines are not really deep

Kian Karimi, MD, FACS · Answer

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.

Martin Jugenburg, MD · Answer

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.

Kristin M. Baird, MD · Answer

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.

Jason Emer, MD · Answer

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.

Ajaya Kashyap, MD · Answer

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

Nelson Castillo, MD · Answer

Thank you for sharing your question.  Normally the puckering and lines of the upper lip respond best to multiple treatments - Botox, dermal fillers, chemical peels, and laser resurfacing.  If mild Botox can be a good first step to prevent the vertical lines from worsening, and if some still remain a thin dermal filler such as Belotero or Volbella can be used.  Hope this helps.

Elham Jafari, MD · Answer

Hi and thank you for sharing your question here! It is
very hard to give opinion without seeing you in person. However as a general
suggestion, I usually inject Botox at the upper lip with very small doses
to prevent the upper lip line from getting deeper. I also fill the upper lip
lines themselves with very thick Hyaluronic acid (HA) filler such a Restylane
or Belotero.

For lip augmentation, I use HA fillers such as Restylane
(which lasts around 6 to 8 months) or Juvederm (which lasts about a year) or
even Voluma (which lasts for around 2 years). I hope it helps and good luck!

Andrei Metelitsa, MD, FRCPC, FAAD · Answer

There are several non-surgical methods of treating upper lip lines. The simplest method involves small dose of botox that is usually repeated every 3-4 months in patients who find it effective. If there is more pronounced volume loss or botox is not working, consideration for injectable filler could also be made. A variety of hyaluronic fillers including juvederm, restylane, emervel and belotero could be considered. An alternate way includes fractional co2 resurfacing which has a longer downtime then either botox or filler but could produce more long-lasting results. Lastly RF devices and microneedling can also be utilized.

Shaun Patel, MD · Answer

Great question. Vertical lip lines are common concern among my patients. They are difficult to treat but I find that combination treatment usually works best. A small amount of Botox 4 units or so combined with a filler such as Restylane Silk or Belotero work great for these. Combine this with nonablative skin resurfacing with Fraxel or microneedling to stimulate collagen production and you will have a very nice result. Hope this helps.

Michele S. Green, MD · Answer

To best treat the lip lines a combination of Volbella, Botox, and PRP with microneedling or Fraxel will correct the problem.  Please consult a board certified dermatologist who is skilled with these techniques for the best cosmetic results. Best, Dr. Green

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

Answers (15)

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