Vertical lip lines still present 2 weeks after laser resurfacing. Should I try fillers instead?

Question

I have Erbium laser resurfacing on my upper lip for vertical lip lines. I am two weeks post procedure and the lip lines are exactly the same. My doctor did 4 passes with the laser and I had redness and some swelling. He wants to re-do the laser resurfacing in about a month and claims he can get these lines eradicated. I have my doubts in that they look exactly the same from the pics he took. Should I resort to fillers instead? I'm turnig 60 in a few days.

Jeff Angobaldo, MD · Answer

Thank you for your question. It takes some time to see your final result after these treatments. It is not uncommon to need repeat treatments depending on the depth of the lines. A detailed plan of what to expect should have been discussed with you before treatment. Consult with a Board Certified Plastic Surgeon for further information.

Ross A. Clevens, MD, FACS · Answer

Dear golergirl,No you should not turn to fillers quite yet. Keep in mind that laser skin resurfacing will take some time until the results are fully disclosed. A huge benefit to laser skin resurfacing, according to many studies, is that the results are permanent. Please consult with your board certified facial plastic surgeon who performed your procedure so that you continue to receive the best care, treatment and access to the largest knowledge-base available.Sincerely,Ross A. Clevens, MD, FACS

Raymond E. Lee, MD · Answer

It is still very early in the healing process. Collagen remodeling needs to occur to help reduce the fine lines. This process really starts at 3 weeks with final visible results at 6 months. Please be patient and it can only really improve. I would hold off on fillers for now. How much is yet to be seen. On occasion i will repeat a fractional co2 laser after 3-4 months if needed. Finally there are filler options such as belotero balance and restalyne silk you could use in the future.

Jason Emer, MD · Answer

There are many treatments for this area.  Fractional co2 laser or fractional RF treatments are usually best to this area in combination with fillers and/or botox.  I suggest you see a cosmetic dermatologist with experience in lasers and fillers. Laser alone is not sufficient most times to get complete improvement.  Best, Dr. Emer.

Gustavo A. Diaz, MD · Answer

The vertical lip lines are difficult to treat by any modality. The treatment that in my opinion gives the best result is a CO2 laser. Also you have to consider that you only has 2 weeks after your resurfacing. After resurfacing the fibroblast cells in the deep dermis will start producing collagen and this collagen will get laid out and increase in quantity and will improve the wrinkles. This process takes time (6 months to 1 year). After aggressive resurfacing I do not recommend a follow up resurfacing prior to 6 months because we do not know how much collagen is going to be laid out and therefore we do not know how efficient the resurfacing was. Consult with a board certified Facial Plastic Surgeon and see your alternatives.Hope this helps,Dr. Gustavo A. DiazDouble Board Certified in Facial Plastic Surgery

Heather J. Furnas, MD · Answer

The skin of the upper lip is closely adherent to the lip muscles, and as we age, the skin more closely follows the undulations of the purse-string-like muscle. If the lines are deeper than just creases in the skin itself and have true hills and valleys, laser will never eradicate those lines. However, a second pass later can improve them.My patients with deep lines benefit from laser resurfacing, a touch of Botox to slightly weaken the pull of the muscles, and subtle filler so they still look like humans and not like ducks!At two weeks, you're still healing. If your doctor feels a second pass will help, you could try that...or talk about fillers. Click on the link below to see an example of lip filler.Happy birthday!

Steven F. Weiner, MD · Answer

I think eradicate is a strong word and I would never tell a patient that.  It takes about 6-9 months to see the full effect of the procedure.  These are difficult, you have to understand that. I think volume makes sense for many people, particularly if you are 60.  Ablative laser or dermabrasion have typically had the best success at helping this.

Brian Windle, MD (retired) · Answer

Vertical lip lines are the result of loss of volume in your
lip as well as loss of elasticity of the skin of your lips.  On patient summed it up by comparing her lips
to a prune; “all shriveled up”.  You may
have noticed that few men get these lines and the reason is that male skin is
thicker and therefore more resistant to the effects of elasticity loss and men
have facial hair which adds to the volume of the lip.

I am not opposed to laser treatments but they do not do much
to deal with the problems I have just outlined. 
Lasers are essentially a controlled burn that will thin the tissue.  The original injury will look reasonable for
a while but as the laser injury matures at about a year there is usually not a
lot of improvement.  Some deeper peels
like a croton oil peel will help as well but again, the results are not as long
lasting as I think most of us would want.

Fillers are your best bet for this problem along with skin
treatments that will actually build collagen.  I prefer the long term filler Bellafill as a
filler for the lips but make sure you see someone who has extensive experience
with it as the results cannot be reversed. 
It actually helps build your own tissue and is a wonderful volume
replacement.

To improve the elasticity of you upper lip skin, micro-needling
and a daily topical with a Vitamin A or retinal will help improve the
elasticity of your skin.

I hope that helps.

Best regards.

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Vertical lip lines still present 2 weeks after laser resurfacing. Should I try fillers instead?

Answers (8)

LASER RESURFACING PROVIDERS NEAR YOU