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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
Thermage is a good option for generalized toning of the skin, but it is not typically used around the mouth. Those lines are dynamic in origin, from movement of the muscle around the mouth (the one that caues "smoker's lines) and more aggressive techniques such as a laser or chemical peel are usually better choices there. Also, Thermage tends to work best in my experience in patients in their 50's or younger.
While Thermage can give some tightening to the skin overall, I have not seen very good results for fine wrinkling around the mouth. Probably the best option is laser resurfacing.
Thermage can be used to diminish or tighten the skin above and below the lips. I like to use Thermage in combination with other treatments at my medical spa, Accents Cosmetic Surgery and Medical Spa, in Michigan. I find my patients do best when thermage is combined with fractional CO2 laser skin resurfacing. I utilize my Mixto laser for this procedure. Additional procedures that can be used to further enhance this delicate area are fillers and judicious use of Botox cosmetic. You need to discuss with your cosmetic surgeon your individual concerns in order to acquire the best combination for you. Good Luck.
Though Thermage is good for skin tightening and collagen stimulation, and I have seen it give some improvement around the mouth for fine lines, it would not be my first choice if you want a significant improvement. It is difficult to say for sure without seeing you what the best course of action would be, but in general these lines are better addressed with things like CO2 Resurfacing, Pearl Fractional Laser, Fillers (like Restylane or Juvederm), Botox, or TCA or other chemical peels. Dr. Grant Stevens