How to best treat mouth and lip lines? (photos)

Question

I'm in my late 30 and wanted to treat the perioral lines that are starting to show around my mouth. I've tried a lot of treatments so far which have had a good skin tightening effect overallbut they did not help reduce the apperance of the fine lines and I'm worried they will get worse overtime. Eg. Scarlet rf, restylane fillers, botox, profhilo, bbl forever young. I'm now considering laser resurfacing either fraxel or erbium or co2 and not sure which device would work best?

Hung William Song, MD · Answer

I'm looking t your photo and it looks like your overall skin quality is very good. Laser and RF treatments will help stimulate collagen and improve skin quality, but I think what's bothering you are the engraved lines which will take repeated resurfacing treatments to soften. I find that these type of fine lines respond best to hyper dilute HA fillers. You should find an injector who is familiar with this technique. If done correctly you should not get any visible lumps or puffiness and the lines will go away instantly

James R. Gordon, MD, FACS, FAAO · Answer

Thanks for sharing your question and posting your photo. I find the erbium laser most effective with the benefit minimal risks. Results are finished lines and improved skin texture. See en experienced oculofacial surgeon for guidance. 
Good luck!

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Jason Emer, MD · Answer

A combination approach would give the most improvement. Deep wrinkles and smile lines can be improved with a combination of Botox and/or fillers for the lines themselves and to build anatomical support with Sculptra for collagen building. Ultherapy is a great skin tightening device, but works best in combination with other treatments like J Plasma, RF treatments, lasers, microneedling/PRP, salt facials, Cosmelan for skin tightening and improve skin tone. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

Anna Chacon, MD, FAAD · Answer

One of the most effective treatments for upper lip wrinkles is laser resurfacing. These laser treatments are usually done with an erbium or carbon dioxide laser.Fractional laser resurfacing can help treat lip lines well. Treatment with fractional non-ablative lasers such as Fraxel Restore, repeated on several occasions and the most effective and longest lasting treatment to turn back the clock around the mouth is the use of a fractional CO2 laser. In the hand of a skilled physician with an aesthetic sense, this laser works effectively to smooth out wrinkles and reduce lines.

Jason Pozner, MD · Answer

I am a big fan of Sciton TRL - that’s their erbium full field tunable resurfacing laser. I have been using for years and it’s still my go to for perioral lines

How to best treat mouth and lip lines? (photos)

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