Can Ultherapy Improve the Appearance of "Smoker's Wrinkles", Deep Vertical Wrinkles Between the Upper Lip and Nose?

Although Ultherapy may be helpful with the 1.5 mm handpiece, I would suggest alternate treatments such as a stimulatory filler combined with fractional co2 laser. Raffy Karamanoukian, Los Angeles

With the advent of the newer 1.5 mm. transducer, the energy of Ultherapy ultrasound penetrates less deeply than the original two depths that were available from the company. The 1.5mm. transducer may provide energy to the right depth to heat up the dermis and cause collagen formation that could distend the skin and minimize the appearance of the smoker's lines. However, these lines are very hard to treat, even with more aggressive fully ablative laser resurfacing, deep chemical peel or dermabrasion because the new skin lies on top of a moving muscle in the lip which will recreate some of the lines as the skin "accordions" as the muscle contracts with pursing of the lip. 

Belotero injections can help these lines but the filler will eventually dissolve and would need retreatment between 6 and 10 months probably.

Ultherapy is a great treatment, but if 3 fractionated CO2 treatments have offered no results, I would not recommend it as a sole treatment for deep vertical lip lines.  These typically can be addressed successfully using a multimodality approach. If they are deep enough, filling them with a fine line filler like Belotero and using very little Botox at the time of filling, to minimize the constant movement creating these lines, would make them appear better. If fractionated lasers have not worked, 100% resurfacing, using a combination of an erbium and CO2 laser to efface the lines is also appropriate in the right hands.  The combination of Ultherapy with a fractionated CO2 treatment around the mouth can also provide nice results in the right candidate.

What you are describing may be improved with the help of newer models. At my practice, a 1.5 mm headpiece has been working great for patients who wish to diminish smokers lines and deep wrinkles.

The new 1.5 mm transducers for Ultherapy have been shown to treat the fine wrinkles in the upper lip associated with smoking and aging. Read the Ultherapy ebook provided on the link below. 

Ultherapy can be very helpful for overall non surgical tightening, but does very little for smokers lines in my opinion.  These are some of the most difficult lines to treat because they are dynamic lines.  In other words, pucker and look at them and you will see how they deepen.  This indicates an attachment to the muscle below the skin and although we can smooth the lines somewhat with a resurfacing procedure (complete resurfacing, not fractionated in most cases), you will always have an attachment to the muscle below.  A combination works best in my hands of complete resurfacing, superficial botox injections along with filler to the lines and lip border.

Good Luck!

Ultherapy with the 10-1.5 transducer can help with fine lines.  However, a treatment of non-fractionated CO2 is probably going to give a better result for these stubborn lines. 

Thank you for your question. Ultherapy is commonly used on areas of the face and neck to address sagging of the eyelids, brow, cheeks, chin and jawline. It can also improve marionette lines and folds and a downturned mouth. The whole face may be treated for an overall tighter, more toned appearance, or individual areas may be targeted. This is an ideal solution for individuals with mild to moderate sagging in the face and neck who are not yet ready to undergo more invasive surgical procedures. Based on the information you have shared, I believe you would be an excellent candidate for the procedure. Best of luck.