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.