What's the Best Treatment for Wrinkles Around the Mouth?

I have wrinkles from puckering the lips and smile lines. How long would the treatment last? How much? What are the good and bad side effects? I am 50.

Doctor Answers 1

Combination of filler and BOTOX

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Smile lines, lipstick lines, smokers lines...whatever they are called, nobody likes them.

Most dermatologists and plastic surgeons like a combination of treatments in this area. I prefer to inject two units in four quadrants of the lip, just above the vermilion border (lip line). Either a hyaluronic filler such as Juvederm or Restylane or a collagen filler such as Cosmoderm are also used to fill these lines. My preference is Juvederm if the patient wants a longer-lasting fill or Cosmoderm if they are planning for a big event. I feel that Juvederm is a little softer and molds into these llines well. I like Cosmoderm for the vermilion border since it gives a bit better definition. I can then use the remainder of the syringe for the lipstick llines.

As for complications: Botox if not placed properly, or if too many units are injected, can cause drooling, which unless you are a baby is not particularly cute. If the injections are performed too high up it can cause a flattenting of the lip, again not a good look. Fillers if they are not done properly can becme very obvious if too much is injected. Also ones lips can be pulled into an unnatural position.

There also can be bruising and swelling but this is temporary and should not last longer than two weeks. Be patient. I saw a woman tonght (at a social function) whom I injected last week. She said that the lower lip at the corner pulled up a bit for a few days but had settled in nicely, but it did take five days.

Good luck.

Virginia Beach Dermatologist

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