How to Treat Lines, Folds, and Wrinkles Around the Mouth and Lips

how can I treat lines around my mouth there are three common types of lines

around the mouth area that occur with facial aging that patients and our

practice often expressed concern about one vertical lip lines or wrinkles above

the lips to nasolabial folds also called parentheses lines that appear at the

outer part of the mouth and taper into the nose area and three mesolabial folds

which become more visible on the outer lower corners of the mouth often refer

to as marionette lines these lines and folds are due to tissue changes

associated with facial aging such as a decrease in facial volume from loss of

bone fat and soft tissue as well as a reduction in skin thickness and quality

I'll talk about how I help my patients with these lines around the mouth in my

practice I'm dr. Amiya Prasad I'm a board-certified cosmetic surgeon and

fellowship trained oculofacial plastic and reconstructive surgeon I've been in

practice in Manhattan and Long Island for over 20 years helping my patients

with changes seen with facial aging is a core focus in my practice with

particular emphasis on the lips and the area around the mouth referred to as the

perioral area vertical lip lines is a term which refers generally to lines

which appear above the upper lip these lines result from several contributing

causes this means that each cause should be approached to get the most effective

outcome deep lines that appear when the lips are puckered are caused by the

activity of a muscle called the orbicularis Oris muscle

the appearance of these deep creases can be improved by strategically reducing

muscle activity using a neurotoxin like Botox as the activity of the muscle

decreases the depth of the creases improve with consistent use of a

neurotoxin over time the skin continues to be less creased with movement and the

lines become less prominent a neurotoxin like Botox takes about three days to

take effect and full effects are seen about two weeks I routinely see my

patients at that time to evaluate the results and see if any enhancement is

needed The effect of Botox or any neurotoxin decreases over several months

so patients come in on an average of about every four months vertical lip

lines can also be due to volume loss of fat and soft tissue beneath the skin

volume loss due to aging causes loss of projection above the lip resulting in

lines increases to be more visible by placing a hyaluronic acid filler like

Restylane or Juvederm for a volumizing effect the skin is lifted slightly

making the lines and creases appear more smooth filler application can be

performed in a few minutes and can last between 6 and 12 months vertical lip

lines can also be caused by diminishing skin quality the skin can lose collagen

and elasticity due to aging to stimulate collagen and tighten the skin treatment

like laser resurfacing or radiofrequency heating can be employed to induce a

controlled injury response the body reacts to this controlled injury by

producing collagen to heal this area the collagen response can also help smooth

and skin and thereby improve the vertical lip lines

the nasolabial folds or parentheses lines appear to deepen due to volume

loss associated with aging the nasolabial fold can be improved

indirectly by adding volume to the cheek as well as to the mid-face I add volume

to these areas using a technique called structural volumizing also called the y

lift where thicker hyaluronic acid fillers are placed at

the bone level which is below the muscle layer this method restores volume where

volume loss is most significant which is at the bone level unlike commonly

practiced filler placement which is just below the skin deeper placement prevents

filler from shifting thereby avoiding the doughy less youthful appearance seen

commonly with traditional filler placement techniques in addition this

structural volumizing technique also has a lifting effect that further softens

the appearance of the nasolabial folds this Structural Volumizing technique

came naturally to me as a surgeon with extensive experience in performing

facial implant surgery and facial fracture repair so instead of placing

silicone implants on top of the bone I place long lasting injectable fillers

using thicker hyaluronic acid fillers like Juvederm Ultra Plus and Juvederm

voluma the results of this procedure can last one to two years the lines and fold

to start at the corners of the mouth and go downward are called mesolabial folds

also known as marionette lines these folds are also due to volume loss caused

by aging and are often treated at the same time as nasolabial folds we treat

these lines with hyaluronic acid fillers like Juvederm Ultra Plus and Juvederm

voluma one particular advance of hyaluronic acid fillers is the ease

of reversal that is they can be dissolved with the enzyme hyaluronidase

if someone is dissatisfied with their results this is an important

differentiation because for this area we can also consider a filler like radius

which is made up of calcium hydroxyapatite a material similar to

bone which is also a long-lasting filler however radius cannot be dissolved we

further addressed the mesolabial fault by adding volume and contour to the jaw

line also at the bone level with Structural Volumizing the jaw line up to

the chin tends to lose its continual contour and definition with age and this

can also affect the appearance of the mouth by adding filler to the jaw line

all the way to the chin to make the contour more continuous and defined the

volume correction can also improve the appearance of mesolabial these

filler treatments take minutes to perform and patients can see improvement

immediately there may be a little temporary swelling after treatment but

this is generally minimal and resolves quickly I regularly see cosmetic filler

patients two weeks after treatment to see how the filler has settled and if

any additional enhancement is needed patients can even have this type of

treatment done shortly before an important event like a wedding in my

opinion filler placement is to be treated as seriously as surgery once

you've entered below the skin in my mind the procedure is invasive fillers are

often applied by non physicians and doctors who don't perform surgery as I

mentioned earlier I feel that my experience as a surgeon has been very

useful in how I place fillers particularly at the

level allowing my patients to have consistently satisfying outcomes with

minimal swelling and rarely experiencing any bruising I hope you found this

information helpful thank you for your question