Lip lines

No one loves lip lines. They're frequently called smoker's lines, but many nonsmokers have them. There is a muscle that circles the lips, the orbicularis oris. When you contract that muscle, you pucker your lips. When someone develops lip lines, each line is at the bottom of a fold when the lip is pursed.

Sometimes Botox is used to weaken this muscle and reduce the wrinkles. The problem is that the orbicularis oris is a very important muscle. If it's too weak, you will have trouble drinking without drooling, and will have some difficulty speaking, particularly saying the letters P and B. This limits the usefulness of Botox or any similar agent for this problem.
The effective treatments for lip lines fall into two categories, fillers and resurfacing agents. Fillers such as Restylane or Juvederm can be injected into the lines to improve them. They can produce improvement, but they don't completely eliminate the lines. 50% improvement is a realistic expectation. An additional disadvantage of fillers is that the more movement there is in an area, the shorter the filler tends to last. The lips are highly mobile, so we tell people to expect about a 6 month benefit with the current fillers. 

Resurfacing procedures have always produced the best and most durable reduction of lip lines. The earliest methods were dermabrasion and the use of very strong peeling agents, phenol peels. These gave very nice results, but there was a significant risk of scarring and frequently patients experienced marked lightening of the treated skin, which they had to use makeup to camouflage. These disadvantages led to the use of the CO2 laser which did almost as good a job, with less risk of side effects. Still, about 20% of patients had some problems. The current state of the art treatment is the erbium YAG laser. This is safer still because it works well while not heating the tissue like the CO2 laser does. The tissue heating is felt to play a role in the permanent loss of pigment.

The photos show a patient before treatment (upper left), after Sciton erbium YAG treatment (upper right) (a MACS-Lift was also done), and after the addition of Restylane filler (lower left). This type of result produces a very happy patient.

Gerald N. Bock MD

Stockton, CA

For further information see:California Skin Laser Resurfacing California Skin Laser Lip Rejuvenation