Lip Rejuvenation Treatments At A Glance
- Best Results1-3 sessions
- Treatment RecoveryVariable
- Procedure Time10- 60 minutes
- Skin SpecialistDermatologist, Nurse Injector
- Duration of Results12 months to years++
- AnaestheticNumbing, blocks
- Back to WorkVariable
- Cost$ to $$$
Lip Rejuvenation Treatments
Smoker’s lines, bar code lines, & upper lip wrinkles are all terms to describe premature crinkles & wrinkles affecting the upper lip of females. Not all cases are due to smoking, however, all cases can be improved with lasers, energy devices & dermal fillers. Skin care including retinol, vitamin C & antioxidants can protect & preserve collagen.
FactsFacts on Upper Lip Rejuvenation
- The most effective treatment for wrinkles at rest is ablative laser resurfacing
- Dermal fillers can reduce both dynamic wrinkles & static wrinkles
- Muscle relaxant injections are effective for dynamic wrinkles
- Chemical peels can improve moderate to severe wrinkles
- Threads can reduce mild to moderate wrinkles
- Good & precise skin care can prevent wrinkles
What can be done to Lip Rejuvenation Treatments?
Lip rejuvenation goes far beyond dermal fillers. Fillers can give more volume to thin lips however in the more mature patient, there are other factors to consider including-
- Skin quality of the upper lip area. This refers to lines, wrinkles, and sunspots.
- Skin quality of the lower lip to the chin area, especially static wrinkles.
- Age-related changes in the ratio of lip to nose height. Over time there is an inversion of the upper lip. This means there is the descent of the upper lip & elongation. This affects the ideal ratio of the lip to nose area & hides the upper teeth.
- Structural support of the perioral area (mouth area). This involves the underlying tissue surrounding the lip itself.
- Pre-cancerous changes of the lip itself, especially in smokers or those who have had a lot of UV exposure.
Depending on the clinical findings, I employ lasers, filler, injection, surgical, peeling, thread & energy-based modalities to rejuvenate the lip area.
Finding a solution for the aging-mature lip is super-important. It is not just about dermal filling, nor is a laser procedure the best option.
Why do I get smoker’s lines if I don’t smoke?
Smoker’s lines can often present in non-smokers. Factors contributing to lines include-
- Sun exposure, as UVR breaks down dermal collagen.
- Age, as there is a decline in collagen & elastin; the building blocks of skin.
- Female gender, as dermal thickness is reduced compared to men.
- Smoking; as this accelerates skin ageing
- Movement; this is a controversial one as it has been proposed that dynamic wrinkles occur more frequently in females due to the fact that females, on average talk more than males. Don’t shoot the messenger, I am only quoting studies.
What is the meaning of ‘age-appropriate lip rejuvenation?’
Ever seen perky breasts on a seventy old woman? Looks odd, so don’t do the same for the lips. When I rejuvenate the perioral area (lips & surrounding skin), I am careful to rejuvenate, & not try to replicate youthful lips (full of volume & definition).
It is important to assess the structural support prior to injecting. Apart from volume, lips require a good frame, namely rejuvenation of the skin on the upper & lower lips. With age, there is downward descent of the lips, with an increased distance from the border of the lip to the nasal spine. All these factors have to be taken into consideration to provide natural rejuvenation. Overdone lips are obvious.
Lip rejuvenation is more than just aesthetics. In Queensland, the majority of people over the age of 50 will have a condition known as ‘actinic cheilitis’ or sun-spots on the vermillion border of the lips. This presents as stingy, dry, & cracked lips. Often the first signs are ‘smudging’ & running of lipstick. Lasers can resurface this precancerous condition.
How can lasers help with lip wrinkles?
Lasers stimulate collagen production. The application of controlled thermal damage (laser resurfacing) stimulates wound repair. This in turn produces collagen, elastin & ground substance. The result? Less wrinkles, better skin texture & quality.
Lasers can be delivered in fractional applications, meaning a fraction of the skin is treated. Lasers can also be delivered in fully ablative mode, meaning the entire surface of the skin is treated to a predetermined depth.
As a guide-
- Mild wrinkles, early wrinkles, preventive treatments: Include fractional lasers such as Clear & Brilliant, 1927 Fraxel, LaseMD Ultra, low energy CO2 laser, fractional erbium lasers, Tixel, RF, eMatrix, Genius RF. Cost: $-$$ Recovery 1-4 days.
- Moderate Wrinkles: High density fractional lasers, 1927 & low density CO2 lasers, combination lasers. Cost $$ Recovery 4-5 days.
- Severe Wrinkles: CO2 lasers, Erbium laser, combination lasers. Cost: $$-$$$ Recovery 5-9 days.
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Can microneedling help?
Yes. Simple microneedling or better still, RFM (Radiofrequency microneedling) can reduce wrinkles. Dermarollers, Dermapens, Dermastamps & SkinPens can all improve lines & wrinkles to a limited extent.
Another low downtime cost effective treatment is Tixel skin resurfacing. Unlike lasers, Tixel generates controlled heating of the dermis without light or plasma. Tixel is great for mild surface changes on the upper lip.
Can dermal fillers rejuvenate older lips?
Careful with this one. Not one feature of the ageing face should stand out more than the rest. It is easy to pump a lip full of dermal fillers, it’s another thing to look natural.
Two questions to be answered before undertaking lip fillers in mature patients; firstly, can the structure support volumized lips? As one ages, the mouth becomes smaller, namely bone & gum recession. If the underlying structure cannot support volume, the lip becomes ‘heavier’ & immobile.
Secondly, lips should be in harmony with the rest of the face. An analogy of mine is that perky gravity defying breasts look somewhat odd on a 60-year old female.
What dermal fillers do I employ for lip rejuvenation?
Hyaluronic acid is my preferred dermal filler of choice as this material can volumize as well as define. In the ageing lip, my usual practice is to provide structural support to the surrounding lip before filling the lip itself. Volume & definition has to be conservative to match the surrounding facial structures.
I also employ collagen stimulating fillers, namely calcium hydroxyl apatite fillers in various hyper diluted concentrations. This is especially useful for patients who do not want the downtime associated with laser resurfacing. This method of filling improves the skin quality & wrinkles over a period of 2 to 4 months. This family of dermal fillers often last twice as long compared to hyaluronic acid fillers.
What can chemical peels do for ageing lips?
Chemical peels are underutilized in the context of smoker’s lines & lip rejuvenation. Medium depth peels such as TCA or Jessner TCA can improve deep upper lip lines, whilst deeper segmental phenol peels can take decades off the ageing lip.
I frequently combine peels with laser resurfacing to revitalise & rejuvenate the perioral area. Peels are excellent at providing a nice natural transition with no demarcation lines for areas of the face, neck & chest.
Superficial peels such as glycolic & lactic acid can help prevent wrinkles. These are conducted monthly in a step up program.
Can anti-wrinkle injections help with upper lip wrinkles?
Yes, small doses of Botox can relax the muscle fibres surrounding the lip. This in turn can reduce dynamic wrinkles, namely wrinkles with puckering & animation. This action usually lasts 2-4 months.
Can threads help with lip wrinkles?
PDO or monofilament threads can reduce wrinkles. Threads last between 6 to 9 months. They are best combined with HIFU, RF (radiofrequency) or with laser resurfacing for optimal results.
The ideal MINT thread candidate is one who has mild to moderate wrinkles. For severe wrinkles, including smoker’s lines, lasers give more predictable results.
Can fat transfer help with upper lip lines & wrinkles?
Yes, I do perform micro & nano fat transfer in this area. There are many advantages to fat transfer including ‘natural use’ of your own tissue & longevity compared to dermal fillers. The downside is that variable amounts of fat are resorbed.
Even with nano-fat & adipose stem cells (ASC), the results are not as good as a simple fractional laser procedure.
Why are surgical options important in some patients?
In the mature lip, a surgical option is often the best option. As one ages, we lose collagen. This results in a deflated lip, but also a long lip. The height from the base of your nose (nasal spine) to the upper lip elongates. This affects not only the ratio of the upper lip to nose, but also hides your upper teeth. Age related changes can compound this effect.
The solution is called a surgical lip lift. This procedure is done under partial sedation in an operating room. I excise 3 to 7 mm of skin, along with fat & hide the incision lines around the base of the nose. Most often I apply a CO2 laser to the area which results in more tissue tightening. The outcome is not only better proportions but importantly teeth show (about 2-3 mm). This eversion of the mature lip defines age-appropriate lip rejuvenation. From there, volumetric correction can be made using dermal fillers.
Can creams help with lip wrinkles?
Yes & no. Topical skin care can prevent wrinkles, however unfortunately there is no magic anti-wrinkle cream. Antioxidants such as vitamin E, ascorbic & ferulic acid can reduce free radical damage from UV & environmental stressors. Hyaluronic acid can improve lip hydration, whilst retinol & retinoic acids can stimulate collagen.
Sensible & precise skincare actives after laser resurfacing or chemical peels can prevent future wrinkles.
Davin’s take on lip rejuvenation
Living in Brisbane, Queensland, I see an immense amount of sun damage. Lip rejuvenation is one of the most common problems facing women over the age of 50! Contrary to popular belief, the majority of smoker’s lines are sun related, namely UV breakdown of collagen & elastin. Ablative lasers & deep chemical peels provide the most dramatic results, albeit a downtime of 8-10 days. Dermal fillers can provide good, natural results with minimal downtime, however they will require a top up every 12 to 18 months.
It is important to consider the rest of the ageing process & facial structures when treating the lips. Lip rejuvenation should always be age appropriate as there is nothing more unnatural than 20 year old lips on a 50-60 year old. Natural never goes out of fashion.