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.

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.

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.

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.

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.

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.

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.

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.

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.