Question: I am a 52 year old woman in good health. I was a 1 pack per day smoker until I quit 5 years ago. I was also a sun worshiper, as I think most of my generationwas, and would burn and tan every summer of my youth. The skin on my face looks pretty good but I am embarrassed by vertical lines around my mouth. Is there anything I can do about this?
Answer: The history you’ve just described is a text book example for developing the lines that you have. Vertical creases around the mouth are a combination of smoking, sun exposure and heredity. These lines can be very deep and often difficult to cover with makeup. Lipstick can creep into the lines creating an uneven lip line or lipstick bleed effect.
Traditionally treatments have been either topical, laser resurfacing or chemical peels, which treat the surface of the skin or injectible, such as botox to weaken the muscles used to pucker the lips and temporary fillers such as collagen, used to plump the lip and lip lines.
Laser resurfacing has good results. Unfortunately, the healing time (several months of redness) and the expense, can be prohibitive. Chemical peels, although more affordable and offering a faster recovery, do not produce a result as a good as the laser.
The injectable methods, such as Botox and collagen products can give a moderate improvement which lasts for several months. The short duration of these products however makes most patients dissatisfied.
The latest option that I’ve been utilizing is a direct injection of the creases with Juvederm, a new hyaluronic acid (HA) filler. This product absorbs the body’s own water which then swells in the crease causing it to flatten. The results are superior to any other method I’ve used up to this point. Injection of Juvederm is an office procedure that allows you to return to work the following day. I only ask that patients not exercise for 24 hours following treatment to prevent swelling from occurring at the injection site. This treatment generally lasts from 6-12 months.
I have had patients come to my office requesting and willing to pay for laser resurfacing or chemical peels but once they evaluate this option they are almost always pleased with the result, it’s less expensive, has minimal risk, negligible recovery time, and reasonable longevity.