I recently received an inquiry from my emails that read “What can I do about the lines around my mouth?”  One of the most common areas of frustration for some women are those little fine, and sometimes not so fine, lines that form along the lip making them look older than they should. . This area shows signs of aging more than wrinkles in any other area of the face. The lip wrinkles are less tolerated than wrinkles around the eyes or other parts of the face.

Let us first explore the reasons the fine lines have formed. The mouth is a very active muscle that undergoes repetitive movement throughout the day. This repetitive movement causes the overlying skin to crease. With repetitive creasing the line becomes etched in the skin and overtime are present at rest as well. Certain behaviors, such as smoking and drinking from a straw can cause these wrinkles from the puckered lip repetitive movement. Sun exposure is always a big culprit causing wrinkles and collagen break down not only around the lips, but anywhere skin is exposed to the sun or tanning beds. Always use sunscreen, everyday, and don’t forget the lip area! Sleeping habits can lead to wrinkles if one tends to sleep on their side and compress the skin around the lips. Aging with a loss of volume in the lips and around the mouth is probably the most common cause since it happens to all of us. Not only tissue volume loss, but aging of the bone structure occurs in the mouth and can lead to a sunken in appearance. Overall lack of hydration adds to wrinkled skin, so remember to apply your moisturizer and skin care products to the skin around your lips as well as something on the lips directly. Prevention of line formation is always better than treatment. Perhaps now you can understand why the peri-oral wrinkles, or lip lines, are some of the toughest wrinkles to treat

Now what can be done to eliminate those nasty little lines? I take a four-step approach.
First, we want to eliminate the existing line and start stimulating the collagen. Depending on the severity of the lines, I recommend resurfacing with microlaser peels at different depths. For the very fine lines, a more superficial resurfacing will work, for deeper lines, a deeper peel will be needed. This can be either done in a series of gentle peels with quicker recovery, or one deeper peel with a longer recovery period. See microlaser peels on our website http://www.elizabethrochemedspa.com for more information about this procedure.

The second step involves Botox. Some patients have very strong muscle movement in this area and need to have these muscles relaxed with a touch of Botox. Be aware though, in the initial two weeks the muscles may be a bit more relaxed than wanted and certain letter formations such as “p” and “b” may be awkward to pronounce. This however dissipates by the third week and gives the wrinkles a softer look over time.

Many patients also have volume loss, therefore replacement of that volume with dermal fillers is the third step. A small amount of filler in the lips to reduce the lines makes a big difference. I have found that when a little is added to the actual lips, less is then needed in the lines above the lips. Another trick is to add filler to the naso-labial folds (the lines that form from the nose to the corners of the mouth). This helps pull and smooth the skin above the lip.
The fourth and final step is to hydrate, hydrate, hydrate. When the lips have moisture in the skin, the are plumper and the wrinkles are reduced. Whenever I use my effusion gel, which is part of the elizabeth roche m.d. med spa product line, or Hydrating Complex by Skin Medica, my lips are fuller. Both effusion gel and Hydrating Complex are made of hyaluronic acid, a naturally occurring substance in the skin which attracts fluid and moisture as well as protecting against degradation of naturally occurring hyaluronic acid and elastin. When these products are used, the lips become plumper and the finer wrinkles disappear.  Remember to apply sunscreen on the lips and around the peri-oral area. For the area around the lips and the rest of the face, I use solareclipse, which is also part of the elizabeth roche m.d. product line.

Remember that prevention is always better than treatment especially when it comes to the difficult area of peri-oral wrinkles.