What is the best cosmetic procedure for, deep lines around and above the mouth?


A patient asks our experts Dr Leah Totton and Dr Rita Rakus 'What is the best cosmetic procedure for,deep lines around and above the mouth?'

Thank you for your message. It is always very difficult to offer any clinical advice without the benefit of seeing the patient first, but as a guideline the following treatments (or a combination of them) may be appropriate to help soften deep lines in the perioral area:
Dermal fillers e.g. Juvderm, Belotero, Princess, Restylane etc.  
Laser therapy e.g. Fraxel, Total FX. 
Microneedling e.g. IntraCel, Rejuvapen. 

Dr Rita Rakus

You have two options (1) Ablative laser- known as i-pixel laser or (2) Dermal filler or a combination of both.  Ablative laser - you will generally need 6 sessions normally 1 month apart (more sessions may be required depending on the depth of the lines)- this treatment is particularly good for lines above the lip known as smokers lines and you can expect a significant reduction in wrinkle depth after 6 sessions. Results are permanent in that the lines will not return to their original depth but over time you will naturally age so a top up session laser session is advised once per year and a factor 50 SPF should be applied to the area to prevent further lines forming. 
Dermal filler
This involves injecting dermal filler into the lines to give an immediate result. The result will last between 6-12 months depending on the type of filler used. The advantage of this over laser is that it gives an immediate correction - the disadvantage in comparison with laser is that lines will return to their original depth once the filler wears off and as you are injecting a filler it can make the area look swollen for several days/ weeks after the treatment. 
In my opinion a combination of both is the best solution so that the wrinkle depth is reduced enough to use very little dermal filler which results in a very natural look with little or no swelling. 

Dr Leah Totton

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