Lip Surgeon

I read a recent article that reports that drinking directly from water bottles can cause just as many upper lip wrinkles as smoking. I wouldn’t doubt it as any activity that makes your lips pucker, which activates the orbicularis oris muscle which encircles the mouth, can cause wrinkles to appear on the upper lip. The development of such wrinkles is a function of both the activity and how often it is done. Drinking water these days for some people is about as frequent as a regular smoker who does one or two packs per day.

As a general principle, wrinkles form on the face perpendicular to the direction of action of the underlying muscle movement. For example, horizontal forehead wrinkles are the result of their vertically-oriented and moving frontalis muscle which extends from the brows upward into the scalp. Since the mouth’s main muscle (like the eyes) is a sphincter or encircling muscle which lies parallel (horizontal) to the upper and lower lip (except at the corners), it is no surprise that the lips (particularly the upper) develops vertical wrinkles in some people. The other factor that highly contributes to lip wrinkles is the thickness of your skin and the size of your lips. (which is interrelated) The thicker your skin, the less likely you will ever develop them. You rarely see lip wrinkles in people with thicker skin such as African-Americans and people of Middle Eastern descents for example. (and they have larger lips to begin with….as their skin is thicker)

Treatment of lip wrinkles is a challenging problem. I tell patients to think of it as improvement as there is no complete cure in most cases. For small and fine lines that are mainly located at the junction of the skin and the lip, an injectable filler can make a nice improvement…provided you find it acceptable to have a larger lip size. (whichever you desire) When the lip wrinkles are deeper and run higher into the upper lip, the concept of skin resurfacing comes into play. This typically means lase resurfacing and the question is how deep to go with how long of a recovery that will be acceptable to the patient. When the lip lines and wrinkles are more severe, I usually use a combination of making the lip bigger with injectable fillers and resurfacing the skin with a laser. This is usually done under local anesthesia in the office unless the patient is having other major facial surgery, such as a facelift, where the procedure would be then performed in the operating room. There is some current debate between the laser techniques of resurfacing or peeling and the use of fractional (fraxel) laser treatments, but there is no hard clinical evidence at this point to say conclusively that fractional laser treatments are better. In the more severe cases, a small amount of Botox to help reduce the amount of muscle movement can also be helpful when done with fillers or laser resurfacing but you must be careful to not use to much lest you make your smile have an unnatural appearance.

Alternative treatments for lip wrinkles through skin modification are currently being evaluated. One method is to combine laser resurfacing with the use of sandpaper (yes I said sandpaper), known as laserbrasion. With laserbrasion, a combination of upper skin removal is done first with the laser and the deeper skin areas are taken down with sandpaper. The concept here is that the use of sandpaper causes less trauma (no heat) and will heal faster without the prolonged redness. And it is just as effective as the laser but safer and with less complications than if one used traditional dermabrasion. The other method is known as percutaneous collagen induction therapy. (PCIT) Like aerating your lawn, making very tiny holes throughout the upper lip with a small wheel lined with microscopic needles cuts into the deepest portions of the skin. As this heals it causes the skin to thicken which helps reduce the amount of visible wrinkling.

Upper lip wrinkles in some women are unavoidable and can be very troubling. Injectable lip fillers, laser resurfacing, and Botox can help but there is no permanent cure. The alternative treatments of fractional laser treatments, laserbrasion, and collagen induction therapy are interesting but it is too early to know if they will offer better results.

If you want to get fuller lips, there are various lip enhancement procedures to consider which will enhance the shape and fullness of lips. Lip augmentation treatments range from the temporary effect of simple lip plumping lipsticks, to lip implant surgery, where the lips are cut and lip implants are inserted. A popular lip enhancing treatment for fuller lips is lip plumping injections, known as dermal fillers. Lip injections such as Restylane can restore lip definition and also remove fine lines around the mouth, and the results will last for around 6 months.

For a temporary result lasting just a few hours for a special occasion, there are creams and lipsticks you can buy which claim to plump up the lips. This gives the lips a fuller, more youthful look. Before considering longer lasting lip enhancements, you should look at some before and after photos of the various treatments. Some women prefer a subtle improvement as they do not want the “trout lips” look which some celebrities have had the misfortune of being ridiculed for in the press.

If you require permanent results and are happy to go under the surgeon’s knife, then you could consider lip implants. There are two methods for this, one being where the lips are cut and a synthetic lip implant strip is inserted before the cuts are stitched together. The other is where your own fat is removed from one part of the body and inserted into the lips. However, with fat implants, the treatment may need to be repeated if the body absorbs some of the fat and so reduces the fullness of the lips.

Perhaps the most popular treatment for augmenting the lips is having dermal filler lip injections. This can be painful, and a local anaesthetic is required, which could be in the form of a cream or an injection which numbs the lips, just like the one you have at the dentist. After treatment, you may experience side effects such as bruising, tenderness and swollen lips. The results will give you fuller, more defined lips for around 6 months, after which time the injections may be repeated.

The lips are one of the most strongly emphasized features of the human face, particularly for women, who often strive to enhance theirs with a variety of cosmetics. A well shaped and symmetrical mouth has been a symbol of feminine beauty throughout many cultures for centuries. This pressure leaves many women and some men dissatisfied with their personal appearances even with the aid of expensive makeup. Fortunately for them, there are a variety of surgical and non-surgical, temporary and permanent solutions to their appearance issues.

Non-Surgical Options

Many people are understandably nervous about undergoing a surgical procedure. Fortunately you may not have to do so in order to gain the facial features you desire. Lips can be plumped or re-shaped by injecting certain materials with small needles. The procedure is relatively quick and generally does not require a stay in a hospital.

The most commonly injected material is collagen, a protein that is usually derived from cows. Adverse reactions to this material are rare, but some people are allergic, so a sensitivity test should be conducted before the procedure. This protein can make lips appear larger and fuller, but it will be reabsorbed by the body over the course of one to three months. For this reason, refresher or maintenance procedures are usually required on a regular basis.

Fascian is a commercial product derived from collagen and the patient’s own fascia, a connective tissue found in the body. This product is preferred by some patients for its firm texture and relatively long life span. Although it is also absorbed by the body over time, this occurs at a much slower rate. Individual results can vary quite a bit in that respect; some patients require a refresher shot after six months, while others find the effects of the procedure last for years.

Surgical Options

Although they involve more discomfort and longer recovery periods, some patients prefer to undergo surgery because the results generally take longer to wear off. The most common of this form is plastic surgery is grafting. In this procedure, tissue that is taken either from the patient or from a donor network is inserted into the lips through small incisions. These incisions are usually strategically placed so that any scars they may leave will not be visible to anyone looking at the patient’s face.

The most common side effects of these procedures are swelling and mild bruising. Both of these generally reside within weeks, and any bruises that many form can generally be hidden with makeup.

For more information about lip enhancement, contact Austin plastic surgeon Dr. Apostolakis.