Due to the high UV index in Brisbane, removing lip wrinkles is in the top 5 most frequently requested treatments that I get asked. Treatments will always depend on the severity of wrinkling- in severe cases, laser resurfacing is needed for the best results, in mild cases muscle relaxants combined with filler can diminish wrinkling. Finding the ideal solution for you will also depend on your downtime, but also the texture and tone of your surrounding skin.
- Premature upper lip wrinkles and lines are due to a combination of genetics, UV exposure and in some cases smoking
- Laser resurfacing is the best method for rejuvenation of moderate to severe wrinkles
- Laser has added advantages of removing sun damage and precancerous lesions
- Combining erbium and CO2 laser, I am able to achieve up to 20 years rejuvenation with this technique
- Mild wrinkling can be treated with filler and muscle relaxants
- Fillers hydrate the skin and can improve skin texture, however repeat treatments are needed every 12 months- 18 months
- Fillers have an advantage over laser as treatment downtime is not an issue with fillers
- Lasers have other advantages over filler as the before and afters are more dramatic, and blending of the surrounding skin can be achieved
- What is the best treatment for you will depend on the current state of your skin, as well as downtime
- Looking after your skin after any laser procedure will give you long lasting results
No matter how severe upper lip lines and wrinkles are, I will have a solution to improve them. In some cases fillers can improve wrinkles and lines by up to 50% in one 10 minute session with zero downtime. The type of treatment will depend on your type of wrinkles- namely if they are static (present at rest) or dynamic (worse with articulation). Treating smokers lines that are static is much easier- that is with the use of lasers.
There are only 2 options that reliably erase upper lip lines and wrinkles.
My favoured treatment for moderate to severe lines and wrinkles is that of laser resurfacing. Laser works be ‘erasing’ the lines and stimulating new collagen. Results are instant, but recovery times vary.
Another method to treat mild to moderate lines and wrinkles is a combination of muscle relaxants and fillers. This method is temporary, and needs to be repeated every 3-8 months. The upside is that downtime is zero. This treatment is best for dynamic wrinkles- namely wrinkles that worsen with articulation and puckering!
Fillers can result in instant improvement with no downtime.
Treating smokers lines and wrinkles
In my opinion laser resurfacing is better than fillers for moderate to severe wrinkles due to the following reasons-
- Treatment is permanent and does not need to be repeated every 6-12 months-unlike filler. This does not mean you will never get wrinkles again, but with laser resurfacing I can ‘take your skin back 15-20 years’.
- Laser resurfacing gives a much better ‘blend.’ By blending I mean it can treat other areas apart from the lip. Most patients with lip wrinkles and lines will also have wrinkles on the cheeks, lower lip and around the eyes- laser can address all these areas.
- Fillers ‘fill and hydrate the skin’ with a natural substance called HA or Hyaluronic Acid. Lasers on the other hand can also address sun damage and pre cancer cells, as well as stimulating HA and collagen by your immune system. If you have DYNAMIC wrinkles, the combination of fillers and muscle relaxants such as Botox is the better option.
More on laser resurfacing
I use 5 different methods to treat wrinkling. This is the order of things from the most powerful to the weakest treatments-
- CO2 CORE laser
- Erbium laser
- Fractional laser/ Fraxel
- RF or eMatrix Radiofrequency treatments (Co
- smetic salon and clinics)
- Picosure Picofacial Fractional laser
- YouLaser (March 2017)– combination Fraxel with Co2 laser- looks like it will be a revolution in the treating smokers lines and wrinkles. Too soon to tell but its my favourite laser at the moment.
My most used treatment is a combination of both CO2 laser and Erbium laser, in the one session. This gives excellent results, but the downside is that it takes up to 10 days before skin recovers.
Fraxel laser, in my opinion is only modest in improvement of wrinkles and lines. Up to 5 treatments are needed. The upside is that this is a safe treatment with little downtime- ideal for anxious patients.
RF or RadioFrequency treatment is marketed as fractional resurfacing by cosmetic clinics. It is not. RF can stimulate collagen, however it s role is early scar remodelling and compounded collagen stimulation. RF by itself, will need 4-5 treatments, and the outcome will be mild to modest at best. Not my ideal treatment.
ePrime is great if you have marked skin laxity and exhibit ethnic skin type. It uses RF delivered up to 3 mm deep, stimulating collagen and tightening skin. In mid 2016 I have started to incorporate a new system of PRP combined with energy based insulated RF INFINI microneedling. Results are excellent, with recovery within 3 days of the procedure. Most patients require 2-3 sessions for optimal outcomes, however the downtime is much less compared to laser resurfacing.
Treating smokers lines and upper lip wrinkles has taken a new turn in 2017 with combination lasers called Hybrid laser resurfacing. The most advanced of these lasers is the YouLaser- more before and afters to come.
Side effects occur in less than 1% of cases. I ensure that areas are blended in for a natural look. Follow ups with my laser nurses will help reduce infection rates following any laser procedure.
Some of the side effects that I discuss with you during the consultation include-
- Darkening or whitening of the skin, including grids and lines. I blend the areas in to ensure that this does not happen.
- Infection- this is rare, however you will be followed up by my nursing team till the areas are completely healed. I also prescribe prophylactic antibiotics and antivirals.
- Scarring. I have only had one case in my experience. This was secondary to an infection and scab that did not heal. Scars can be revised with surgery and injections, however they are extremely rare in my hands.
No. I use a numbing cream followed by local anaesthetic blocks to the area. This ensures that you are comfortable during and after the procedure.
If full face resurfacing is undertaken, this is done under sedation in the operating theatres at Westside Laser Dermatology. Patient comfort is maintained throughout the entire procedure. After the laser treatment, pain is minimal.
No. I always use fillers that contain a local numbing solution. My favourite filler is either Restylane or Juvaderm Volbella or Ultra XC. Botox to the area feels like tiny ant bites. I use a numbing cream on the upper lip before injections to make the procedure comfortable.
How long will I be out of action after laser treatment for my wrinkles?
This depends on the depth and severity of your wrinkles and lines, as well as your overall health.
As a guide-
- Deep resurfacing for extreme sun damage and smokers lines- 10 days to heal.
- Moderate resurfacing – 6-7 days to heal
- Fractional resurfacing – 3-5 days to heal
During the healing time you are allowed to wear a special make up called Lycogel. This speeds up the healing process, is safe to use, and hides the redness associated with laser resurfacing.
Filler are ideal for fine lines and moderate wrinkles but most importantly in patients who cannot have the downtime associated with laser resurfacing. Fillers are literally a walk in walk out procedure, whilst laser treatments are conducted in theatre and will be associated with a healing time of 4-10 days; depending on the severity of wrinkles and lines.
Patients with DYNAMIC wrinkles, namely wrinkles than worsen with puckering of the lips or talking will have a better result with a combination of fillers and Botox.
Side effects of filler are more common than laser, and include temporary lumps and bumps. This settles with massage. Swelling and bruising are other side effects that can happen in 10% of cases. This settles within a week.
The most common side effect is bruising of the upper lip following dermal filler injections for the treating smoker’s lines- in fact this is not a side effect, and occurs in almost everyone. The aim of demal-filler is to lessen the superficial muscles in your upper lip giving rise to wrinkles, filling in the gaps between muscles of expression that gives rise to lines.
Fillers are great for hydrating the lip and preventing lip stick lines from running and bleeding. Mild wrinkles do well with both filler or laser. My favourite filler for treating smoker’s lines include Restylane, Boletero and Juvederm.
The term is called micro Botox and it refers to placement of tiny blebs of muscle relaxants in areas of your upper lip. This softens the muscles, and reduces dynamic wrinkles (wrinkles that move), and helps prevent static wrinkles (wrinkles at rest).
Everyone will have a different movement pattern of the upper lip. If you are extremely expressive and ‘recruit’ the superficial muscles of the lip, I often combine Botox and fillers to address both dynamic and static wrinkles. The same principle applies to treating forehead lines and smile lines. Treating smoker’s lines with Botox can be highly effective, however the down side is that it has to be repeated every 3-5 months. I do prefer dermal fillers such as Restylane in this area.
Laser results last a lot longer than fillers/ Botox. How long it will last depends on many factors including genetics, your current and previous sun exposure, smoking history and health. As a rough guide-
- Laser resurfacing – I can make your upper lip wrinkles ‘ look 15 years younger.’
- Fillers- may need to be repeated every 6-12 months.
- Botox – used for treating fine lines and wrinkles due to muscle movement, needs to be repeated every 3-4 months.
It is important to treat the supporting structures of the lips for best results. Fillers, and lasers can help.
Treatment depends on the severity and extent of either laser or filling.
As a guide-
- Deep laser full face resurfacing- including upper lip $4500
- Fractional laser upper lip blend (CO2 or Fraxel) $990
- Fillers to upper lip $990 – $1990
- Micro Botox to upper lip – $ 190- 290
An assessment will give a better guide as to the exact costing and what the best treatment options are.
The more wrinkles you have the better the result!
Three Golden rules apply-
- Use an SPF 50+ at least twice a day
- Don’t smoke
- Incorporate active cosmeuticals in your daily regime- this means either a high strength vitamin A cream, or Specialist grade creams that contain anti-oxidants, and collagen stimulating peptides.
Of course your genetics will determine how quickly you age, and when the next procedure will need to be repeated. The good news is that wrinkles, no matter how old or severe can ALWAYS be improved.
Quitting smoking will give you the very best future.
By Dr Davin Lim
Laser and Aesthetic Dermatologist
This is one of my most requested treatments. Why? Because the lifestyle of people who reside in Brisbane, the Gold Coast and the Sunshine Coast expose the face to high amounts of UV rays. In some patients this is compounded by smoking.
No matter how severe the sundamage and smoker’s damage, treatments are always possible. In fact the worse the damage the better the results. Have a look at my before and afters to see the difference. Laser resurfacing is the absolute best treatment for severe solar elastosis and treating smokers lines. This treatment erases wrinkles and stimulates your own collagen to reduce and remove lines. The downside? You must quit smoking for at least 8 weeks before laser resurfacing, and ideally quit for life- if not wrinkles will recur.
What about dermal fillers? I love them! The upside of dermal fillers is that results are instant with no downtime. Yes, you can continue to smoke after fillers (but be warned that wrinkles will come back faster). Filler results are not as good as full laser resurfacing – two treatments will give you between 50-90% improvement, depending on how deep the wrinkles are. In some cases wrinkles are DYNAMIC, meaning treating smoker’s lines are only possible with dermal fillers and Botox.
Do I perform mini-Botox for wrinkles? Yes, but I am not a big fan of this treatment because it doesn’t work as well as laser, and only last 3-4 months. Additionally some people get temporary weakness of their upper lips.