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These days, a record number of people are opting for lip enhancement procedures. In fact, lip augmentation is the second-fastest growing cosmetic procedure in the US, ahead of even breast augmentation.
Though many people are choosing to increase the size of their pout, there’s more to the lip equation. We’ve been getting questions about expression lines around the lip area, such as marionette or smile lines, but readers also want to know about the tiny, seemingly irreversible fine lines that appear around the lips, AKA perioral rhytids.
It’s about the big picture.
“When we assess patients, we want to make sure we look at the whole face,” Dr. Amanda Doyle of Russak Dermatology says. “And when treating the lips, we look at the area around the lips before even proceeding. When you smooth out the expression lines around the lip area, you’ll actually get the effect of a more defined pout and see more bang for your buck,” she tells us.
“The analogy we love telling our patients is: think of folding the corner of a piece of paper and what happens if you unfold and smooth it out. You can still see a crease left behind,” says Dr. Doyle. “In the same way, constant pursing of the lips causes tiny wrinkling over time,” she says.
We reached out to a few of our experts to understand the cause behind perioral rhytids, and the most effective treatments to address them permanently.
What causes these fine lines around the lips?
“There are several underlying causes,” says Dr. Doris Day. “The main culprits are sun exposure over time, smoking, volume loss, and repetitive motion of the muscle (as in pursing or puckering).” According to Dr. Day, this motion also causes the breakdown of collagen, which creates etched-in lines that ultimately look and act like scars.
The Permanence of Smoking
“Smoking especially—both because of the pursing movement of the lips and the free radical damage from the smoke—accelerate the aging process,” says Dr. Jennifer Chwalek of Union Square Laser Dermatology. Then when you add daily sun exposure to the list, the combination keeps contributing to these vertical lip lines.
There are some unexpected culprits, too.
“If you think about it, all of the ways we contract or purse our lips theoretically causes wrinkling: drinking out of straws, speaking, and even kissing!” Dr. Doyle tells us. Other less common reasons can be an imbalance of the upper to lower lip ratio caused by aging.
“Dental issues, such as buck teeth, recession of the chin, or any imbalance of how the lips come together when you close your mouth can exacerbate the upper lip lines for overcompensating,” says Dr. Day. She explains that volume loss of the lips—especially the lower lips—also makes the daily action of pushing our lips together harder for the muscle in the area.
Prevention over Correction
“Our motto at Russak Dermatology is always prevention,” Dr. Doyle tells us. “So opt out of drinking out of straws and apply SPF to the whole face every two hours—even in winter; you may not feel the sun’s rays, but they’re there.”
You can also promote prevention by following proper skincare routines. “I recommend the use of antioxidants, retinol, peptides, and the right hydrators to work simultaneously with any corrective in-office treatment,” Dr. Day says. She also often recommends dental work (including laminates or veneers) to patients to restore the proper teeth to lip ratio, and therefore prevent future fine lines.
Is there a permanent solution to fine lines around the lip area?
“Fillers offer instant gratification to my patients, and they can see obvious results right away,” says Dr. Doyle. “For long-lasting results, I recommend filler and a series of laser or microneedling treatments. This stimulates collagen production in the body and smooths the area out.” Fillers and lasers or microneedling can be done 2-4 weeks apart.
Dr. Day is also a fan of microneedling. “Microneedling with or without PRP (though I recommend with PRP for extra collagen boost in the area) can be a very effective and almost permanent way to prevent the fine lines around the lips,” she tells us. “Especially if it’s done with proper skin and sun care.”
Who’s the best candidate for treatment?
“People with mild to moderate perioral rhytids are the best candidates for treatment,” says Dr. Chwalek. “Once the wrinkles become quite deep, it becomes harder to treat and may require more more treatments and/or more aggressive laser resurfacing to improve the lines.”
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