I hate the lines on my lips, what can be done for them?

Many women are bothered by lip lines, especially the upper lip. Young women start with fine lines that increasingly get worse and become deep furrows later in life. Also, as the lip fullness decreases with aging, the pink area of the lip gradually vanishes. Lipstick and make up do not go on well with the deepening lines and the vanishing lip.

Among various options, I find fillers as the most effective tool. For fine lines, the thinnest injectables available are the collagens: Cosmoderm or Zyderm. More thicker and longer lasting fillers such as Restylane and the other collagens (Cosmoplast and Zyplast) are more appropriate for deeper lines and lip fullness. Combination of these fillers can help create a beautiful lip.

Fat injections in general do not give attractive lips and are not meant for lip lines. Radiance is another bulk filler that is known to cause cysts, especially in the lips. Botox has a limited role in lip rejuvenation by relaxing puckering of lip muscles. However, precise sculpting of lip lines and shape are not possible, risking lip weakness and function. I mainly use Botox as an adjunct to fillers. While laser resurfacing, dermabrasion and phenol peels can help improve lip lines (to a lesser degree than fillers) and skin smoothness, they do not give fullness to the lips. These procedures cause open wounds with down time along with the possibility of scars and pigment problems. No down time lasers, IPL, chemical peels and microdermabrasion give only a milder improvement of the lines. Surgical procedures often leave unacceptable scars. Protecting skin from sun and using sunscreens are also important.

Sree Karukonda, M.D.,Ph. D.
Diplomate, American Board of Dermatology
Member, South Bay Independent Physicians Medical Group, Inc.