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Melissa Hu, MD

Board Certified Facial Plastic Surgeon

It's natural to take steps to look your best
  • Dr. Melissa Hu

Lip & Mouth Rejuvenation

As we age, we experience volume loss involving skin, fat, muscle, bone. These changes can lead to some characteristic changes around the mouth with aging. This includes: 1) corners of the mouth turning downward, 2) blunting of lip borders that contribute to lip thinning, 3) vertical lines and wrinkles around the mouth, 4) elongation of the white lip, and 5) thickening of skin around the mouth and chin. Excessive sun exposure and smoking can expedite the aging process even more. Do not fret, there are options to combat these changes which include non-invasive, minimally invasive, and surgical procedures.

Down Turned Corners:

The most commonly used treatment for downward turned corners of the mouth and deep creases that contribute to jowling (marionette lines) is fillers. Results last 9-18 months depending on the type of filler used. Bruising may develop as this area is quite vascular. Because of this, it is also important that an injector uses proper technique to avoid intra-vascular injection. A less commonly utilized procedure involves surgical lifting of the corners. Though results are permanent, it may be associated with a visible scar at the corner of the mouth. It also does not treat the volume loss, and the issue with the marionette lines very well.

Blunting of Lip Borders / Lip Thinning:

This is the most commonly treated issue of the aging mouth and lips. Lips thin also due to the decrease in estrogen in our bodies over time. Fillers have been an extremely popular method of treatment. The process is simple, results are immediate, and the lips can have a very natural feel. However, the effects are still temporary and require retreatment every 6-12 months, depending on the individual. Silicone implants have historically been used, but the unnatural feel and extrusion of these implants have made this procedure less sought after. Fat grafting was also a fad of the past as the fat often resulted in lumpiness and usually dissolved over time. Lip implants using a patient's own SMAS (superficial musculoaponeurotic system) tissue, harvested at the time of a face lift, has demonstrated long-lasting, natural and aesthetically pleasing results. Only moderate augmentation can be achieved with tissue implantation of the lips as excessive tissue implantation may compromise graft take and healing.

Vertical Lines and Wrinkles Around the Mouth:

Many people associate these findings with smoking. However, they can develop in people who have never smoked in the past. There is some speculation that frequent straw use may contribute to the development of these lines. Treatment of the lines crossing the border of the

lip (vermillion border) can be effectively treated with fillers. Deeper lines that extend far into the white lip may not resolve completely with filler. There is also a risk of developing permanent changes to the skin in this region with over-injection that results in a puffy or prominent upper lip complex. When the deeper lines are accompanied by skin thickening of the lip and chin, resurfacing procedures using lasers or dermabrasion can very effectively treat the deeper lines and skin texture issues of the white lip. Botox decreases movement of the lip and thus formation of these lines, but its use may potentially have an effect on the ability to move your mouth in speaking, eating, and drinking.

The Elongated Lip:

Bone loss around the nose/upper jaw region and thinning of tissues results in the effect of a longer upper lip. This can sometimes exacerbate the appearance of a thinned upper lip. Correction of this is achieved through a surgical lip lift. The incisions are typically placed along the base of the nose which usually heal inconspicuously. Results are permanent, only possibly needing revision should the procedure have been completed at a younger age.

Thickened Skin Around the Mouth & Chin:

This occurs when the sebaceous glands of the skin enlarge which then cause a porous and spongey texture to the skin of the chin and mouth region. This is often associated with deep lines in the skin around the mouth. The most effective treatment for these skin changes usually involves skin resurfacing. There are various types of lasers that have effectively been used for resurfacing. Mechanical resurfacing with dermabrasion has also been extremely effective and has been associated with less pain and redness than lasers in this region. Medium and Deep chemical peels may also be effective in resurfacing the skin, but is somewhat more difficult to control in smaller treatment areas.

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