As an aesthetic physician with over 20 years of injection experience, several things genuinely make me cringe when I see them. One of the top things is someone trying to fill in radial lip lines with a filler of some sort. This treatment will never look natural, no matter what filler or how much you use.
Everyone has seen this look on some influencers or “injectors” Instagram and thinks maybe the patient should fly south for the winter. In this post, I want to discuss the treatment of vertical lip lines and how to properly use filler in the lower to mid-face. First, we will discuss some major types of filler.
Sculptra: Sculptra is an injectable treatment that stimulates collagen production to help restore volume and smooth out skin. It is made from a biocompatible, biodegradable substance called poly-L-lactic acid (PLLA), which has been used in medical devices for years. Sculptra is injected deep into the skin, where it works gradually over time to boost collagen production and create a fuller, more youthful look. This treatment is ideal for patients who want long-lasting results that look natural without the need for repeated injections.
Renuva: The Renuva filler is a non-invasive, professional-grade filler made from processed adipose tissue (fat cells). Renuva is an extracellular matrix containing similar proteins, growth factors, and collagens in your fat. Renuva works to create a honeycomb-structured matrix filled with the patient’s body’s fat. After about 3-6 months following treatment, the Renuva matrix becomes gradually eliminated from the body – eventually leaving the patient’s own fat in exactly the places they want! Renuva can fill in deep wrinkles, lines, and other areas of the face and body that have lost volume or elasticity, like buttocks and breasts. Renuva is considered a permanent option since it can last 10-plus years.
HA Fillers: Hyaluronic Acid Fillers are the most popular choice for patients looking to diminish the appearance of vertical lip lines. There are several brand names: Juvéderm, Bolotero, Restylane, Revanesse, and others. They work by filling in the wrinkles and creases with a substance like hyaluronic acid, which adds volume and moisture to the skin. This treatment is customized to fit the severity of your lines and the desired level of plumpness, and the formulation of each filler often influences where it’s most often used. HA fillers can augment the temples, tear troughs, cheekbones, smile lines, lips, chin, jawline, and hands. Hyaluronic Acid fillers are a quick procedure, typically taking 30 minutes or less, and require little to no downtime. Results can last several months to over a year, depending on the type of filler used.
Techniques for Mid-Face and Lower-Face Filler Application
Mid-Face Filler Treatment: The area should focus on the cheeks to replace lost volume to create a lifting effect. An effective combination could involve treating the mid-face first, which can often reduce the need to inject the higher areas. The goal is to restore youthful contours and proportions while maintaining a natural appearance.
Lower-Face Filler Treatment: In the lower face, fillers are often used to treat nasolabial folds, support the corners of the mouth, and smooth marionette lines. Fillers can also be used to reshape the jawline, improving the facial contour for a more youthful appearance.
But which filler should be used for “Smokers Lines”?
NONE! Don’t do it. To understand why, one must understand the anatomy of the lips. Radial lip lines, also called “smoker’s lines,” are actually muscle fibers connecting to the skin. When the “kissing muscle” (orbicularis oris) flexes, it causes the lips to pucker and the lines to deepen. This is generally not a problem in youth because of the youthful elasticity the facial skin possesses. Over time, as we lose collagen, the skin begins to thin out, resulting in the lines becoming deeper and etched into the lines of the skin. This process will depend on the quality of the skin and the location and size of the muscle. Smoking may affect the process as well, but genetics and aging are likely to be more prominent factors.
The region is dynamic, and the upper lip should have a natural concave curve. Adding a filler here fills the naturally recessed area, causing a flattening and lengthening of the upper lip, causing the infamous “Duck Lip” look. It puts the patient at high risk for filler migration due to the muscular dynamics at play.
So, how can Radial Lip Lines be treated?
Radial lip lines are challenging to treat. These hard-to-address areas require real solutions, not necessarily “convenient” or easy ones. I think only Ablative Fractional or Non-Fractional CO2 and Erbium laser resurfacing are the only options here since the texture changes around the lip are profound. They do require 7-10 days of social downtime. The treatment was wasted if you don’t have 7-14 days of social downtime (red/pink skin, peeling). All Lasers are different, and the lower downtime lasers are quite popular because not many people have two weeks to dedicate to this treatment. Still, they are also not powerful enough to address this problematic area. They will not give you the results you are looking for. To achieve the desired outcome, the patient should always select a physician who is very experienced in complete ablative laser treatment. I prefer the Erbium: Yag 2940 laser for its superior control, results, and less downtime.
At Body by Blink, we believe everyone deserves to feel confident and beautiful at any age. If you’re ready to rejuvenate your appearance and say goodbye to vertical lip lines, we’re here to help. Our team of experienced medical professionals can help you choose the proper treatment and tailor your entire experience to your needs. We specialize in a proactive approach to healthcare and aesthetics, focusing on providing advanced medicine and procedures in boutique comfort. So why wait? Schedule your consultation with us today, and let’s start your beauty journey together!