Published on December 2021
All Smiles: Rejuvenating the Perioral Region
As mask mandates loosen and ZOOM calls become more commonplace, more attention is being placed on the area that lies beneath the mask-the smile. So too the Holiday Season has officially begun, meaning that more close interactions with family, friends, and loved ones will be had. That said, this month’s article will focus on how to reverse the signs of aging around the mouth using a variety of non-surgical and surgical modalities befitting any budget or aesthetic. As theys ay, “nothing you wear is more important than your smile.”
Lines and Wrinkles: Injectables, microneedling, chemical peels
Over time, fine lines and wrinkles manifest around the mouth due to the constant use of the underlying lip muscles as well as other factors, namely sun and weather exposure. That said, a great way to correct these troublesome perioral wrinkles includes the use of small amounts of botulinum toxin (e.g., Botox) or precisely placed dermal fillers (e.g., Juvederm) to decrease muscle activity and to fill in fines lines. Additionally, one may consider a series of in-office chemical peels, microneedling sessions, or microdermabrasion (i.e., DiamondGlow) with the goal of improving skin texture and tone. Lastly, don’t forget the importance of a daily skincare, with key anti-aging ingredients to include antioxidants (Vitamin C/E), Retinol/ tretinoin (Vitamin A), and sunscreen (SPF 30 or greater). Remember that with any skincare, daily use is key!
Lip shape/volume: Filler, Botox Lip Flip, Surgical Lip Lift
A healthy lip displays appropriate volume, height, lip pout, and well-defined borders (i.e., cupid’s bow and philtral columns).
One of the best ways to recreate this youthful lip appearance is with dermal filler, a non-surgical in-office procedure associated with minimal discomfort, virtually no downtime, modest cost (average $750 per session), moderate durability (~12 months), and a high safety profile.
A “lip flip” represents using botulinum toxin to relax the superficial muscles around the mouth and thus promote more lip pout and vertical lip height. For most patients, anywhere from 8-10 units of Botox is recommended, with results lasting 3-5 months.
For those patients interested in a more durable alternative to filler and Botox, you may consider undergoing a surgical “lip lift” wherein a small amount of skin under your nose is removed to decrease the length of your upper lip skin. This quick, in-office procedure is performed under local anesthesia (numbing injections) and represents a great way to create a more youthful but natural appearance to the upper lip, oftentimes negating the need for future lip filler. Moreover, the surgical lip lift has minimal downtime (1 week), high safety profile, and long-lasting results.
Downturned corner of the mouth: Injectables
Injectables such as Botox and filler can also be used to treat a downturned corner of the mouth. In short, adding support to the outer aspects of the mouth and relaxing downward-pulling muscles converts the resting appearance of the face from a frown to a more neutral and approachable look. The change is subtle but effective.
“Gummy smile”: Botulinum toxin
Excessive gingival show represents a relatively common smile characteristic and affects up to 10% of the population. For those bothered by their “gummy smile,” a small amount of Botox targeted to the upper lip retractors can help soften this aspect of the smile. Normally, only 10 units are required for maximal effect.
How can I learn more?
If you are interested in learning more about mouth/smile rejuvenation, I suggest consulting with a surgeon experienced in facial rejuvenation procedures. This will ensure that you receive a comprehensive, non- biased assessment and treatment plan. As a fellowship-trained Facial Plastic Surgeon, I always encourage patients to understand the treatments available to them before deciding on their plan of action, as frequently, a combined modality (surgical and non-surgical) represents the best option.
Lastly, choose a surgeon whom you trust.
There are few things more important than
your relationship with your doctor.
In Good Health,
Blake Raggio, M.D
Double Board Certified Facial Plastic Surgeon
