Hello again and thanks for your interest and support.This week we talk about the infamous ‘smoker’s lines’ (AKA perioral rhytids) that form around our mouths as we age. While smoking predisposes us to these lines, not all who wear them have smoked. As we mature, the padding between the skin and muscle lessens and the mouth muscle (AKA orbicularis oris)  is an active muscle so lines form over time. These lines are a common reason people come see me and luckily there are evidence-based treatments out there to lessen their appearance (1). 

While there are many different routes to treat this part of the face, here are the five main routes that I take:

1. Neurotoxin (Botox) to the orbicularis oris relaxes this muscle so that lines are less apparent with animation. Botox can be used as a singular treatment and is an easy add-on to your regular treatment. It can also be used in combination with other treatments. Because this is a very sensitive area for injecting, I will typically apply a topical numbing agent for comfort. Bruising is a potential although not common and results last about 12 weeks. 

1. Hyaluronic dermal fillers are helpful with lines that are there even when you’re not in animation; these are referred to as static lines. I like to place the filler superficially in the static lines, sometimes integrating the fern technique to strengthen the tissue. For the right candidate, I also employ a technique I learned from Dr. Swift where I blend 5 units with 0.1-0.2 ml of filler and use a cannula to place the blended product in the area of concern. This gives overall support to the area and added results over the weeks as the Botox kicks in. You can expect swelling and bruising with dermal filler with immediate results that last about a year. 

2. Microneedling is helpful for static lines around the mouth and works by creating controlled injury to the area. This controlled injury elicits the healing response and promotes collagen growth and creates new vascularization. Downtime is about a day, multiple treatments are required, and results are seen at six weeks with maximum benefit at 6 months. You can expect lines to be softened rather than disappear. 

1. Chemical Peels ​​are a powerful tool used to resurface the skin and restore a more youthful appearance (2). Currently in my practice I have several options of light peels to choose from which offer superficial resurfacing of the skin. Typically done in a series of treatments, you can expect softening of the superficial imprinted smoker’s lines.  

1. Topical Products: Topicals are a great way to consistently treat this area. First and foremost, daily sunscreen with reapplications throughout the day is important to protect us from UV exposure and subsequent breakdown of collagen and elastin (3). I also carry Jan Marnini’s Hyla3D Lip complex to include peptides, retinol, hyaluronic acid, and more which is formulated to hydrate and soften the appearance of lip lines and wrinkles.

While all the above treatments offer results, you can expect the best result with a combination of the above treatments. I like to say a little bit at a time, with all these treatments moving into the direction of softening and enhancing. If you’re curious about any of the above offerings, book a complimentary consultation to discuss which treatments are best for you.