The mouth is a symbol of youth, attraction and sensuality. It should be well formed, and the lips clearly defined and plump.
Due to anatomical reasons, and aggressive environmental factors, this zone often ages more markedly than the rest of the face.
Glogau has defined a photo ageing scale for the lip-mouth area :
Early to moderate photo-ageing
Advanced photo- ageing
Severe Photo ageing
|Age||20-30 years||30-40 years||40-60 years||60-70 years|
|Clinical signs||Tiny signs of vertical wrinkles, minimal change to the upper lip||Light to moderate vertical wrinkles. Starting to see: lip atrophy, nasolabial lines, nasolabial ptosis||Increasingly marked vertical lines to the upper lip. Moderate atrophy to red of the lip +/–
Sagging of the edge of the lip (labial commissures) +/–
Lip folds _
|Nasolabial folds Deep vertical lines to the upper lip
Lip-chin folds ++/- Atrophy to the red of the lip
More or less marked ptosis
Age-related changes to the lips include:
– Drying and discoloration of the red of the lip.
– The loss of definition of the lip edge and the lips.
– The red of the lip thins/ loses volume.
– The labial commissures (side edges) sag and become hollow.
– The philtral crests flatten and the Cupid’s bow loses definition.
– Vertical wrinkles appear, notably above the upper lip, creating the ‘bar code’ or ‘sun folds’ effect).
The ‘bar code’, frequently seen among smokers, is due to dermal breakage, caused by repeated contractions of the dermis when the orbicular mouth muscle moves.
Several ‘at rest’ stages exist :
and several ‘movement’ stages :
Aesthetic medical treatment for lip wrinkles
The ‘bar code’ can be treated by:
– Hyaluronic acid injections
Injection is by needle along the line of the ‘red lip’ or by the ‘bleaching technique’.
A very feebly reticulated product is used, such as Emervel touch or Emervel Classic (this is not used for the ‘bleaching technique’). If the wrinkles are accentuated and the photo-ageing too significant, ‘cross-hatching’ is performed via cannula to the white of the upper lip, perpendicular to the lines (this procedure is a bit tedious as the dermal contacts must be broken). Sometimes, just the coating suffices.
Some doctors use small quantities of botox to treat the wrinkles (in this area, the skin is in contact with the mouth’s orbicular muscle which can be blocked with the toxin). I don’t use this technique because there is a risk of the toxin spreading (even if the doctor is very experienced and the injection performed absolutely correctly) and as a consequence the risk of loss of control over the lips (the lips will no longer be able to contain saliva, solids and liquids introduced into the mouth, which will not be very glamourous!).
– Ablative laser (Erbium Fractionated), or (even better) Continuous laser : this treatment is the equivalent of a phenol peel. (See the details on the Erbium laser)
If one chooses the Fractional laser, four sessions will be needed. If the Continuous laser is chosen, one session will suffice. The result will last about ten years, and rejuvenates without equal, but there is a down time of about two days if by Fractional laser, and ten days for Continuous laser. Please see the details on deep peels where this treatment is detailed.
Aesthetic treatment of lips wrinkles: before and after photos
For more images go to : www.dr-romano-esthetique.com/en/results-before-after/ageing-lips/
This page is purely informative, in accordance with the guidelines of the Ordre of Doctors.It is not a publicity for treatments