There comes a time when lipstick alone, cannot revitalize the central landmark of a woman’s face. Many of the problems are the result of volume loss, repetitive muscle lines, bone erosion and undesirable change of skin texture. The results: thin, elongated wrinkly lips, which have virtually lost the cupid’s bow peak, “smoker’s lines”, marionette’s zones and “golf ball” chins, features which contribute to defeminization and despair. So what’s a woman to do? Seek solutions, develop selfknowledge about your aesthetic sensibilities and be candid about any other treatments or conditions you have previously had, including cold sores and history of unfavorable scarring.
Volume restoration: Lips and chins can be reflated, lines softened, puppet lines supported with a variety of dermal fillers, (usually Hyaluronic acids), as long as “normal” anatomy is replicated. Exaggerated “trout pouts” or replacing “lipstick bleed” lines with columns is not an aesthetic service. As Fantastic Sam’s salons maintains, “if you don’t look good, we don’t look good”. What doesn’t work: Silcon100 (microdroplet silicone), Radiesse; these fillers are likely to make granulomas or little bumps.
Structural fat grafting: is a great option, as long as the patient is scheduled for other procedures, which require anesthesia. The percentage of fat graft retention depends on the method of harvest, preparation, delivery and the recipient site. Typically, perioral and lips retain about 50%. The procedure can be repeated as necessary. Neuromuscular toxins:Repetitive stress lines around lips, corners of the mouth and chin puckers can be temporarily blocked, provided your injector knows the relevant anatomy and sets the patient’s expectations appropriately.
Regional laser resurfacing: Contemporary fractionated Carbon Dioxide laser resurfacing can be done with dental blocks or with topical anesthetic. Higher energy treatments are associated with longer recovery time but overall better outcomes.
Upper lip lifts: are most suitable for older women, whose upper lip has literally stretched, elongating the flesh colored portion and obscuring the dry vermillion. The procedure can be done under dental blocks, carefully concealing the scar at the base of the nose. Dental hygiene: Promotion of good dental health is essential to conserving the bone stock of the jaws, which in turn support the soft tissues of the lips, chin and cheeks. Regular prophylaxis can identify and treat periodontal disease, which unchecked can result in unfavorable changes in the lower third of the face. I am not advocating full mouth restoration with veneers, merely preserving bony support.