What can be the cause of lip lines, and what can be done?

Lip lines are vertical lines on the upper white lip or the mustache area, and in the white skin just below the lower lip. These are relatively common in men and women as we age. It is often attributed to smokers or those who use straws frequently. It certainly can be seen in patients who fit this profile, but these lines also affect non-smokers and those who do not use straws frequently. I see both categories of patients in my practice regularly. These visible vertical lines are caused by the underlying muscle of the lip, which is called the orbicularis oris, contracting. This can happen with pursing the lips, with cigarette smoking, or with straws, but often times it is a result of how patients express themselves and move their lips in natural conversation. Over time as the muscle contracts and even when it just is at rest, due to its natural tone, the overlying skin folds.

Over time these folds become visible even during periods of rest. In my practice the first line of treatment is a low dose superficial treatment with Botox into this area. This addresses the root problem, which is muscle contraction. Botox causes a softening of the contraction and resting tone, which often alleviates or dramatically softens these lines and often keeps them from becoming deeper. For patients whose lines are very deep and persist after superficial Botox treatment, I use fillers, such as Juvederm, on a limited basis. Fillers are not my first line of treatment because they add volume into the white area surrounding the lips and can cause an area that is naturally lower or concave to become level or convex. This can look unnatural if not done very carefully.