What is the best procedure for deep, vertical lines on both upper and lower lips?


I read that laser resurfacing may be best for vertical lips lines. Is this true? If not, is there anything else? I am 63 years old and considering a facelift. Should I have the facelift before laser resurfacing or just the opposite?


 Deep vertical lines of the lips are best corrected with the Fill & Re-Surface approach. First, the peri-oral is restored with the volume lost over the years. This can be either a temporary filler or fat grafting. Next, the area is resurfaced usually with a laser. These procedures can be performed as separate procedures or in conjunction with a FaceLift. You can find some patient examples at this link:http://garyculbertson.com/facial-plastic-surgery-before-and-after/. Best,


Gary R Culbertson, MD, FACS


There are a number of things that can be done to improve vertical lines around the lips. The first is good skin care using Retin-A and a Zinc Oxide sun block. This will build collagen, improve the lines somewhat, set the skin up for whatever else is done, and protect you from further sun damage, the main cause of these wrinkles. It will also improve the rest of your skin and should be started before the facelift. I prefer the Obagi Nu-Derm system as I have found it to be better than anything else I have tried (and I have tried almost everything out there). What you do next depends on the condition of the rest of your skin and what it looks like after the initial Obagi treatment. A few vertical wrinkles in the lips can be treated with a dermal alpha hydroxyl filler such as Juvederm. More involved wrinkles just of the lips respond well to laser. More generalized wrinkles respond well to laser or a leveling peel. I would, however, never consider either until you have been on the skin care regimen for some time. This sets your skin up to build collagen well and markedly reduces the possible complications and problems with the laser or a peel.


In addition to skin resurfacing you must add volume to the lips; a major component of the deep vertical lines is deflation or loss of fat in the lips during aging. Fat grafting to the corpus of the lips as well as the white roll and tissues around the lips followed by deep skin resurfacing is necessary to treat lip lines. Facelift by itself does not address the vertical lip lines.


Laser resurfacing is the preferred option for vertical deep creases are lines around the upper and lower lips.

If you have facial laxity with jowls, loose neck skin and cheek skin and a facelift is your better option.

If you have these indications for a facelift and plan on having a facelift in my practice for facelift would be done first.  6 months after the facelift laser resurfacing can be done to improve residual wrinkles and may provide some additional skin tightening which can benefit the facelift that has already been done.


Best Procedure For Deep Vertical Lines- The optimal procedure for reshaping the lips for deep vertical lines is Erbium dual laser. Along with plumping of these deep areas approximately 3-6 weeks after your laser brasion with a Filler like, Restylane Silk, or Belotero. One should and can do the laser resurfacing and Facelift simultaneously in the hands of a Board Certified Plastic Surgeon with expertise in Facial Resurfacing and Facial Reconstruction.     

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