If I have deep wrinkles and lines around the mouth, how do I fix them?

I am 64 yr. old and have deep wrinkles around my mouth and one side of my upper lip is slightly lower than the other. I have been to a cosmetic surgeon inquiring about fat transfer but then I read that too much is dangerous and lumps might occur. I did not know if I should use a filler or laser or microneedleing (used to stimulate collagen if I have any). I really do not know what to do. I do get headaches from weather changes (I use over the counter migraine medicine, will this effect the procedure or results? I read I should not take any aspirin, ibupropine, or any anti inflamatory. I appreciate your website. I have been investigating this for 6weeks. I do not know which technique/products to select. Can you make any suggestions?

I really wish this was a “one size fits all kind of thing,” and…. I would love it if there was just one thing that would truly solve this problem.    Here are some things to consider and a combination of a filler like Juvederm, or Restylane Silk, a whiff of Botox and lasers work best if the lines are deep.   Microneedling may help a little with fine lines but it won’t do much for deeper wrinkles.

This area is complex so here’s what to think about:

  • The muscles around the mouth that cause you to purse your lips, like sipping through a straw, are very strong on some people.   The small amount of Botox/Dysport tends relax these muscles and prevents as much contraction.  Too much Botox/Dysport though and you’ll feel like you can’t move your mouth normally – it needs to be done carefully;
  • Why the filler?   It’s because  with aging, we gradually lose bone, fat and dermis (skin) and that also aggravates lines.  The filler, if done well should support around the lips and can also provide support in the actual lines to plump them out.  Too much and your lips will look bloated and ducky;
  • For deeper wrinkles, the CO2 fractionated laser and some erbiums are best for collagen stimulation and to reverse the sun damage on the surface of the skin.

Ideally, you would consider all three for best results at 64.

Hope this helps,  Dr. I

Dr. Brandith Irwin, MD

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