Deeper facial lines and wrinkles.

I have very strong facial muscles and use my face to express myself. I have deep lip lines and crows feet. I am 58 and look older than my friends the same age. What is the best treatment?

I hear you because it’s our genes plus environmental factors.  We can look at our parents and sibs which generally gives us a pretty good sense for where we might be headed.  Please keep in mind that it can take some time and money to repair damage already done, but it CAN be done.  The maintenance phase after that is much easier.

If you are serious about wanting to correct deep lines and wrinkles, you’ll want to find a really wonderful cosmetically oriented board certified dermatologist to help guide you through the process.

What causes wrinkles and deep lines?

  • Muscles of facial expression.  Like you described above, repetitive movements and expressions make a difference.  On the good side crow’s feet may mean you are smiling a lot.  Smokers tend to have deeper upper lip lines, as do people who use straws frequently.  Kissing is the good side of this. 🙂
  • Sun damage.  Look at both sides of your face.  Is the driver’s side worse?  If so, it’s because UVA goes through window glass, including cars. UVA causes wrinkles over time, therefore it’s good to block it with a high zinc sunscreen.  (SkinTour Sunscreens)
  • Volume loss due to weight loss, aging or illness.  Think of this like a deflating balloon.  As we age, many of us lose fat in our faces or it redistributes in ways we don’t like.  Illness and poor nutrition for any reason contribute.

Some examples of fixes:

  1. For deep crow’s feet, Botox/dysport are the first step.  The CF won’t be gone completely, but they will start to soften, and it helps to prevent the lines from getting deeper. Other things to consider are hyaluronic acid (HA) fillers for more volume support and also directly in the lines themselves.  Also lasers like the CO2 (carbon dioxide) fractionated laser or the Fraxel Dual may be helpful to rebuild the collagen.
  2.  For deeper upper lip lines, again a little Botox/dysport (needs to be done lightly) help to reduce the creasing with talking, etc.  Upper lip line fillers both superficial and deep support.  Peels, if done correctly are helpful here, as are certain lasers.  Often 3-4 strategies over time will create the best results. Multiple treatments are the norm, if the lines are deep.
  3.  Deep cheek lines are a different problem.  For them, often the best approach is to replace the volume lost in the mid face (area between the eyes and the mouth), tighten everything (we use deep radiofrequency like Profound on our patients over 45ish), then to resurface with a laser.  These are just some examples.  We have other strategies now also, but these are the most common ones.

I hope this helps,

Dr. Brandith Irwin

Dr. Brandith Irwin, MD

Ask me your skincare question!

Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

  • All our content is written and researched by myself.
  • My medical office in Seattle has treated thousands of patients for 15+ years.
  • This site is not affiliated or financially tied to any product, treatment or device.
Ask Me Something
SkinTour Skincare
One of the best investments in your skin is your daily skincare. Why? Because you can prevent many problems with blotchy skin color, lack of glow, texture, some types of acne, and fine lines with good skincare products. You can also correct some of these problems with effective skincare products. Great skincare is often more expensive because quality ingredients are expensive. Some companies spend on research/development which benefits all of us and adds to the cost. Are they worth it? In general - yes! I have handpicked some of what I consider to be the best skin care products, and offer them for sale on SkinTour's shop. This is based on my team and I's testing and research at our clinic. Many of the products are in my own regimen. What could be better than using skin care products a dermatologist uses?!