I read a recent article that reports that drinking directly
from water bottles can cause just as many upper lip
wrinkles as smoking. I wouldn't doubt it as any activity
that makes your lips pucker, which activates the
orbicularis oris muscle which encircles the mouth, can
cause wrinkles to appear on the upper lip. The development
of such wrinkles is a function of both the activity and how
often it is done. Drinking water these days for some people
is about as frequent as a regular smoker who does one or
two packs per day.
As a general principle, wrinkles form on the face
perpendicular to the direction of action of the underlying
muscle movement. For example, horizontal forehead wrinkles
are the result of ther vertically-oriented and moving
frontalis muscle which extends from the brows upward into
the scalp. Since the mouth's main muscle (like the eyes) is
a sphincter or encircling muscle which lies parallel
(horizontal) to the upper and lower lip (except at the
corners), it is no surprise that the lips (particularly the
upper) develops vertical wrinkles in some people. The other
factor that highly contributes to lip wrinkles is the
thickness of your skin and the size of your lips. (which is
interrelated) The thicker your skin, the less likely you
will ever develop them. Take a look at African-Americans
and people of Middle Eastern Descent, you rarely ever see
them develop wrinkling of the lips. (and they have larger
lips to begin with....as their skin is thicker)
Treatment of lip wrinkles is a challenging problem. I tell
patients to think of it as improvement as there is no
complete cure in most cases. For small and fine lines that
are mainly located at the junction of the skin and the lip,
an injectable filler can make a nice improvement...if you
can accept having slightly to substantially larger lips.
(whichever you desire) When the lip wrinkles are deeper and
run higher into the upper lip, the concept of skin
resurfacing comes into play. Usually this means laser
resurfacing and it is just a question of how deep to go and
how much recovery does the patient want. Laser resurfacing
with lip augmentation with an injectable filler is the most
common method by which I treat more significant lip
wrinkling issues. This is done in the office under local
anesthesia unless the patient is having other facial
procedures which requires a trip to the operating room with
the use of deeper anesthesia. There is some current debate
between the laser techniques of resurfacing or peeling and
the use of fractional (fraxel) laser treatments, but there
is no hard clinical evidence at this point to say
conclusively that fractional laser treatments are better.
In the more severe cases, a small amount of Botox to help
reduce the amount of muscle movement can also be helpful
when done with fillers or laser resurfacing but you must be
careful to not use to much lest you make your smile have an
unnatural appearance.
Other methods of upper lip resurfacing for lip wrinkles is
currently being evaluated. One method is to combine laser
resurfacing with the use of sandpaper (yes I said
sandpaper), known as laserbrasion. With this technique, the
laser is only used for the first pass (to remove the very
top layer of skin) and the deeper layers are then taken
done by fine sandpaper. The concept here is that the use of
sandpaper causes less trauma (no heat) and will heal faster
without the prolonged redness. And it is just as effective
as the laser but safer and with less complications than if
one used traditional dermabrasion. The other method is
known as percutaneous collagen induction therapy. (PCIT)
Known aerating your lawn, a small wheel with fine needles
is run over the upper lip, cutting many fine holes into the
deeper portions of the skin. As this heals it causes the
skin to thicken which helps reduce the amount of visible
wrinkling.
Upper lip wrinkles in some women are unavoidable and can be
very troubling. Injectable lip fillers, laser resurfacing,
and Botox can help but there is no permanent cure. The
alternative treatments of fractional laser treatments,
laserbrasion, and collagen induction therapy are
interesting but it is too early to know if they will offer
better results.
----------------------------------------------------
Dr Barry Eppley, board-certified plastic surgeon of
Indianapolis, operates his private practice at Clarian
North and West Medical Centers in suburban Indianapolis. He
writes a daily blog on topics and trends in plastic surgery
at http://www.exploreplasticsurgery.com
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