LIP LINES - UNDERSTANDING THE BEAUTY OF NORMAL LIPS
“I have fillers done to my lips because they give me confidence and I think they are my best feature. Dr. Patel always talks me out of over-filling them and I am glad he does as I work in medicine and would not like patients to think I look funny. Although I like fuller lips, he shapes them beautifully and no-one realizes I get fillers to make my beautiful lips look even better. I know it is shallow of me because I look after cancer patients but many of my patients pass comments on my “beautiful lips” and I enjoy talking to them about things other than cancer” L. Restori 29 Yrs Old with Gorgeous Lips in London- London, England
LIP LINES - APPLYING KNOWLEDGE OF SURFACE & THREE-DIMENSIONAL ANATOMY TO RECONSTRUCTION AFTER TRAUMA AND CANCER
Understanding the surface anatomy described above, the relationships between the wet and dry zones of the lips, the vermillion border, the gradual but defined decrease in fullness of the normal lip as one gets to the lateral edges and the importance of preserving and recreating the lip mound (I call it “the earthworm that sits on the lip’s edge” giving it the prominence and beauty of a normal lip) allows the cosmetic and reconstructive surgeon to use his cosmetic understanding and respect for proportions to be applied to reconstructive cases.
“My husband actually asked me the other day when I was going to see Dr. Patel as he loves my lips after I have filler done by Dr. Patel. It is always invisible to everyone and I don’t know how but he makes those two vertical lines for me and what he calls the cupid’s bow to give me a hollow between the lines which makes my lips look much younger. I have fine lines on my lips which look much better after the filler and I like having my lips fuller again. I would like them fuller still but he tells me to be conservative “don’t spoil a perfectly good result” is what he told me and so I am sticking with just one vial of restylane filler for my lips!” Mary S 49 Yrs Old with Lips in Park City, Utah
UNDERSTANDING THE FOUR TYPES OF "LINES" THAT AFFLICT LIPS OVER TIME
1. VERTICAL LIP LINES
Vertical lip lines are variously called “smoker’s lines”, “straw lines”, “marionette lines” (which is an incorrect use of the descriptor “marionette”), “whistle lines” and just plain “old lady lines”.
Interestingly these occur much less impressively in chaps: whether hormones have anything to do with them is unknown. Those men that do get them are generally smokers. Genetics has an important role, as is lifestyle (smoking, sun damage, etc). Although over decades these lines become deeper, the first lines are often seen in the third decade in non-smokers (and white Caucasians) and in even in the second decade in smokers.
The lines are much less common in people with darker skin: melanin protection has some part to play.
2. DOWNWARD TURNING LINES AT THE CORNERS OF LIPS
As one develops laxity of the lower face, and, in particular jowls, these corners of the lips turn further downwards. The depressor angularis oris muscle also, over time, seems to dynamically pull the corners of the lips downwards.
Downturning corners of lips seem to affect all races, but the depth of the lines are less deep in races with more pigment.
3. HORIZONTAL MENTAL CREASE
This is less common as a cosmetic concern than the first two types of lines described. As can be sen in the photos below, there is generally a gentle depression between the lower lip and the chin. In youth, it is rarely deep, but does deepen with time. At what level it becomes cosmetically objectionable is undefined. In my experience, some people are bothered by it more than others. A number of tissue release and augmentation with fillers or fat may be used to improve the deep crease, as seen in some of the results shown further below.
4. SUBNASAL CREASE
This is the least common of the lines around the lips that is seen and needing attention. However, when it is present, it becomes accentuated when one smiles and gives a rather pronounced look to the perioral region. Those people who have it, know about it and do not like it!!
BEFORE-AND-AFTER PHOTOGRAPHS OF THE FOUR TYPES OF LIP LINES
Some lip lines may be treated in isolation with lasers with or without fillers. More often, a combination of tissue manipulation, augmentation, laser use, tissue repositioning and repair of surrounding tissues (jowls, folds, grooves, volume deficiency, volume excess, etc) is used to give the best possible results.
COMBINATION MANAGEMENT OF LIPS
In this patient, three of the four types of lines were addressed. However, to make lips and the perioral region look more attractive, attention must be paid to the tissues surrounding lips and the mouth, viz. the jowls, the jawline, the nasolabial folds and also any lower facial deformities.
In this case, a lower cervico-facial rhytidectomy (facelift) allowed us to improve the jowls, achieve elevation of the descended cheek fat pads, augmentation of the jawline and the lips with fat and the use of lasers to the perioral pores and rhytids. This rejuvenates the whole region. it is a mistake to try to improve just one single change that may affect the lips: results are then incongruous.
Lip augmentation can be undertaken after the cosmetic reconstructive surgery is complete, giving a nice chape and age-appropriate fullness to the lips.
ISOLATED VERTICAL LIP LINES
If you are an active smoker, treatment of the lips with lasers can be undertaken, but your healing will be slower, there is a greater risk of infection and the risk of scarring is also increased. These are just facts that you ned to know. If you have completely stopped smoking, these risks reduce over time!
In many cases, these lines are seen in non-smokers. Certainly, in the modern world, second-hand smoke does have a part to play in the development of some of these changes. Genetics, sun exposure and lifestyle also have a bearing on the speed with which these appear and progress.
In the absence of other surrounding changes (jowls, labio-mental lines, neck laxity, etc), isolated treatment of the lips can give very gratifying results as seen here.
HORIZONTAL LINE SUB-NASAL/SUPR-LABIAL!
With great care and attention to surrounding surface anatomical contours and changes
SCHEDULE YOUR CONSULT TODAY
A combination of dissolving sutures and more permanent sutures (which are removed after a few days) are used for surgical procedures around the mouth and involving the lips
Although we can rejuvenate the mouth area and the lips consierably, every single lip line cannot be wiped away! Patients may need further laser treatments as well, depending upon your history of previous smoking, habits, ethnic background and other factors
VEIW OUR EVER-EXPANDING COLLECTION OF EDUCATIONAL, TECHNIQUE AND TEACHING VIDEOS
WE ARE HERE FOR YOU
CONTACT DR. PATEL
Do you have questions or need more answers?
Dr. BCK Patel MD, FRCS
Salt Lake City, Utah 84106, USA
(801) 413-3599 (phone/text)
Dr. BCK Patel MD, FRCS
617 E Riverside Dr Suite 101
Saint George, UT 84790, USA