Dr. Barbour's Answer: Although the term “smokers’ lines” is often used for those wrinkles, they happen to most of us just because we have birthdays. Smoking makes them worse because the nicotine constricts the blood vessels and therefore limits the amount of oxygen that can get to the skin. It’s a cruel joke of nature’s architecture, but women are more prone to them than men (that and cellulite). The good news is that they can be made smooth again in the vast majority of cases!
There are basically three causes of the wrinkles and each one that is contributing to your particular problem needs to be evaluated and addressed by your doctor:
1. The first common cause of the lines around the lips is loss of elasticity of the skin. Sun exposure damages the skin and hastens the process.
The solution: Just about everybody can benefit from using some sort of topical retinoid (In English – Retin-A or one of its newer incarnations) on a consistent basis. Over time, a prescription-strength retinoid will stimulate collagen in the skin and help shed the old surface cells more quickly so that the “baby skin” is out there to be appreciated by all. With more severe lines, there are lasers and radiofrequency wave devices that will resurface and shrink the skin – and stimulate that wonderful collagen.
2. As we accumulate years, the cushioning layer of fat under the skin and lips tends to thin – and we deflate.
The solution: There is an ever-increasing arsenal of injectable fillers out now to help replace the volume. Your doctor must choose the correct filler for you and must have a real finesse with technique or the upper lip particularly can look a bit simian (monkey-lips). Also, the doctor must attend to giving structure to the area to keep it looking proportional and harmonious with the rest of the face. When it’s done properly and with the correct filler, the results can be beautiful and very long-lasting.
3. Constant contraction of the muscle (pursing of the lips) will cause the muscle to bulk up a little and make those lines more prominent.
The solution: If this is a contributing factor, tiny amounts of Dysport or BoTox (or soon, the newly FDA-approved Xeomin), properly placed, can help to relax any overuse of the muscle that purses the lips. Again, proper technique is imperative to avoid over-relaxing the lip (which can affect speech) or the appearance of a “long” lip.
Sometimes some combination of the above is the best approach. You are unique and so your care must be unique to you!