Fraxel™ - Related FAQ's

Q: I have vertical creases on the upper lip. I hate them because they make me look old and my lipstick runs into the lines. Will the Fraxel™ laser help me?

A: Upper lip vertical wrinkles can be improved by resurfacing. However, these wrinkles are related to a combination of sun damage weakening the dermal collagen and elastic tissue, especially the Ultraviolet A waves that penetrate deeply, and the muscle activity of the upper lip that makes the skin crease as an accordion when the muscle contracts. Smoking has been shown to cause damage to the skin both by the toxins in the blood stream and air breathed in, and the constant pursing of the lip that makes the skin fold into the creases. Resurfacing deeply can only improve these lines to a certain degree, because the muscle will still fold and the skin will crease as a result of this activity, but less than before resurfacing.

Fillers can help these lines too, but may look lumpy and needs to be done very meticulously, and is often done with Juvederm™ or Restylane™, NOT Radiesse™ or Fat, as the latter two are too viscous and may cause lumps. Furthermore, the Juvederm™ Ultra or Restlyane can be reversed by dissolving it with hyaluronidase. Deep resurfacing with Fraxel™ Repair or multiple Fraxel™ Restore treatments can help improve the skin creases but more aggressive treatments such as dermabrasion and carbon dioxide non-fractional laser, can improve the condition further, but increase the risk of scarring and hypopigmentation.

Some people with severe photodamage of the face need to have the whole face treated, otherwise there would be too much contrast between the newly formed skin around the mouth and the aged appearance around the face. Sometimes, very low units of Botox, one to two units, can be injected in four tiny areas of the upper lip to minimize pursing prior to the laser being done to help it heal on smoother skin. This is avoided in singers, vocalists, wind instrument musicians, and other people who can't afford minimization of their lip motion. Botox injections of the upper lip can risk excessive drooping which can interfere with speech, eating, smiling, and brushing the teeth, so only an expert in this treatment should do Botox or Dysport treatment of lip lines.

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