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Vertical Lip Lines - Botox, Juvederm and Active Fx

June 17, 2008
I am in my 50's and the deepest lines on my face are in the mouth area, vertical lines above the top and bottom lips. I am a non-smoker, light-skinned caucasian female. It has been suggested to use Fraxel over the entire face gradually lightening the intensity as we go up the face and later use a filler if needed for the smile lines. Is there something else at this time more effective and possibly with less down-time than Fraxel? I bruise easily. Do you suggest eating or taking something before a procedure to reduce the bruising?

Hi,
Vertical lip lines are not just for smokers, unfortunately. We see them also in people who have a genetic predisposition. Oh well.
In terms of treatment, your first option is Botox. 4 units in each lip, spread out in 1 unit injections works great to decrease the appearance of the lines. This works because these lines are caused by lip movement - smiling, kissing, pursing the lips in conversation. Botox will relax the muscles just a bit. Enough that the lines are less, but not so much that speaking or smiling is affected.
Your next option depends on how many lines there are, how deep they are and how thin your lips are. If you have thin lips and many lines, I would consider some Juvederm in the vermillion border of the lips (the junction between the red and white) as well as in the red portion to help with general lip volume. If you're going to do this, go to someone experienced - you don't want to come out looking like a duck or a fish.
If you have just a few lines, we can use Juvederm to fill them directly. Again, you do not want someone to put so much filler in your upper lip that you look like you've been sparring with Mike Tyson.
If you have many thin lines and you do not want more volume in your lips, I would consider laser treatment. I do not think that Fraxel will do the job, however. It is not powerful enough. In order to really improve those lines, you need a fractionated CO2 laser. I have the Active Fx and I get very good results, but the downtime is actually more, and not less than the Fraxel. I tell people to give themselves a week of redness and swelling.
Prior to any of these procedures, Arnica is a good idea. It will decrease bruising and swelling and you should take it afterwards as well.

http://www.westsidemedicalspa.com/botox.html
http://www.westsidemedicalspa.com/juvederm.html
http://www.westsidemedicalspa.com/activefxlaser.html

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