The Aging Mouth
Signs of Aging Around the Mouth
Many blogs and articles have been written about how the eyes are usually the areas that show aging first in many if not most people. This is reflected by the extra skin in the upper eyelids, the bags beneath the lower eyelids, the shadows (“circles”) beneath the lower lids, and/or the crow’s feet. However, the Aging Mouth is a close second for showing the appearance of age.
Wrinkles Around the Aging Mouth
Wrinkles (whistle or smoker’s wrinkles), in either or both upper and lower lips. These are much worse in smokers, sun worshipers, and those who tend to purse their lips or drink with straws get them too. The treatment can require fillers with a fine needle, plus laser resurfacing or medium depth chemical peels in addition to fillers, which thicken the skin above the upper lip. As with most treatments for aging faces, the damage is cumulative, so repeat treatments may be needed.
Drooping of the upper lip. The distance from the base of the nose to the border of the vermillion (the red part of the lips) is optimally about 15 millimeters (ml) to look most youthful. As aging occurs, the mentioned distance often increases to as much as 22-23 mm. As this happens, the lip covers the upper teeth (not a youthful appearance), and the lip turns down and under and looks thinner.
While an aggressive laser, such as a Fraxel CO2 laser, will shorten the lip and diminish the wrinkles. If even more elevation is needed, a lip lift may be necessary. This is a minor surgical procedure done under local anesthesia, and it requires removing a “buckhorn” shaped strip of skin just below the upper lip. The scar is typically imperceptible, and the procedure is very effective.
Lips that turn down at each end makes one look sad or angry. Fillers below the corners are an excellent start to make the lips look “happier” along with a paralytic, such as Dysport or Botox injected just below the edge of the mouth. If these measures are insufficient because of the extent of the problem, a minor surgical procedure can be performed which will turn up the corner of the mouth and diminish the Marionette lines. The result is a happier expression.
Thin lips: Correcting this problem is one of the most common requests, and the solution is injections with “fillers” of your doctor’s and your choice. These must be individualized to the patient’s goals and their anatomy. Different techniques achieve different results. Most people want full natural lips, which do not appear over-done.
Chin and Marionettes Lines Around the Aging Mouth
Those that have Marionette lines (ML) usually hate them. The problem is a loss of volume in the chin area from both losses of bone and fat. The first step is to inject the lateral chin including the ML to reduce the total volume loss in that part of the chin. Volume may need to be restored in the cheeks as well to help lift the face upward.
If the Marionette lines are too deep for fillers or there is just too much sagging the actual folds outside of the ML can be excised. This can make a dramatic difference by reducing the Marionettes lines and turning the corners of the mouth more upward into a more youthful happier mouth. A fine, almost invisible scar is felt to be a reasonable trade-off. All of the above procedures must be done skillfully, so a natural, but more youthful appearance is achieved.
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