Mary Byron By Mary Byron • September 29, 2017

Banish Marionette, Lipstick, and Smoker's Lines

Banish Marionette, Lipstick, and Smoker's Lines

Are you one of those who always looks tired, worried or angry because those tell-tale lines around your mouth (marionette, lipstick, and smoker's lines) refuse to go away even when you are in an upbeat mood? Or have you ever experienced having Botox and rejoiced over non-existent 11's, forehead lines and crow's feet until your eyes revet to your lips and you can see how your pucker betrays your real age? And worse, has your lipstick spilled over into the fissures around your mouth making you look like a hag even when you are at your prime?

Even young ones in their twenties can suffer from unwanted creases as a result of genetics, unprotected sun exposure, sudden weight loss, lifestyle choices and use of facial expressions that predispose to developing creases. Sometimes, these changes are accompanied by a downturn of the mouth and sagging of the cheeks that worsen the "unhappy" look. Nasolabial folds, marionette lines (vertical lines that run from the corner of the mouth to the chin) and the smoker's lines (vertical lines that radiate from the lip) easily adds 10 years or more!

Over time these changes happen in the skin and in the deeper layers that contribute to concavities and creases:

1. Loss/decreased rate of production of collagen, elastin and hyaluronic acid thins out the skin and makes it less plump and elastic. Loss of hyaluronic acid drastically reduces volume and increases chances of wrinkling.When the skin creases, it doesn't "return" to its original state right away so folds become deeper and more "set" and

2. Gradual bone and fat loss that lead to hollowness. When this happens in the cheek or midface areas, the nasolabial folds, marionette lines and smoker's lines are accentuated - and the face looks gaunt.

Fashion is fickle and currently, it is in vogue to have voluptous lips so it is most desirable to have the Kylie or Angelina pout. But whether big lips are in fashion or not, one thing is constant - lip and wrinkles aren't! 

There are 2 general non-surgical procedures that we use to diminish signs of facial ageing. 

1. Use of injectibles such as neurotoxins (e.g. Botox, Dysport and Xeomin), hyaluronic acid fillers (Restylane family such as Restylane Silk/Lyft/Defyne/Refyne, Juvederm family such as Voluma/Volbella/Vollure, and Belotero), and Poly-L-Lactic Acid (PLLA or Sculptra). Juvly cautions against the use of Bellafill because it is made of bovine collagen which many are allergic to and it has a permanent component which makes it more difficult to correct.

Two techniques can be "layered" to achieve more natural-looking and longer lasting results. One is to inject into the area that needs volume and structure, adjacent to the problematic lines. For example, injecting the tandem of Voluma and Sculptra or Restylane Lyft and Defyne can lift the adjacent area and result to diminished lines which may or may not need addtional filler as a result of the stretching effect of the injected filler. The other technique is to inject directly just medial to the folds. Newer products are the "souped up versions" using state-of-art technology such as Vycross (Juvederm) and XpresHAn (Restylane). Part of being more natural-looking is that the face remains animated BUT without the unsightly lines. Products would differ in total hyaluronic content, percentage of heavy and light molecules and matrix. One nice thing about the Juvederm and Restylane family of fillers is their versatility and capacity to be layered. For instance, the filler that goe to your lips to plump them up can be used for tear troughs as well. The filler that restore the natural contour of the cheeks and midface can also augment the nose and chin.



Very fine lines can be smoothened out by using Boletero which is less dense and spreads more easily. It has affinity to the skin and can be injected superficially - perfect for smoker's lines! Botox has been used to immobilize muscles so that the creases are relaxed. Fillers and neurotoxin are like Yin and Yang; complementary in action and to a certain extent, incomplete without the other.

2. Resurfacing improves the texture of the skin, corrects uneven skin tone and diminishes blemishes. This can be done through chemical peels, photolaser and microneedling.  



And last but not least...

Proper skincare containing Vitamin C, retinoic acid and glycolic acid (or similar ones) does wonders to prevent new wrinkles from forming and improves skin texture. Wearing sunblock, hydrating, exfoliating and moisturizing can help prevent surgical intervention in the future. As they say, an ounce of prevention is worth a pound of cure!

Banish Tell-Tale Age Lines  Around the Lips