whitewater SAID:

Hi, I am 53, very thin, ex-smoker and ex sun worshipper. I have serious wrinkling around my lips and deep wrinkles on my upper chin area. I was recently told I look 100 years old :(
I saw one plastic surgeon and he said I need to use Obaji and have lasar resurfacing , besides that, but there was little he could do for my lip and chin area. I dont believe that. Can you give me any suggestions…I am desperate!

Topic:
On: December 13, 2013
To doctors from: AZ
  • http://www.faboverfifty.com/women/members/dr-rondi-walker/ DrRondiWalker

    Thank you for your question.

    Your problem is not uncommon and is treatable with combination of an ablative laser resurfacing and structural fat augmentation. It you are not a candidate for laser resurfacing a deep chemical peel may be beneficial. A thin layer of filler or fat injected along your lip line will also be helpful in stopping “lipstick bleed” and improving lip lines.

  • http://www.faboverfifty.com/women/members/dr-david-motoki/ DrDavidSMotoki

    Skin care products and laser resurfacing are commonly used for wrinkles around the mouth. More severe cases of wrinkling might benefit from surgical procedures such as fat grafting, chin implants, etc. Consult with a Board Certified ASPS Plastic Surgeon to learn about your options.

  • http://www.faboverfifty.com/women/members/dr-diana-ghosh/ DrDianaBreisterGhosh

    I would recommend Laser resurfacing and fillers such as Juvederm or Restylane. This problem is one of the most difficult to correct.

  • http://www.faboverfifty.com/women/members/dr-susan-kaweski/ DrSusanKaweski

    Hi Debbie, I usually recommend to my patients micro fat grafting for deep lines around the mouth. Yes, this can be difficult if the patient does not have enough fat for harvesting. The best thing to do is set up a consult with myself or another board certified plastic surgeon who has experience in micro fat grafting. Your only other option would be dermabrasion. Both of these procedures can be performed either under local or general anesthesia which would be determined at the consult between yourself and the surgeon.

  • http://www.faboverfifty.com/women/members/dr-james-wethe/ DrJamesWethe

    OK…first, don’t be desperate…it makes nothing better but does make you feel worse. If you have been a sun worshiper and former smoker I can image that there has been some long term effects on your skin. Having said that, there are several things that can make improvements, including Obagi and skin resurfacing. The best option for you currently is to get more than one opinion as to what would be best to help accomplish that improvement. I would suggest about 3 consults with board certified plastic surgeons and then pick the one you have the best relationship with and go for a second visit to re-discuss what he/she recommended and review what the other 2 surgeons thought and why the physician you choose does or does not like those options. An open discussion will give you the best chances for the greatest improvement as well as the peace of mind knowing you have explored all the options. Good luck!
    J. Wethe, M.D.

  • http://www.faboverfifty.com/women/members/dr-steve-laverson/ DrSteveLaverson

    In the photo, you look fantastic… Aging skin around lips and deep wrinkling on upper chin are common, especially among caucasians in 5th or 6th decade with history of sun exposure, smoking, and who are facially expressive. The good news is that this can be completely smoothed. Tretinoin .1% or modified Kligman formula is a good start, but this should be complemented with skillfully used hyaluronan fillers placed with surgical optics by a skilled practitioner, possible peri-oral surgical rejuvenation, and skin textural treatments such as carbon dioxide laser, croton oil peel(s), and/or dermabrasion. A recent publication also describes “nanofat” grafting for this application. There are a variety of choices and possibilities to improve these areas, and usually, a combination of treatments are most effective.

  • http://www.faboverfifty.com/women/members/dr-curtis-wong/ CurtisWongMD

    With your history, your surgeon was correct. If you had fat, you could consider fat grafting if you didn’t mind having fuller lips but you describe yourself as thin. Only options left are resurfacing, whether it be through laser or chemical peels. The sun is unforgiving.