Smoker’s pucker (Botox / Hyaluronic acid-based fillers)

Smoker’s pucker

Vertical lines on the upper lip are called smoker’s pucker. But even non-smokers can get these lines along the upper lip with increasing age. The upper lip wrinkles only appear with movement and become more apparent when lipstick starts to bleed into the fuzzy contours of the lips. After a few years of continuous movement from smoking and kissing the wrinkled upper lip turns into the smoker’s pucker when not in motion.

Upper lip wrinkles are called “smoker’s pucker”

Cause of smoker’s pucker

Length of procedure:20 minutes
Hospital stay:ambulatory
Anesthesia:local
Follow-up treatment:cooling
No exercise or sports:one day
Fee according to GOÄ:from 395€

The cause of smoker’s pucker is diminishing skin quality; meaning the decreasing number of collagen fibers and the reduction of body producing hyaluronic acid of the skin, in combination with a pronounced mimic. While the patient has little influence over genetic mimic, giving up or not smoking would reduce the amount of motion of the upper lip. Frequent exposure to strong ultraviolet rays through tanning beds or unprotected direct sunlight accelerate the formation of a smoker’s pucker.

Treating upper lip wrinkles

Besides using protection for ultraviolet rays (anti-wrinkle cream with UV protection) giving up nicotine would slow down the aging process of the skin.

NEW: Underlying smoker’s pucker with threads

An early treatment of emerging wrinkles could be thread lifting with PDO threads. Underlying upper lip wrinkles with solid fibers (surgical threads) is an alternative to injections with hyaluronic acid-based fillers. The constant fibrous break-down of the threads over several months stabilizes the wrinkled area and leads to the production of new collagen fibers – without a substantial increase in volume to the upper lip. In contrast to an injection with hyaluronic acid-based filler the patient is socially presentable after a thread lift. However, a hyaluronic acid-based filler treatment is highly recommended for those with advanced loss of volume of and around the lips accompanied with adjuvant botulinum toxin therapy.

Botulinum toxin for smoker’s pucker

Raucherfältchen behandeln

The strength of the lip muscles can be reduced with botulinum toxin and with time the depth of the lip wrinkles. However, it is important to commence treatment at the right time because botulinum toxin can only be injected in very small doses around the lips. A larger dosage would certainly improve and smooth out the wrinkles more, but an articulation and movement disorder of the upper lip would definitely be unacceptable.

Treating smoker’s pucker with hyaluronic acid

The skin quality in the area above the upper lip can be improved with an injection of cross-linked hyaluronic acid-based filler. Hyaluronic acid binds moisture and works very well in plumping the area above the upper lip. A lip augmentation with hyaluronic acid-based filler also reduces upper lip wrinkles. The area and technique used to treat these wrinkles should be discussed here with your practitioner.

Upper lip area: botulinum toxin or hyaluronic acid-based filler?

Either a mono (Wiki) or combination therapy of upper lip wrinkles is recommended depending on the patient’s wishes and practicability regarding results and progress. The result, long-term effect and possible side effects regarding swelling and hematoma (bruising) after an upper lip treatment with botulinum toxin or hyaluronic acid-based filler are very different from one another.

Medical Needling as a supportive therapy

For treating very fine upper lip wrinkles Medical Needling is recommended. It stimulates the formation of collagen, induces a better blood flow and the skin is moisturized.

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