I read a recent article that reports that drinking directly from
water bottles can cause just as many upper lip wrinkles as smoking. I
wouldn't doubt it as any activity that makes your lips pucker, which
activates the orbicularis oris muscle which encircles the mouth, can
cause wrinkles to appear on the upper lip. The development of such
wrinkles is a function of both the activity and how often it is done.
Drinking water these days for some people is about as frequent as a
regular smoker who does one or two packs per day.
As a general
principle, wrinkles form on the face perpendicular to the direction of
action of the underlying muscle movement. For example, horizontal
forehead wrinkles are the result of their vertically-oriented and moving
frontalis muscle which extends from the brows upward into the scalp.
Since the mouth's main muscle (like the eyes) is a sphincter or
encircling muscle which lies parallel (horizontal) to the upper and
lower lip (except at the corners), it is no surprise that the lips
(particularly the upper) develops vertical wrinkles in some people. The
other factor that highly contributes to lip wrinkles is the thickness of
your skin and the size of your lips. (which is interrelated) The
thicker your skin, the less likely you will ever develop them. You
rarely see lip wrinkles in people with thicker skin such as
African-Americans and people of Middle Eastern descents for example.
(and they have larger lips to begin with....as their skin is thicker)
Treatment
of lip wrinkles is a challenging problem. I tell patients to think of
it as improvement as there is no complete cure in most cases. For small
and fine lines that are mainly located at the junction of the skin and
the lip, an injectable filler can make a nice improvement...provided you
find it acceptable to have a larger lip size. (whichever you desire)
When the lip wrinkles are deeper and run higher into the upper lip, the
concept of skin resurfacing comes into play. This typically means lase
resurfacing and the question is how deep to go with how long of a
recovery that will be acceptable to the patient. When the lip lines and
wrinkles are more severe, I usually use a combination of making the lip
bigger with injectable fillers and resurfacing the skin with a laser.
This is usually done under local anesthesia in the office unless the
patient is having other major facial surgery, such as a facelift, where
the procedure would be then performed in the operating room. There is
some current debate between the laser techniques of resurfacing or
peeling and the use of fractional (fraxel) laser treatments, but there
is no hard clinical evidence at this point to say conclusively that
fractional laser treatments are better. In the more severe cases, a
small amount of Botox to help reduce the amount of muscle movement can
also be helpful when done with fillers or laser resurfacing but you must
be careful to not use to much lest you make your smile have an
unnatural appearance.
Alternative treatments for lip wrinkles
through skin modification are currently being evaluated. One method is
to combine laser resurfacing with the use of sandpaper (yes I said
sandpaper), known as laserbrasion. With laserbrasion, a combination of
upper skin removal is done first with the laser and the deeper skin
areas are taken down with sandpaper. The concept here is that the use of
sandpaper causes less trauma (no heat) and will heal faster without the
prolonged redness. And it is just as effective as the laser but safer
and with less complications than if one used traditional dermabrasion.
The other method is known as percutaneous collagen induction therapy.
(PCIT) Like aerating your lawn, making very tiny holes throughout the
upper lip with a small wheel lined with microscopic needles cuts into
the deepest portions of the skin. As this heals it causes the skin to
thicken which helps reduce the amount of visible wrinkling.
Upper
lip wrinkles in some women are unavoidable and can be very troubling.
Injectable lip fillers, laser resurfacing, and Botox can help but there
is no permanent cure. The alternative treatments of fractional laser
treatments, laserbrasion, and collagen induction therapy are interesting
but it is too early to know if they will offer better results.