How do you get rid lines around the mouth, nose and chin? Dr Leo Avgerinos gives us a glimpse of what’s involved.

It’s not just our eyes that start to show the ravages of time – the area from our nose to our chin can also be affected by wrinkles. There are three main types of lines that appear around the mouth:

• Marionette lines are the long vertical lines that run from the corners of the mouth down each side of the chin
• Nasolabial or parentheses lines which extend from nose to mouth, and,
• ‘lipstick’ or ‘smoker’s lines’ that usually appear at the top part and around the lips.

How and why they appear?

These types of  lines usually start appearing during a person’s 30s or 40s, with 46% of people over 60 years of age having a fair amount of visible marionette lines. Of course their development depends on an individual’s genetic makeup and and lifestyle and some people might never get them.

Studies have shown that females show a sudden rise in signs of ageing basically due to hormonal changes that affect most women’s skin, which is softer than men’s.

There are two main causes of these:

• a decrease in collagen production as we age, which leads to loosening of the ligaments around the mouth and chin, or
• decreasing fat deposits around the face, which can make the skin around the chin area look more saggy and wrinkled.

And, there are environmental factors that can also affect their development. For example, extensive sun exposure without protection as well as chronic smoking (due to the constant movement of taking a puff) can intensify these lines and make them appear earlier than someone with no such exposure or who is not a smoker.

Nutrition and exercise also play their part, as they greatly affect the skin’s health and elasticity.

How can we get rid of them?

-Prevention

There is no way to completely prevent marionette lines. Their course of development depends on many factors, but they will eventually form in all people – some are just ‘luckier’ than others in the sense that they can get them in a later stage in life, whereas other can have them from their 30s. But, there are a few tips to help keep them at bay:

1. Follow a disciplined skincare routine and uses skincare products that are rich in collagen boosting active ingredients like Vitamin C and Vitamin A. (Editor’s note: they’re also antioxidants which are great for the skin in general)
2. Follow a good diet, rich in fruit and vegetables as they contain nutrients that are good for skin elasticity
3. Get plenty of regular exercise
4. Don’t smoke – this is a primary cause of wrinkles around the lips
5. Don’t drink too much alcohol and this decreases nutrients in the body and increases the likelihood of wrinkles
6. Always use sunscreen.

-Cosmetic Treatments

Injectable fillers can plum up the areas with lines, making them less visible and the creases less deep. However the lines are not permanently removed and the procedure will need topping up regularly. Options include injecting the cheeks so that lines can be lift up, or plumping the lips for the same reason. The area is numbed before the injections and

Advantages:

• Less invasive than plastic surgery
• As injectable fillers are absorbed by the body after 3 to 8 months (depending on the individual), you can decide to either top up or not

Disadvantages:

• Not a permanent solution
• Dangerous area – many facial nerves and muscles are involved, if not injected correctly filler can cause paralysis or ptosis (drooping)
• Usual side-effects of dermal fillers (swelling and bruising, which usually subsides within a day or so.)

Over the past few years different types of fillers have come onto the market that focus on skin rejuventation rather than simply ‘filling’. examples of this include Profhilo and Ellansé®.

Profhilo is a hyaluronic acid based injectable that acts differently under the skin. It flows to fill out and rejuvenate across a broad area. Ellansé® consists of synthetic microspheres made from a medical grade polymer called Polycaprolactone or PCL which are suspended in a carboxymethyl cellulose (CMC) gel.

It is a semi-permanent ‘filler’ which is used to treat the visible signs of ageing including lines and wrinkles on many areas around the face including around the mouth. It stimulates your body’s own collagen production in the area being treated. It is not a filler for lips or contouring, but for skin rejuvenation.

– RadioFrequency, Fractional Laser, Plasma, PRP and Ultrasound

There are a number of other treatments that work on improving skin tone and reducing fine lines and wrinkles which can be useful around the mouth as well. These include HI-FU, Thermiva (usually associated with vaginal rejuvenation but it has an attachment that can be used for other areas of the body), Ultherapy, fractional laser and plasma treatments such as Plexr and Jett Plasma.

PRP – or Platelet Rich Plasma – perhaps best associated with Kim Kardashian and the ‘vampire facial’ she has regularly is another non-surgical option. It involves taking your blood, spinning it down to separate it from the plasma which contains growth factors that can help rejuvenate and improve texture.

-Plastic surgery

A face lift, done by a plastic surgeon might be an option.

Advantages

• It lasts longer – usually several years depending on the person’s skin and lifestyle
• It may be more cost-effective in the long run

Disadvantages

• Long healing times
• Aftercare is crucial in order to prevent complications

A thorough facial examination is crucial before determining which will be the best approach to treatment.

It’s vital to ensure your practitioner is qualified to reduce the risk of complications and that do not overfill 1/3 of the face with injectable fillers.

Conclusion

You should always consult with a doctor about which options are best for you, based on your needs.

Most importantly is that people feel comfortable in their own skin. This article is intended to be informative, and not to prompt you to have a treatment if you do not deem that is necessary.