One of the main reasons why patients seek non-surgical aesthetic facial correction is to address the problem of aging of the perioral region, in particular the formation of vertical wrinkles, commonly known as "smoker's wrinkles".
Smoker's lines — these are small wrinkles that vertically move away from the lips, visually "stretching" them.
The lips and surrounding soft tissue play a key role in non-verbal communication, such as smiling or grimace.
Thus, visible signs of aging in the perioral region can have a significant impact on a person's self-perception and confidence in interpersonal relationships. Read about the technique of wrinkle correction around the lips on estet-portal.com in this article.
Internal and external aging: why wrinkles appear around the lips
Successful correction of smoker's lines requires a thorough understanding of the underlying perioral anatomy and a detailed knowledge of the changes associated with aging in this area.
Aging — it is a multifactorial process involving a complex interplay of internal and external factors.
The intrinsic factors of aging consist of genetic components that play a dominant role in this process, while the extrinsic factors include sun exposure, smoking, alcohol consumption, stress and depression.
Although smoking does not necessarily cause wrinkles in a smoker, it can predispose a person to developing vertical wrinkles or accelerating their formation. This is partly due to repeated pursing of the lips while smoking, as well as pathophysiological effects such as hypoxia or microvascular changes in the skin, which negatively affect the integrity of elastin and collagen.
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Dynamics of the appearance of "smoker's wrinkles"
As we age, the skin between the nose and upper lip lengthens and sags. This is mainly due to a decrease in skin elasticity, which is a normal part of aging. Decreased volume of the facial skeleton is also a typical part of aging, with this loss of volume being caused by decreased bone support and soft tissue atrophy.
In addition, there is a marked decrease in subcutaneous tissue in the perioral region, which, along with the accumulation of skin and soft tissues due to muscle activity, leads to the formation of smoker's lines.
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Effective correction of "smoker's wrinkles"
Smoker's lines are usually corrected is performed using a combination of hyaluronic acid dermal fillers and botulinum toxin type A. The choice of correction depends on the depth of the lines and the degree of wrinkling, while hyaluronic acid provides the most effective non-surgical method for correcting smoker's lines.
The use of hyaluronic acid fillers is a non-invasive, cost-effective, effective treatment with proven safety. It is also best to use them in combination with botulinum toxin type A for best results.
Botulinum toxin type A helps to loosen the strength of muscle contracture, thereby relaxing wrinkles, while hyaluronic acid helps to soften the appearance of smoker's lines.
The combination of hyaluronic acid and botulinum toxin type A not only gives excellent results, but can also lead to a longer lasting correction effect.
Technique for correcting wrinkles around the lips
Two basic injection methods can be used: the linear antero-retrograde method for linear wrinkles and the hatching method for smoker's wrinkles. and accordion lines, especially if the patient has a finely wrinkled face type.
The linear antero-retrograde method consists in the fact that the needle is inserted superficially along the entire length of the wrinkle, regularly leaving the product, moving the needle back and forth several times. During the injection, you can stretch the wrinkle between two fingers; alternatively, you can pinch the wrinkle when you inject to compress the surrounding blood vessels. Injections should be started from the border of vermilion, moving up.
The cross-hatching technique involves multiple injections in a grid pattern, both vertically and horizontally. Injections are made in the subepidermal plane at regular intervals of 1-2 mm. You can also use a fan-shaped injection pattern. For deep lines occurring in elastic or thick leather, hatching processing can be combined with the linear method.
It should be noted that unlike other fillers, Teoxane's Teosyal®RHA 1 filler injection must create a visible ridge of material for satisfactory results . These ridges will pass within 24-36 hours.
After the procedure, the injection area should be gently massaged with a finger or a cotton swab. There may be slight swelling at the injection site for 1-2 days after the procedure. Treatment can be repeated after 3-4 weeks if the need arises. The patient should be informed that it may take several weeks to see significant improvement in order to avoid overcorrection.
It is highly recommended that the patient be scheduled for a follow-up visit to ensure the best possible clinical outcome.
Due to its low density, Teosyal RHA 1 filler is ideal for correcting perioral lines that visually disappear or are significantly smoothed when the skin is stretched between the fingers.
The depth at which this filler is injected is shallow. The gray color of the subcutaneous needle can be visualized to confirm the correct depth of product placement.
The gel is injected with a 30G needle to relieve pain and contains lidocaine. If necessary, local anesthesia can also be used. It is helpful to mark wrinkles before using anesthetic cream, as subsequent swelling can obscure them, especially fine lines.
Again, precise injection into the superficial dermis is the key to success. After the injection, the injection site should be massaged vigorously to smooth out the filler and make sure it softens. This helps to avoid overcorrecting "smoker lines", which is a common mistake.
"Teoxane's patented method of preserving hyaluronic acid chains during the manufacturing process gives Teosyal RHA unique properties that make it an excellent product for this dynamic area of the face." Dr. Kieren BONG
Technically difficult to treat "smoker's wrinkles" hyaluronic acid fillers, but the unique formula of the Teosyal® RHA line of elastic hyaluronic acid fillers by Teoxane, greatly simplifies the correction of the perioral region.
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