Age changes around the mouth area are more than just wrinkles and vertical lip lines. The upper lip actually lengthens, the corners of the mouth turn downward and the lips lose fullness. Three distinct grooves appear around the mouth including the nasolabial lines (oblique lip-cheek grooves), marionette lines (vertical chin-facial groove) and the horizontal labiomental groove below the lower lip. These grooves frame the mouth and add to its aging appearance.
Contrary to popular perception, no type of facelift or necklift can change the tissues around the mouth. The pull of these operations is too distant from the mouth to affect the tissues that immediately frame it. The only methods to change the aging mouth must treat it directly.
INDIANAPOLIS
The changes around the mouth with age represent a problem with the thinning and downturning of tissues. Treatments that reverse these problems must, therefore, be about thickening and uplifting these tissues. Direct surgical approaches include thickening with injectable fillers and uplifting through lip lifts and advancements.
The combination of injectable fillers for the nasolabial folds and a direct corner of the mouth lift is an excellent approach to certain aspects of the aging mouth. This combination is particularly beneficial because both procedures affect the same vertical line of tissue aging. Both can be performed as a short office procedure under local anesthesia with no significant downtime.
The use of injectable fillers is a common and very effective method for most deepening nasolabial fold areas. They are not effective when the folds are so deep that they are inverted however. But for shallow and moderate depths folds, injectable fillers will provide a nice softening with an instantaneous result. There are numerous filler options and all will work. I prefer those that last the longest such as Juvaderm, Perlane, Evolence, Radiesse, or Sculptra. Injection under an infraorbital local anesthetic nerve block makes the injection painless.
The corner of the mouth lift is done to turn up the corners of the mouth. This small procedure is quite powerful as it alters the sad mouth appearance. By removing a small triangle of overhanging or downturned skin above each mouth corner, the mouth line becomes level. This does result in a fine line white scar that lies along the upper lip border and extends slightly beyond the mouth corner. This does result in a scar but it is only visible on very close inspection. The little scar is red for a while but will fade to a white color over time. Tiny little dissolveable sutures are used and make-up can be applied immediately.
The combination of nasolabial fold augmentation with injectable fillers and a corner of the mouth lift helps address collateral areas of the aging mouth. In my Indianapolis plastic surgery practice, I perform both under local anesthesia in the office which takes about an hour to complete. These changes are effective and easy to go through with no recovery. Some corner of mouth lifts may require a touch-up but they are very long-lasting. Injectable fillers are temporary and they will need to be repeated every year for their benefits to be maintained.
Rejuvenation of the Aging Mouth - Corner of Mouth Lift and Nasolabial Fold Augmentation
Dr Barry Eppley is a board-certified premiere plastic surgeon in Indianapolis, Indiana where he practices at his Ology Spa locations at Clarian North Medical Center in Carmel Indiana and at Clarian West Medical Center in Avon Indiana.(http://www.eppleyplasticsurgery.com) He writes a daily blog on plastic surgery, spa therapies, and medical skin care at http://www.exploreplasticsurgery.com. Dr. Eppley can be heard weekly on his radio show, Doc Chat, on WXNT 1430 AM every Saturday afternoon.
INDIANAPOLIS
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