The vertical lines of the upper lip are a common and frustrating sign of aging.  For some women, it is the feathering of their lipstick that draws their attention to it first, where once it stayed in place it now travels up these channeled groves giving an unfortunate aged appearance to the area. Reds become impossible, pinks are soon dropped, and once you are limited to clear gloss, you know you have an issue. 

Fortunately, there are multiple options available to improve and eliminate these “smoker’s lines” or “bar code lines” as they are commonly referred to.  Depending upon the extent of their involvement, number present, and involvement of the underlying hyperdynamic musculature; your aesthetic provider can tailor a treatment to address the appearance as well as the cause, so you can eliminate them for good and bring that bold red back into your lipstick repertoire.


Neuromodulators, such as Botox, Dysport, Jeaveau, and Xeomin can be used in very low unit dosing to be placed along the muscle fiber that is creating the hyperdynamic pull.  These have to be placed with an extremely judicious aliquot or it can create motor dysfunction and drooping in the localized area. Meaning, it can negatively impact the pursing motion to drink and so forth.


Hyaluronic Acid fillers are the type that are appropriate in the oral and perioral region to restore the vermillion border of the lip and the upper lip lines. For the intradermal filling of the fine lines I like to utilize an extremely small needle such as a 32G ½” needle for precise placement and to avoid a worm of product appearance post treatment. I also typically thin the filler and utilize a cannulua in the upper lip, (we call this area the ergatroid), in which I go underneath the skin to break up the adhesions and then place a small amount of the thinned product just to create a bit of a buffered layer so they do not reform.

After treating with the above two, again with extreme restraint of overutilization, I have my patients return in 2 weeks at which that time I inject some PRP and perform a Clear and Brilliant laser on them. This provides resurfacing of the topical layer and the PRP enhances all the prior treatments boosting the body’s own regenerative process of collagen and elastin formation.

Results typically last 12-16 months and some patients like to keep up with the neuromodulator component as they prefer the subduing aspect of the hyperdynamic prone area.

As with every treatment, it is imperative to use sunscreen every day, avoid known contributing factors; in this case, smoking, drinking through a straw, pursing the lips when concentrating, and so forth; as well as using a nightly retinol assist in supporting and prolonging your positive results.

This week’s giveaway is your choice of ONE of the components to treat the upper lip lines: Neuromodular, Filler, PRP, or Clear and Briliant. To enter: Must be following  @J_Derme  and  @SoCalMoments, like the Instagram post, and comment “LIP FIX”. The winner will be announced in next week’s social IG post.

Author Bio: Heidi Lindner has been an aesthetics expert for over 17 years specializing in all aspects of non-surgical aesthetics and plastic surgery. She is sought out for her techniques that focus on a natural-looking approach to facial balancing, restoration, and beauty optimization. Follow her on Instagram @j_derme