The perioral area is a troublesome area for most women and men as age-related changes produce sagging, deflation and fine lines to deep wrinkles, especially in the upper lip. 

Decreased soft tissue thickness, lengthening and volume loss contribute to signs of aging in this area, especially at the alar nasolabial fold coming from the base of the nose to the corners of the lip. The loss of soft tissue allows fine lines and deep wrinkles to form around the mouth as the muscles work closer to the skin. 

Lengthening of tissues between the base of the nose to the vermillion border of the lip or philtrum leads the upper lip to roll inward and appear thinner. 

The best approach to rejuvenating the perioral area focuses on non-surgical interventions to treat fine lines and wrinkles and restore volume and considering surgical intervention to reduce lengthening.

Optimizing your skin health with medical grade skin care can improve skin texture, treat lines, and help prevent aging in the perioral area. 

Medical grade skin peels and laser skin resurfacing treatments in a series stimulate peeling and ablate damaged and dead skin in the epidermal and dermal layer of skin and may be adjusted according to the desired result from light to aggressive treatment. 

Removing these outer layers reveals fresh skin with decreased lines and improved texture. Laser skin resurfacing goes further to stimulate the production of collagen and elastin for more long-term effects. 

Injectables such as neuromodulators and dermal fillers can help prevent aging and soften lines in the perioral area.

Neuromodulators by an expert injector can reduce muscle movement and the subsequent formation of lines and wrinkles. Dermal fillers soften fine lines around the mouth and when injected into the lips restore the vermillion border and add volume to the upper and lower lip for a youthful appearance. 

Treatment with neuromodulators and dermal fillers requires ongoing treatment to maintain results. 

Finally, to address the elongation of the philtrum greater than 15-18mm, the lip lift is an excellent minor outpatient procedure. Lip lift surgery reduces the length of the area from the base of the nose to the vermillion border of the upper lip. 

Lip lift surgery brings a youthful, rejuvenated look to the perioral area that has long-term results. Even for younger patients, this surgery is highly sought after to change the shape of naturally thin lips and as an alternative to repetitive lip injections. By reducing the space in this area, the pink hue of the lip rolls outward, creating a fuller shape the upper lip. 

This surgery may be tailored to the patient who may have to folding over of the corners of the lip or to accentuate the Cupid’s bow in the inner lip. Lip lift surgery is often part of a facelift and brow lift surgery, setting the clock back about 10-plus years for ideal candidates with excellent longevity. 

Mathew T. Epps, MD, MS, DABS is a plastic surgeon, triple- fellowship trained in facial, eyelid, and breast surgery. or