21 Sep 2023 | by Leonard Miller, MD, FACS, FRCS

Fine lines and wrinkles are usually the first sign of aging that most people notice. Crow’s feet around the eyes and vertical “smoker’s” lines above the mouth are two of the most common problem spots for our Boston area patients. The skin around your eyes is thinner and more delicate than the skin around your lips, but what these two share is that they are the motor for all of your facial expressions. Some people have a more expressive face than others which can contribute to the formation of lines earlier rather than later, but we all convey emotion through our eyes and mouth. At Boston Center for Plastic Surgery, we are proud to offer a full array of non-surgical treatments to address aging skin. Here are some of the best procedures to improve lines around the eyes and mouth.

The skin around your eyes is thinner and more delicate than the skin around your lips

What Causes Aging Skin?

It’s important when discussing treatment options for improving fine lines and wrinkles that you have some understanding of what causes skin aging. Despite what the internet may have you believe, aging is never due to just one thing. Instead, there is a multitude of factors that contribute to how quickly and intensely your skin shows its age. These include:

  • Genetics
  • Sun exposure
  • Diet & exercise routine
  • Hydration levels
  • Skincare
  • Living in or near a big city
  • Hormones

Since aging in the skin is multifactorial and different for everyone, any effective treatment plan must be tailored to your individual needs. Furthermore, most plans are going to entail a combination of procedures.

Botox® & Fillers Around the Eyes

Botox® and fillers are probably the most popular non-surgical combination for addressing fine lines and wrinkles, including those around the eyes. As discussed, one of the underlying reasons why some develop crow’s feet earlier and more intensely than others is due to how often you use the dynamic muscles around your eyes when you laugh, smile or cry. The sole job of a neurotoxin like Botox® or Dysport® is to temporarily inhibit the full range of this type of “active” muscle. With less movement pulling on the skin, the surface of the treatment area relaxes, smoothing out fine lines and wrinkles. This is why Botox® is so effective for reducing the appearance of crow’s feet. It is also one of those procedures that delivers a huge payoff as reducing crow’s feet will make you look and feel more awake, vital, and energetic.

Filler is better for addressing deeper lines around the eyes and can even induce a slight “lift” to the upper lid. It is also the procedure of choice for improving the appearance of under-eye hollows and dark shadows. The key, as always, is choosing the right filler for the job.

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See a Skilled Injector

It is imperative that you see a highly skilled injector. The area around the eyes is extremely delicate.

  • Improper placement of a neurotoxin
  • Choosing the wrong filler
  • Placing too much of either Botox® or fillers

These can all have serious ramifications not just in terms of your aesthetic result, but also in terms of your health. One of the many reasons why patients love Boston Center for Plastic Surgery is that all of our doctors are Board-Certified. This means that we have the education, expertise, and artistic eye to deliver consistently safe, exemplary results. Dr. Doherty and myself all have a deep understanding of facial anatomy, and because we offer both surgical and non-surgical procedures, we are never going to recommend something that won’t actually deliver on your goals. This is not the case when you visit a MedSpa, for example, that only offers injectables. It is our philosophy to always be honest with our patients about what a procedure can and can not achieve as we want you to be happy with your results.

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Best Treatments for Lines Around the Mouth

Upper lip lines are often referred to as “smoker’s lines”, but you don’t need to have been a smoker to develop them. They result, in part, from the movement of the muscles around your mouth. So, again, if you have a very expressive face or have spent a lot of time outdoors without sunscreen, you may be bothered by these fines lines and wrinkles earlier rather than later. Treating upper lip lines is something that definitely requires a multi-prong approach. If the lines are fairly new and shallow, a combination of a neurotoxin and light-weight filler is often the first line of defense. But as the lines deepen, we take a unique approach here at Boston Center for Plastic Surgery, and address them with a combination of microneedling procedures that may include:

  • Derma roller
  • Wide gauge needle
  • Skin pen

The differing needle lengths of 1 to 3 mm from these three modalities can deliver a truly marked improvement without any of the downsides associated with a chemical peel. Depending on the severity of your lines, we may also add volume with filler or micro-fat injections. The right choice for you is always going to depend on your anatomy, desired outcome, and tolerance for downtime.

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To find out more about Botox®, fillers, microneedling, fat grafting, or any surgical or non-surgical procedure with Dr. Leonard Miller at Boston Center for Plastic Surgery, check out our website or call (617) 735- 8735 to schedule a consultation.


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