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

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You may have heard the term “microneedling” in the context of aesthetic procedures, but did you know of its power to transform lines and wrinkles? I had the privilege of introducing the procedure to this country over 30 years ago, and it has become a crucial component of my facial rejuvenation toolbox. As an early adopter and someone who has worked with manufacturers to help develop a number of cutting-edge non-surgical devices to improve skin tone and texture, I enjoy pushing the boundaries to discover new ways to safely use a technique to address issues that have historically been hard to treat such as the upper lip lines.

Sometimes referred to as smoker’s lines, these are vertical lines that extend from the upper lip up toward the nose. This is why I have developed a completely unique microneedling treatment that can safely improve the appearance of vertical lip lines without any adverse side effects. And there is no better time to address this issue than now when you can quietly heal beneath the privacy of a mask.

How are lips different?

Microneedling for the lips requires special consideration due to the unique properties of the skin on the lips. Like all skin, the lips have three layers – the epidermis, the dermis, and the subcutaneous fat beneath it. However, the top layer, or stratum corneum, is much thinner on the lips than on other parts of the face.

The lips have fewer skin cells than other parts of the body, as well as no sebaceous glands that produce oil for moisture. This is why saliva from the mouth provides vital hydration for the lips, especially during colder months. Instead, the lips rely on saliva from the mouth for moisture, which is why they can become dry in the winter. Additionally, the lips lack the pigment melanin, which acts as a defense for skin against sunshine.

Despite the absence of melanin, the lips still have color. The lips are naturally pink due to the visible circulatory system beneath their thin skin. Human lips are the only lips of any animal that are distinctly colored in this way. The border where the lips transition to the rest of the skin is known as the vermillion border.

What Causes Upper Lip Lines?

There are many factors that can make a person develop smoker’s lines – many of these don’t even have to be related to smoking at all, these may include:

  • Sun damage
  • Lifestyle choices like diet & exercise
  • Genetics
  • Exposure to pollution
  • Dehydration

Starting around age 25, the body produces less collagen and elastin, proteins that are critical for making your skin look more lifted, plump, and youthful. The good news is that procedures such as microneedling actually promote your body’s collagen production as well as elastin production. During your microneedling procedure, a series of tiny needles will be rolled or passed over the treatment area. Your body’s healing response to these “micro-injuries” is to generate collagen and elastin. This is what makes microneedling so effective for turning back the clock.

Not All Microneedling Is Created Equal

Not all microneedling, however, is created equal as there are many different techniques. Cosmetic microneedling can be administered by an aesthetician, but a medical microneedling procedure can only be performed by a physician such as myself. It allows me to use much longer needles in order to deliver a more dramatic result. The trade-off, of course, is that it requires a bit more downtime for recovery. For my unique microneedling for upper lip lines procedure, I actually use a combination of 3 different devices:

  • Derma roller
  • Skin pen
  • Wide gauge needle

This is one of the things that makes my cosmetic procedure so effective. Cosmetic microneedling alone in this area will not, in my experience, accomplish significant improvement in vertical lip lines even after multiple sessions. By combining different techniques with varying needle lengths of 1 to 3 mm, I am able to significantly soften and sometimes even remove upper lip lines without any of the adverse side effects associated with a chemical peel or laser.

Microneedling vs. Chemical Peel and Laser

As a Board-Certified Plastic Surgeon who specializes in facial rejuvenation, I want to be able to help my patients look and feel their best. Upper lip lines eventually become an issue for almost everyone, even if you never picked up a cigarette. If you have an expressive face or drink your beverages through a straw or sports bottle then chances are this will show up as lines above your lip. Unfortunately, even though the issue is so pervasive, there are a few great options for addressing upper lip lines either surgically or non-surgically.

A facelift will not erase upper lip lines. Many doctors will use lip fillers such as hyaluronic acid to address the issue, but it does not take much to become “too much” in this delicate area, leading to a puffy and unnatural look that Dermal Fillers may achieve. Other non-surgical modalities for erasing upper lip lines are a chemical peel or a Fraxel laser treatment. Both have risks, however, such as hypopigmentation and/or scarring. This is why I am so happy that my years of experience have enabled me to develop a truly safe, effective, non-surgical treatment for upper lip lines with no adverse side effects.

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So, is Microneedling Better for Lip Lines?

Microneedling has a deeper effect than lasers or chemical peels, which only target the outer layer of the skin. The depth of Dermapen treatments can be customized to meet the needs of each patient, taking into consideration the severity of lip wrinkles and the thickness of the skin. There’s also a case for it being better than Dermal Fillers.

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