All you need to know about vertical lip line treatment in NYC

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lip lines treatment

All you need to know about Perioral lines

Our skin is a vital organ that needs to be treated with care as it is exposed to various outside components that could cause tremendous damage to it. As we become older common signs of aging become increasingly apparent in the form of fine lines and wrinkles alongside lax skin and droopiness. Our skin loses its elasticity and produces less collagen and hyaluronic acid, resulting in lines, wrinkles, and folds. If this sounds familiar to you, you may have noticed some fine vertical lines forming on and around your lips, also known as “smoker’s lines”. These lines are extremely common and unfortunately inevitable even for those who don’t actually smoke. Consistent facial expressions, pouting, and puckering the lips are all common muscle contractions that contribute to the formation of these lipstick lines. While these pesky lines can be frustrating, medical technology has given us a variety of options to eliminate and prevent the formation of vertical lip lines and rejuvenate the lips and the area surrounding the mouth. Minimally invasive cosmetic procedures have grown in popularity over the past two decades and allow cosmetic physicians like Dr. Schwarzburg to reach their patient’s aesthetic goals without the risks and downtime associated with plastic surgery. 

When it comes to vertical lip lines, there are various treatments that can diminish or reduce their appearance. 

Neurotoxins like Botox and Dysport can be injected into the muscles surrounding the lips to prevent puckering and thus, preventing the lines that form as a result.

Dermal fillers such as RHA, Juvederm and Restylane are commonly injected into and around the lips to eliminate deep lines and add volume and hydration to the lips. This can be done in such a way that allows you to look natural, without any signs of having had work done. Aside from injectables, laser treatments such as Fraxel and various forms of microneedling including Secret RF and Mesotherapy are also suitable to treat vertical lip lines if deemed appropriate by your provider. In addition, Dr. Schwarzburg offers PDO (Polydioxanone) thread lifts, which can be used not only for a non-surgical face lift, but also to boost collagen and smooth fine lines that form around the mouth.

What are perioral lines and why do I have them?

Perioral lines, also known as vertical lip lines, lipstick lines, or smoker’s lines are the fine lines that form on and around the mouth and lips beyond the vermillion border making your lips appear dry and old. Naturally, the skin produces less collagen and elastin as it ages. At younger ages, the skin is smooth, firm, and elastic due to sufficient collagen and elastin production; however, as your skin ages, both of these proteins gradually decline, causing the skin to become loose and crepey, accompanied by thinning of the lips. A decrease in collagen and elastin production results in more visible fine lines and wrinkles, especially around the lips, hence, the formation of vertical lip lines.

Vertical lip lines are common and are caused by a number of factors that are typically accompanied by the natural aging process. As we become older our skin begins to produce less collagen and elastin, two proteins that are the building blocks of the skin, keeping it firm and supple. As these proteins and hyaluronic acid production decrease, the body and the delicate skin around the lips begin to lose their structure and stability, resulting in fine lines, wrinkles, creases, and dryness.

Alongside properly moisturized and hydrated skin, at younger ages your body efficiently produces sebum, the natural oil that prevents your skin from becoming dry. At a certain age, the skin is more prone to dryness due to a decrease in hyaluronic acid production, which causes rhytids, particularly in more delicate areas such as the lips, to become more pronounced. As such, it is important to keep yourself hydrated by drinking water, moisturizing your skin, applying lip balm, and if necessary getting a hyaluronic acid based dermal filler to restore lost volume and moisture. Another factor contributing to dryness and the formation of vertical lip lines is overexposure to the sun. UV rays cause tremendous damage to the skin if you don’t protect yourself from it by wearing sunscreen high in SPF. Sun exposure causes dryness, accentuating wrinkles and various forms of damage to your delicate skin. 

Ultimately, aside from aging, the primary cause for perioral lines around the mouth are constant facial expressions and the formation of static wrinkles from dynamic wrinkles. Dynamic wrinkles are the wrinkles and folds that are only visible when you make certain facial expressions, such as raising your eyebrows, frowning, and smiling. Static wrinkles form over a long period of time as the dynamic wrinkles slowly but surely create permanent “indents” known as wrinkles. Wrinkles around the mouth are essentially like scars that form from constant facial expressions, like puckering your lips, sucking on straws, smoking cigarettes (hence, their nickname “smoker’s lines”). To remedy this, Dr. Schwarzburg often injects Botox around the lips, restricting the muscle contractions that allow us to pucker your lips, and in turn, preventing the formation of perioral lines.

Which treatment should I get for my perioral lines?

Deciding which treatment to get can be challenging, which is why the best approach to eliminating vertical lip lines is to schedule an appointment with Dr. Schwarzburg, a board-certified cosmetic physician who has the expertise to configure a treatment plan that will meet your individual needs based on your anatomy and aesthetic goals. After your consultation Dr. Schwarzburg will move forward, using neurotoxins, dermal fillers, microneedling, laser resurfacing, PDO threads, or a combination treatment plan to safely and effectively eliminate your vertical lip lines. The most common procedures used for this area are the following:


Neurotoxins (Botox, Dysport, Xeomin, and Jeuveau) are an injectable medication that work by paralyzing or relaxing the orbicularis oris muscle located around the mouth. By blocking the neurotransmitters in the injected muscle, Botox essentially paralyzes or “freezes” your muscles, preventing and eliminating the formation and appearance of perioral lines. Botox is ideal for patients who have the tendency to be very expressive with their faces and can be used preventatively on younger patients who haven’t yet formed vertical lip lines.

Dr. Schwarzburg will inject just enough Botox to relax the necessary muscles and ease wrinkles without limiting your ability to express yourself.

If you want to remove wrinkles without any downtime, Botox is the right choice. Botox does not affect your skin negatively and comes with limited to no downtime. You can expect to see your Botox results within 5 – 7 days post injection, lasting for up to 4 months.

Hyaluronic acid dermal fillers

Dermal fillers can be used on various regions of the face, and can be used to add volume or contour certain areas of the face such as jawline contouring. When it comes to treating vertical lip lines, hyaluronic acid fillers work best as they provide volume and hydration upon injection, which non-HA based fillers will not.

Lip filler is often associated with its primary purpose, which is to add volume to the lips. However, small amounts of carefully placed filler can also be used to treat vertical lip lines that extend beyond the vermilion border, reducing or fully eliminating their appearance. Lip filler for perioral lines is usually paired with Botox or a “lip flip” as filler will only fill in the lines, while the Botox will prevent them from forming any further. Filler touch ups are typically performed within 6 – 9 months post injection as this is when your lip filler will begin to fade.

Different forms of microneedling

Microneedling is performed using a handheld mechanical tool equipped with several fine needles that puncture the skin at a rapid rate. This causes controlled damage to the skin, leading to an increase in collagen production as the skin repairs itself. The increase in collagen improves the texture of the skin, reduces fine lines and wrinkles, and gives you an overall smoother look. In many cases, microneedling is integrated with radiofrequency (Secret RF microneedling) for a more advanced approach to enhance the rejuvenation process. Other forms of microneedling include Mesotherapy and AquaGold, which serve the added benefit of additional hydration and nourishment to the skin. Depending on the type of microneedling treatment you are getting, you can get 1 – 2 treatments monthly, or, with Secret RF, 1 – 3 treatments yearly. 

Fraxel and other laser resurfacing treatments

Fraxel causes controlled damage to superficial layers of the skin, boosting collagen and elastin production, and tightening the skin for a more youthful appearance. It eliminates fine lines and wrinkles around the mouth and is also used to smooth the skin and reduce sun spots and other signs of sun damage. Because the delicate skin around the mouth is so susceptible to sun damage, using laser resurfacing can make a significant difference in the appearance of the area around your mouth. Fraxel is typically performed 2 – 3 times yearly depending on the severity of the wrinkles and level of maintenance needed.

PDO threads for vertical lip lines

PDO threads are commonly used for non-surgical facelifts. However, with a variety of threads to choose from, the ones used to treat lip lines are smooth threads. Smooth threads are inserted into the dermis and stimulate collagen production in the areas in which they are placed. Over time they dissolve, leaving traces of collagen behind, giving your skin more durability and eliminating the fine lines surrounding your mouth. According to MiracleFace medspa located in NYC results can last up to 2 years, making PDO threads a go-to for patients eager to lose their vertical lip lines once and for all.

Non-medical remedies for vertical lip lines

If you would like to completely eliminate the appearance of vertical lip lines, a cosmetic procedure such as those listed above is your best bet. As much as we want a miracle topical solution to eliminate wrinkles and lines, existing rhytids can not be remedied with any cream or serum. However, if you are looking to prevent vertical lip lines from forming, there are a few things you can do. 

Staying hydrated by drinking plenty of water and moisturizing your skin on a daily basis is key to maintaining smooth skin and may help conceal vertical lip lines as dry skin can make them appear more prominent. Protecting yourself from the sun and using a quality sunscreen and lip balm containing SPF will also help prevent the formation of these pesky lines.

Are there any particular products that can be used to prevent or disguise  perioral lines?

  • Vitamin C Serum has the potential to stimulate collagen production to maintain smooth, firm, elastic skin. 
  • Antioxidant and Vitamin Infusions help hydrate the skin and nourish the body.
  • Vitamins A, C, and E supplements and creams are all great to help nourish your skin.
  • A powerful sunscreen high in SPF should be applied anytime before going outside. The sensitive skin around the mouth is susceptible to photoaging, which can cause premature aging. 

What can I do to get rid of vertical lines above my upper lip?

In response to the question of how to get rid of vertical lines above the lips, there are many methods available to eliminate fine lines and wrinkles around your mouth and lip area. The best way to avoid the formation of wrinkles and to relax already existing ones is to use Botox, Dysport, or other neurotoxins. Dermal fillers are a great option for those looking to replace lost volume and fill in deeper lines and wrinkles that cannot be addressed with Botox alone. Various forms of microneedling and laser resurfacing may be recommended by Dr. Schwarzburg as a way to boost the natural production of collagen for smoother, more supple skin. During your consultation with Dr. Schwarzburg, he will compose the ideal treatment plan for your unique anatomy and aesthetic goals. 

Vertical lip line treatment: how to get started

Signs of aging around the lips by the appearance of vertical lip lines. Whether it be on or around the lips, vertical creases are unwanted reminders of the aging process. If you’d like to remove fine lines and wrinkles around your lips, there are many options available. Dr. Schwarzburg’s clinic, Skinly Aesthetics, is located on the Upper East Side of Manhattan, NYC and offers a wide range of non-surgical, minimally invasive, and non-invasive cosmetic treatments to help you reach your aesthetic goals. Using a conservative approach, Dr. Schwarzburg will start you off with a one on one consultation in which he can establish a treatment plan that will meet your aesthetic goals and needs.

You can schedule your one on one consultation with Dr. Schwarzburg by calling or texting (212) 774-4264, emailing us at, or visiting our website.