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I read a recent article that reports that drinking directly from water bottles can cause just as many upper lip wrinkles as smoking. I wouldn’t doubt it as any activity that makes your lips pucker, which activates the orbicularis oris muscle which encircles the mouth, can cause wrinkles to appear on the upper lip. The development of such wrinkles is a function of both the activity and how often it is done. Drinking water these days for some people is about as frequent as a regular smoker who does one or two packs per day.
As a general principle, wrinkles form on the face perpendicular to the direction of action of the underlying muscle movement. For example, horizontal forehead wrinkles are the result of ther vertically-oriented and moving frontalis muscle which extends from the brows upward into the scalp. Since the mouth’s main muscle (like the eyes) is a sphincter or encircling muscle which lies parallel (horizontal) to the upper and lower lip (except at the corners), it is no surprise that the lips (particularly the upper) develops vertical wrinkles in some people. The other factor that highly contributes to lip wrinkles is the thickness of your skin and the size of your lips. (which is interrelated) The thicker your skin, the less likely you will ever develop them. Take a look at African-Americans and people of Middle Eastern Descent, you rarely ever see them develop wrinkling of the lips. (and they have larger lips to begin with….as their skin is thicker)
Treatment of lip wrinkles is a challenging problem. I tell patients to think of it as improvement as there is no complete cure in most cases. For small and fine lines that are mainly located at the junction of the skin and the lip, an injectable filler can make a nice improvement…if you can accept having slightly to substantially larger lips. (whichever you desire) When the lip wrinkles are deeper and run higher into the upper lip, the concept of skin resurfacing comes into play. Usually this means laser resurfacing and it is just a question of how deep to go and how much recovery does the patient want. Laser resurfacing with lip augmentation with an injectable filler is the most common method by which I treat more significant lip wrinkling issues. This is done in the office under local anesthesia unless the patient is having other facial procedures which requires a trip to the operating room with the use of deeper anesthesia. There is some current debate between the laser techniques of resurfacing or peeling and the use of fractional (fraxel) laser treatments, but there is no hard clinical evidence at this point to say conclusively that fractional laser treatments are better. In the more severe cases, a small amount of Botox to help reduce the amount of muscle movement can also be helpful when done with fillers or laser resurfacing but you must be careful to not use to much lest you make your smile have an unnatural appearance.
Other methods of upper lip resurfacing for lip wrinkles is currently being evaluated. One method is to combine laser resurfacing with the use of sandpaper (yes I said sandpaper), known as laserbrasion. With this technique, the laser is only used for the first pass (to remove the very top layer of skin) and the deeper layers are then taken done by fine sandpaper. The concept here is that the use of sandpaper causes less trauma (no heat) and will heal faster without the prolonged redness. And it is just as effective as the laser but safer and with less complications than if one used traditional dermabrasion. The other method is known as percutaneous collagen induction therapy. (PCIT) Known aerating your lawn, a small wheel with fine needles is run over the upper lip, cutting many fine holes into the deeper portions of the skin. As this heals it causes the skin to thicken which helps reduce the amount of visible wrinkling.
Upper lip wrinkles in some women are unavoidable and can be very troubling. Injectable lip fillers, laser resurfacing, abd Botox can help but there is no permanent cure. The alternative treatments of fractional laser treatments, laserbrasion, and collagen induction therapy are interesting but it is too early to know if they will offer better results.
Dr. Barry Eppley
http://www.eppleyplasticsurgery.com/
http://www.ologyspa.com/
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

One of the features of facial aging that bothers women the most is the development of upper lip lines. Whether they be small fine lines that are at the junction of the skin and upper lip or much deeper lines that extend vertically way up into the skin…women hate them…as they indicate a more aged mouth look and in more severe cases allows lipstick to bleed up into the lines. Many patients think it is due to smoking and chronic sun exposure (and clearly these can make a big contribution) but the reality is…it is a function of full your lips are and how thick your skin is. This is why this is much more of a problem in Caucasians of northern European and English descent than it ever is in African-Americans, southern Europeans, or those of Mediterranean origins. As all natural wrinkles form perpendicular to the direction and action of the underlying muscles, vertical lip lines develop from the action of the circumferential orbicularis muscle that purses your mouth around a straw, cigarette, or puckers ofr that kiss.
While the diagnosis of this problem is easy, it’s treatment is not. Since you can’t cure the cuse of the lines (thicken your skin or stop moving your mouth), I tell patients to think about improvement (but not elimination of the upper lip lines) and the need for maintenance treatments as we are not curing the root of the problem. Treatment choices are based on three achievable objectives; diminish the muscle movement (Botox), plump up the lips ir fill the lip lines (injectable fillers), or ’sand’ down the wrinkles. (dermabrasion or laser resurfacing). Any combination of two or more of these will produce a better result in most patients. While Botox can certainly weaken the muscle movement and cause less puckering, it must be done carefully so as not to create an unnatural lip movement with smiling. For this reason, this is usually the last procedure I will do or will do it only in combination with everything else in the most severe cases. Injectable fillers are a good option if the patient can accept or wants a larger lip. If not, then dermabrasion or medium-depth laser resurfacing is the only other option. The best results that I usually see is when the upper lip is slightly enhanced with a filler and the upper lip is then laser resurfaced at a depth of 50 - 100 microns. This is probably the best combination if, again, the patient can accept a larger upper lip. It heals within a week and can be done in the office under local anesthesia. Patients will usually have to repeat the procedure once a year for maintenance of good results. However, it is fair to say that upper lip lines defy one single permanent solution.
Dr Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis