Background: Aging affects all areas of the face and is always most observed in the sphinteric areas of the eyes and mouth. The mouth develops very consistent age-related changes including thinning of lip vermilion show, lengthening of the upper lip and a downward slant to the corners of the mouth. It is all part of the overall tissue shrinkage and southern drift that occurs in overall facial aging.
One of the main differences in male vs. female perioral aging is that men develop far less vertical lip wrinkles. The thicker skin of men due to containing hair follicles and the lifelong use of microdermabrasion (shaving) accounts for the far less number and depth of perioral wrinkles.
The other difference between men and women in age-related mouth changes is that men generally tend to care less about them. This, however, does not mean all men do and there is one mouth change that even most men will eventually dislike…the downturning of the mouth corners.
Case Study: This 68 year-old male was bothered by his mouth appearance. He felt his upper lip was too long and he particularly disliked his mouth frowns. He felt that people viewed him as being angry and unpleasant…when he was not really that way. He felt that people saw him as unapproachable and unfriendly because is mouth at rest had a frown.
Under local anesthesia, a subnasal lip lift was initially performed. His upper lip length along the philtral columns was 20mms. This was reduced by 6mms to 14mmw, a more normal upper lip length. Corner of the mouth lifts were performed using the pennant technique. An 8mm lift was done with skin excision and orbicularis muscle plication. This also had about 2 to 3mms of a mouth widening effect at each corner.
The thicker beard skin of men makes lip lifts and corner of mouth lifts more favorable in their scar formation than women. Such perioral rejuvenation procedures can work well for men as long as they are not overdone. (over lifted) The other potential adverse scar formation is that with corner of the mouth lifts…but this potential revisional issue is the same for both men and women.
Highlights:
1) Aging of the male mouth consists of upper lip lengthening, thinning of the upper lip vermilion and downturning of the mouth corners.
2) A subnasal lip lift in a male rejuvenates the lip-nose relationship and is an important part of many male mouth rejuvenation efforts.
3) A corner of the mouth lift in a males strives to achieve a neutral or unfrowning mouth appearance.
Dr. Barry Eppley
Indianapolis, Indiana