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Background:  The facelift procedure makes for major anti-aging changes but is not all encompassing rejuvenation procedure. Its effects are limited to the neck and jowl areas and in some types even the cheeks. But the one area that a facelift can never affect is the mouth or central facial region. It does not matter how aggressive  a facelift is done, no amount of tissue repositioning at the sides of the face will improve downturning mouth corners or lip wrinkles/lines.

The most common adjunctive technique done at the same time as a facelift is laser resurfacing around the mouth. One of the sure signs of aging for women are vertical lip lines, always a pesky issue that can be temporarily improved but never permanently eliminated. (due to the constant movement of the mouth)

Laser resurfacing around the mouth, is always completed as the last procedure in a facelift. It is a perfectly safe procedure to do concurrently as the treated skin lies beyond the undermining (and partial devascularization) of the facelift skin flaps. Other perioral rejuvenation precedes such as lip lifts, lip advancements, corner of mouth lifts and injectable fillers/implants/fat injections for lip augmentation can also be done.

Case Study:  This 62 year-old thin female had all the signs of facial aging that present in Caucasian females who have thin skin. She ha moderate neck sagging and jowling but lots of fine lines around the lips and thin creapy type skin changes.

Under general anesthesia she has a full lower facelift with moderate depth laser resurfacing around the lips and chin.

Her early facial rejuvenation result showed a smoother jawline and improved neck with far less wrinkles around the mouth. Ultimately she will need further laser  resurfacing efforts done at the office under topical anesthesia to maintain her perioral improvements.

Case Highlights:

1) Facial aging affects numerous areas of the face in which a facelift can not improve particularly the mouth area.

2) Almost all facelifts incorporate adjunctive soft tissue procedures of which perioral rejuvenation techniques are common.

3) Laser resurfacing of the mouth is a safe adjunctive procedure as it is done beyond the elevation of the face and neck skin flaps.

Dr. Barry Eppley

Indianapolis, Indiana

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