Micro-needling can treat some lines around the mouth

Periodically, this column will focus on questions from our readers.

While we cannot publish answers to all of your questions, we will try to pick those that seem to resonate through our readership.

Whenever possible, we will respond to your email directly, but please understand we cannot give medical advice or instructions in this manner.

General interest in our topics has been high, and we are happy to receive your comments. For answers to personal and specific questions, you should always consult with your personal physician.

J.L., in Vancouver, inquired about micro-needling for lines in the mouth area.

If the lines in question are the vertical lines on the lips, the ones we used to call smoker’s lines, micro-needling is an excellent modality for treatment.

The micro wounds and the introduction of PRP (Platelet-Rich Plasma) growth factors helps fill out and replace the broken-down collagen, which causes the lines. In my experience, three sessions are necessary. These are spaced several weeks apart to allow healing and collagen growth. Most patients report seeing an improvement after the first treatment. However, professional micro-needling with PRP is expensive. The cost of treatments varies greatly across both Canada and the U.S., averaging more than $750 per session.

The important thing is to choose a qualified practitioner who is experienced in the technique.

Under properly controlled circumstances, the procedure is easily tolerated, with 24 to 48 hours of down time, and very few complications.

S.D., from Ottawa, asked whether micro-needling with PRP is more cost-effective than fillers like Juvederm or Restylane for treating laugh lines around the mouth.

These are the deep folds that develop between the outside of the nose and the corners of the mouth. They are referred to as Nasolabial lines, or folds, describing their anatomical position. There are related lines that look like parentheses marks outside the corners of the mouth, as well as marionette lines from the corners of the mouth to the jaw.

Although we have not covered the topic yet, these lines represent both the folding action of facial expression and a loss of elasticity of the skin. The latter is responsible for the heaviness of the folds.

These areas cannot be corrected by micro-needling and PRP. Although the procedure encourages collagen regrowth, it will not fill in these folds. Obviously, the best solution is to reverse the losing battle with gravity by repositioning, or lifting the skin. Short of that, and surely in early stages, the use of fillers reduces the depth of the folds and makes them less obvious.

Various fillers are available for the task.

These include hyaluronic acid fillers such as Juvederm, cosmoplast, and others, as well as fat transfer, using one’s own fat.

These procedures have found wide acceptance because they work, and will be the subject of future columns.