How to improve chin wrinkles, wrinkles around the mouth, and marionette lines? How to choose lifting, Botox, or fillers for aging changes around the mouth.

 

Hello! This is Dr. Han Kyu-nam, Director of Samsao Plastic Surgery. 😊

 

We are continuing the 'Creating a Proper Plastic Surgery Culture' series, which provides helpful information from the perspective of consumers and customers to ensure safe cosmetic procedures and surgeries. This is a time to examine plastic surgery in detail, divided by category; following the previous 'Eyes' episode, today we will look at facial changes caused by aging, and among them... 'Corner of the Mouth' episode no see.

 

Let’s sort through the confusing details regarding nasolabial folds, marionette lines, chin lines, and lip wrinkles—names you have likely heard often but find confusing—such as why they occur and which areas improve with lifting procedures while which do not.

 

1️⃣ Why does aging show up around the mouth the fastest after the eyes?

A floating part above the oral cavity that moves all day but lacks support

 

The most mobile part of the face is the eyes. This is because they blink approximately 10,000 times or more a day. Next is the mouth. We use our mouths extensively not only when speaking and eating, but also when smiling or making facial expressions.

 

Many facial expression muscles are attached to the corners of the mouth, pulling them upward, outward, and downward, while the muscles around the mouth are used to blow out or suck in air. If the movement is comparable to opening and closing the eyes, the movement of the mouth is quite dynamic.

 

🔸 Characteristics of aging around the mouth
There is not much fat around the corners of the mouth. Furthermore, the corners of the mouth are characterized by three-dimensional empty spaces—that is, they appear to float above the oral cavity. Although they rest on the gums and teeth, they lack sufficient support despite their significant movement. Therefore, aging around the corners of the mouth is characterized more by sagging than... sunken and wrinkled shape It mainly appears as.

 

Due to repetitive movements, nasolabial folds, marionette lines, and lip wrinkles deepen, and the lips curl inward and thin due to bone resorption caused by the aging of the gum bone and dental problems.

 

Deepening wrinkles around the mouth due to repetitive movement and volume loss

 

2️⃣ Why do chin wrinkles and marionette lines worsen?

The habit of tensing the mouth, and inner wrinkles that the lifting effect does not reach

 

Koreans often have protruding mouths and small jaws, so their mouths tend to open naturally when in a relaxed position. Because of this, they unconsciously tense their mouths and clench their lips, which often exacerbates chin wrinkles or marionette lines.

 

When walnut wrinkles form, the flesh of the chin is pulled up toward the lower lip, causing the area below the lip to appear sunken as well.

 

💡 Director Han Kyu-nam's Tip
In such cases, it is very important to practice relaxing your mouth. You should slightly separate your upper and lower lips so they do not stick together, and press your tongue against the roof of your mouth to prevent mouth breathing.

 

🔸 Wrinkles that improve with lifting and those that do not
The skin around the mouth has little subcutaneous fat and adheres tightly to the underlying muscles. Therefore, while marionette lines and nasolabial folds can be improved through lifting, the procedure is less effective for inner lip wrinkles or fine lines on the skin around the mouth.

 

Sometimes, patients say that their wrinkles around the mouth have not improved at all because they reappear after swelling following a lifting surgery. This is precisely why a thorough explanation is necessary before the surgery.

 

🔸 Reasons why the procedure is more considered for Asians
Western Caucasians often improve their skin itself through chemical peels or laser treatments. On the other hand, Asians, who have relatively darker skin and a higher risk of hyperpigmentation, consider procedures such as Botox, fillers, or skin boosters.

 

3️⃣ How are Botox and fillers used for wrinkles around the mouth?

Choices varying depending on the location of the folds, and structural limitations

 

🔸 Chin walnut wrinkles · Vertical wrinkles around the mouth → Botox
Botox can be effective for chin wrinkles or vertical wrinkles around the mouth. However, a precise procedure is required as asymmetry may occur or it may cause discomfort when eating.

 

🔸 Nasolabial folds/Marionette lines → Filler
Filler injections are recommended for nasolabial folds and marionette lines because these areas have a relatively low fat graft survival rate and involve significant movement. However, please keep in mind that there is a possibility the filler may shift depending on the type of filler, injection depth, and injection method.

 

💡 Director Han Kyu-nam's Tip
If the deep cheeks are convex and the lower jawbone is small and recessed, there may be limitations to how much marionette lines can be improved with lifting or fillers. This is due to structural reasons why it is difficult to expect results comparable to what can be achieved by simply pulling the skin with your hands while looking in a mirror.

 

4️⃣ Why are the philtrum, lips, and teeth important to look at along with the corners of the mouth?

Changes such as thinning lips and a longer philtrum, and teeth that determine the mouth shape

 

When discussing the area around the mouth, the philtrum and lips are also important to consider. As you age, your lips become thinner and your mouth recedes, making the philtrum appear longer.

 

🔸 Lip fillers and philtrum reduction surgery
In some cases, making the lips fuller with fillers can make the philtrum appear less long. Conversely, performing philtrum reduction surgery pulls the upper lip, creating a volumizing effect. However, caution is advised because the incision is made around the nostrils to conceal scarring, and since the pulling does not cover the entire lip, the corners of the mouth may appear relatively droopy.

 

🔸 dental condition
Finally, the condition of your teeth also has a significant impact on your mouth shape. If you have ever seen the change in shape between wearing and removing dentures, you will immediately understand what this means.

 

 

💬 Frequently Asked Questions

Q1. Will all wrinkles around the mouth disappear if I have a lifting surgery?

While lifting can improve marionette lines and nasolabial folds, it is less effective for lip wrinkles and fine lines around the mouth located further inside. Since the lines may appear smoothed out immediately after surgery due to swelling but may reappear, it is recommended to receive a thorough explanation of the potential improvements before making a decision.

 

Q2. What procedure is suitable for walnut-shaped wrinkles on the chin?

Botox can be effective for chin wrinkles and vertical wrinkles around the mouth. However, a precise procedure is required as asymmetry or discomfort during meals may occur. Additionally, if you have a habit of clenching your lips, practicing slightly separating your lips and pressing your tongue against the roof of your mouth can be helpful.

 

Q3. Are there cases where marionette lines do not improve as much as expected even after receiving fillers?

Yes, if the deep cheekbones are convex and the lower jawbone is small and recessed, there may be limitations to improvement using only lifting or fillers. Additionally, you must also consider the possibility that fillers may shift depending on the type, injection depth, and procedure.

 

Q4. My philtrum looks long. Which would be better, lip fillers or philtrum reduction surgery?

Lip fillers can make the lips plumper, making the philtrum appear less long, while philtrum reduction surgery pulls the upper lip and adds volume. However, due to the nature of the incision location, the corners of the mouth may appear relatively droopy, so it is recommended to make a decision after examining the condition of the lips, philtrum, and teeth together.

 

🎯 Conclusion

The area around the mouth shows distinct changes due to aging, but the effects of lifting may be minimal.

✔️ Nasolabial folds and marionette lines can be treated with lifting and fillers, and chin wrinkles and vertical lines around the mouth with Botox, but other methods must be considered for lip wrinkles and fine lines inside.

To accurately predict the results, you must examine habits of clenching the mouth, the structure of the deep cheekbone and lower jawbone, and the condition of the philtrum, lips, and teeth.

💡 Since identifying the exact cause is essential to finding an effective solution, it is of the utmost importance to see an experienced doctor who performs a thorough examination. Find a good doctor!