Vertical lip lines or wrinkles case study

Case study, Good Skin stories

Radiofrequency & Dermapen

Summary: lovely improvement to vertical Lip lines
Client: early 60s, non-smoker, laughs a lot

The issue:
The vertical lines above the upper lip, we have them as we age, and they are notoriously difficult to treat. Smoker’s lines. Even in non-smokers. These are expression lines caused by the repeated pursing of the lip muscles, as we speak, pout, and express ourselves.

Various treatments target the improvement of vertical lip lines – any treatment which increases the production of collagen will have some impact on these lines – but as these creases are persistent and result from movement, results are frequently not enough for you the client to be happy with the treatment.



My treatment of choice used in this case study, is the combination of Dermapen microneedling and radiofrequency skin tightening using the BTL Exilis Elite machine.
Both treatments can be made to produce highly specific targeted results. In the case of vertical lip lines, the combination results in boosted collagen, greater elasticity, and better overall skin tone and texture. Of all the radiofrequency devices I have tried or researched, I find Exilis unique in treating lips – this is because of the small treatment tip, which makes this area accessible, and the high variable power for safe specific targeting of skin depth.



Overall the skin is fresher, softer, more alive looking.
The vertical lip lines have been significantly softened – not removed, but improved in a way I have not seen possible with other therapies.

Bonus: the lips themselves are fuller and the skin on the lips is healthier-looking. Unusually, the Exilis is able to treat the lips themselves.



In this case, the client had a full-face course of Exilis radiofrequency treatments – four sessions, forehead to neck and including lips. This was followed by one dermapen treatment, including a glycolic peel from Akademikliniken.
And then time, while the skin did its healing thing.


This particular client had chosen full face and neck treatment, the ‘lighter brighter tighter‘ which comprises four radiofrequency treatments and four dermapen sessions, £2000. (She has so far had four radio frequency and one dermapen).
For lower face and neck only, four treatments would cost £1000 (other combinations could be lower face and eyes, if that is what you want to target)
Dermapen per session £200



“I have tried the lighter Belotero lip fillers above my upper lip before, but they left raised vertical lines, cost a lot, and wore off very quickly. I love that this treatment has meant fresher skin all over my face.”



So, the results of this case study show the combination of radiofrequency and microneedling for collagen boosting, skin tightening and surface brightening. This is my treatment of choice.

Here is a summary of some other options used for upper lip lines. (But in my experience, none are as effective as RF skin tightening and dermapen microneedling):

Skin resurfacing superficial peels – resurfacing as part of your skincare treatment can improve the elasticity of the skin, and so improve the quality of the skin.

Microdermabrasion – superficial skin resurfacing, which removes the very uppermost dead skin layer will make your skin healthier and more glowing, but is not deep enough to make a difference to these lines.

Fillers, women are often tempted to ask for fillers to inflate this area and so smooth the appearance of the vertical lines. Fillers will have a limited impact on the skin outside of the lip margins. Any added volume in this area risks changing the look of your lips because the filler is effectively in the wrong place, outside of the natural vermilion border of the lip; enough filler to smooth the upper lip will change your pout in a way that you don’t necessarily intend. Newer softer fillers have been developed specifically to work at a superficial level for filling wrinkes, but on balance these do not last well on the upper lip where there is constant movement.

Botox trademarked – wrinkle relaxing injections can work wonders on deep expression lines by stopping your ability to repeat that expression and so softening the line made over time. However on the upper lip this would not work – botox would compromise your ability to move your mouth, never a good thing.

Subcision – this is a minor surgical procedure, performed using a hypodermic needle. Subcutaneous incisional surgery as it is also called, was developed as a way of releasing fibrotic tissue within scars – effectively, by using a needle to cut through fibres attaching a scar or deep wrinkle, the indentation could be released. The minor trauma to the skin would also have the effect of stimulating healing in the skin, and healing response means improved collagen.

Skin resurfacing – working at a deeper level, the resurfacing offered by lasers, deep peels or fractionated radiofrequency can stand a chance of making an impact on these vertical lip lines, but in order to make enough of a difference they need to go deeply, and such treatments are often performed while under general anaesthetic, often in conjunction with facelift surgery.