There is significant demand for the treatment of peribuccal lines in aesthetic medicine. These lines, also called “bar code” by some patients. They appear over time and are exacerbated by smoking and sun exposure. In the eye contour area, the peribuccal skin is very thin and very sensitive. It is degraded and deteriorates when exposed to UV rays and to tobacco toxins.

Two types of procedures can treat peribuccal lines. One is using volumizing treatments, which do not act on the volume of the lips, but work on the wrinkles by filling them in a precise and fine way. The second is to use surface treatments which will help smooth the area with an exfoliating action which will homogenize the cutaneous surface.

Prevention and maintenance of the result:

A preventive treatment using mesotherapy can be performed as soon as the first signs of weakening and dehydrating appear in the perioral area. Uncrosslinked hyaluronic acid and the multi-vitamin complex enable a deep rehydration of the weakened dermis. Yearly maintenance sessions will help maintain the result over time. This technique does not bring any volume but restores the dermis elasticity.

Volumizing treatments:

  • Hyaluronic acid injections will be necessary to treat the marked lines. A cross-linked non volumizing product should be used for the product to stay in place and the morphology and the volume of the lips to stay the same. The technique used consists in a grid pattern perpendicular to the axle of the wrinkles completed with microinjections inside the wrinkles. As it is the case for every lips injection procedure, a local anesthesia will be performed before the treatment for your comfort.
  • A new technique designed to treat the lines and improvi cutaneous quality appeared recently. It is called nano-lipofilling. Performed with very thin cannulas, this procedure allows for treatment of the superior layers of the dermis in order to improve their texture. Carried out in a precise manner, perpendicularly to the lines as for hyaluronic acid injections, a nano-lipofilling will help filling in the lines with very small and precise injections of fat and improves the texture of the skin with growth factors naturally found in the injected fat.  Nano-lipofilling is a genuine surgical procedure performed in an operating room, most of the time under general anaesthesia. As it is the case for every lipofilling procedure, edema may appear after the surgery but usually subsides within 4 days.

Surface traitements:

  • A peel can help improve the perioral area by smoothing the lines. A moderate or a deep peel will create an abrasion which will destroy the dermis and the papillary dermis, the superficial layer of the dermis. In other words, it consists in a chemical burn managed by the surgeon, who controls the type of peel, the concentration, and the duration of the application. The surgeon makes those choices depending on the quality of the skin and the importance of the lines that need to be treated. After the treatment, the destructed dermo-epidermal layer will restore itself thanks to a natural healing process which will give a smoother aspect to the skin by erasing the lines.
    A moderate peel can be performed in the office without local anesthesia, but a deep peel will be carried out in an operating room under brief general anesthesia. In every case, one session is enough to obtain the desired result.
    Immediately after the treatment, redness and edema appear in the perioral area. Local care based on specific creams will be applied during about 10 days following the peel. Healing is generally over after this period, but the skin may remain reactive, dry and delicatefor a few weeks.
  • Laser treatments can also help improve the lines in the perioral area. This abrasive thermal technique will heat the superficial and the medium layers of the dermis while protecting the epidermis with cold.  Fraxel or CO2 lasers can be used. Doctor Natalie Rajaonarivelo does not practice these laser treatments, but she will provide the contact information of a laserist specialized in this delicate area.
  • Dermabrasion is a surgical technique aiming at treating the surface of the skin. It can be used to correct perioral lines. The procedure consists in erasing the superficial layer of the skin, the epidermis, and it can reach the medium dermis. It is performed with an abrasive spare wheel and the depth depends on the importance of the problem, location of the area, the quality of the skin, and the desired result.
    The procedure is carried out in an operating room under brief general anaesthesia. The destructed superficial layer will restore itself in the natural healing process from the dermo-epidermal basal membrane islets and the pilosebaceous units present in the deep dermis. That is called re-epidermalization. The procedure implies a healing time for very delicate skin and thorough care. Healing will take place for about 1 month.

As it is the case with all surface treatments, sun exposure is forbidden in the days following the treatment in order to avoid residual hyperpigmentation.