In short. Lip lines above the border are the vertical creases running from the upper lip towards the nose, and they have four possible causes rather than one. Muscle pull, sun damage, smoking and volume loss produce similar lines but respond to different treatment, so the cause is named before the plan is chosen.
Key points
- Lines above the lip come from muscle pull, sun, smoking or volume loss.
- Each cause has its own route, and each route leaves the other three unchanged.
- Relaxing the muscle answers lines that appear mainly when the mouth moves.
- Stopping smoking changes the blood supply within weeks but does not remove formed lines.
- Restored volume supports the skin and can be dissolved, but does not repair sun damage.
Why do lines above the lip have more than one cause?
Lines running from the upper border towards the nose are treated as one problem and produced by four. A plan that does not name the one doing the work tends not to hold. Muscle, sun, smoke and volume each have a route that reaches them, and each route leaves the other three exactly as they were. Doing nothing to the surface while treating the muscle is the commonest reason a plan disappoints.
The muscle that circles the mouth
The orbicularis oris contracts thousands of times a day: with every word, every sip, every expression. Each contraction folds the skin above the border in the same places, and over years those folds become the lines visible at rest. Where the lines are fine and appear mainly when the mouth moves, relaxing the muscle addresses the cause rather than the result. The effect wears off, so it is repeated rather than done once.
Sun exposure and the surface
The skin above the lip is thin and heavily exposed, and sunlight thins it further and damages the fibres that keep it taut. The result is a surface that creases more easily and holds the crease longer, sometimes with uneven pigment. Where the surface is the main finding, treatment is aimed at the surface and planned over more than one session, because the skin has to recover between them. Protecting the area from further exposure is part of the treatment rather than advice added at the end.
Smoking, which does two things
Smoking reduces the blood supply to the skin and adds years of pursing, so it both weakens the surface and gives the muscle more work to do. The second effect is why smokers often have lines that are deeper than their age would suggest. Stopping changes the blood supply within weeks and is the single most useful thing that can be done for this area. It does not remove lines that have formed.
Volume loss, which changes what the skin has under it
As the lip and the tissue around it lose volume, the skin above the border has less beneath it and folds more readily. Where this is contributing, restoring volume in the lip and the border reduces the depth of the lines by giving the skin support, and it is a change that can be dissolved if it does not suit. It does not repair sun damage and it does not stop the muscle, so it is usually one part of a plan rather than the whole of it. Where all four are present, the order is agreed first, and the order is not the same for everyone.
Which cause is doing the work?
The four causes produce similar lines, so the assessment has to name the one doing the work before treatment is chosen. The table sets out what each cause does and what reaches it. Where more than one is present, the order is agreed first, and the order is not the same for everyone.
| Cause | What it does | What reaches it | What it leaves unchanged |
|---|---|---|---|
| Muscle pull | Folds the skin above the border with every word, sip and expression | Relaxing the muscle | Sun damage, volume and the surface |
| Sun exposure | Thins the skin and damages the fibres that keep it taut | Treatment aimed at the surface, planned over more than one session | Muscle pull and volume |
| Smoking | Reduces the blood supply and adds years of pursing | Stopping, which changes the blood supply within weeks | Lines that have already formed |
| Volume loss | Leaves less tissue beneath the skin above the border | Restoring volume in the lip and the border | Sun damage and muscle pull |
| More than one cause | Produces lines that no single route reaches | An order agreed before treatment starts | Nothing, because each cause still needs its own route |
When are the lines not the question?
The lines are not the question when there is a sore, ulcer or white patch on the lip that has not healed; when there is a change in the lip on one side only, or numbness that is new; or when lines appeared suddenly, or with redness and scaling of the skin.
Sources
Internal links
Frequently asked questions
Will relaxing the muscle stop the lines coming back?
It reduces the force that folds the skin, so the lines fade while the effect lasts and return more slowly afterwards, but it does not remove them and it does not repair the surface. Where the lines are largely produced by muscle pull and the skin is otherwise in good condition, relaxing is often the change that makes the most difference. Where sun damage has thinned the skin, the surface has to be treated as well or the lines stay visible between contractions.
Can resurfacing be used on the lip itself?
Resurfacing is aimed at the skin above the border rather than at the vermilion. The vermilion has no hair follicles and no sweat glands and heals differently from skin, so it is not treated as though it were skin. Where the border itself has faded, that is a question of the ridge and is answered by material placed in the border plane, not by resurfacing. The two are often planned together without being the same treatment.
What can I do about lip lines if my lip is also very dry?
Say so at the assessment, because dryness changes the order of treatment. Skin that is dry and cracked is a poor surface for resurfacing and heals less predictably afterwards, so the surface is usually settled first and the lines addressed once it is. Dryness is also worth investigating in its own right, since it can be a habit, a medicine or a condition rather than simply a lack of moisture, and it responds to different things depending on which.
Risks & Limitations
- A dissolvable gel filler can be broken down with an enzyme. Skin or tissue removed by an operation cannot be put back.
- Bruising and swelling after a lip injection are common and usually settle over one to two weeks.
- Repeated filler over years can accumulate in the lip, and dissolving may not return it to its untreated state.
- Every operation on the lip leaves a scar, and the lines above the border and the way the mouth closes can change.
When to Seek Care
- Severe pain, blanching or mottled skin during or after a lip injection, or a change in vision.
- A sore, ulcer or white patch on the lip that has not healed in a few weeks.
- A lip that is numb, or a mouth that no longer closes, after an operation.
- Fever with spreading redness, warmth or discharge, or a wound that opens.
References & Further Reading
- American Society of Plastic Surgeons (ASPS) — procedure and safety guidance
- National Institute for Health and Care Excellence (NICE, UK) — relevant guidance
- Cochrane Library — systematic reviews
- Chinese Medical Association Plastic Surgery Branch — clinical guidance
This page is patient education, not medical advice, and it does not cite individual studies. Discuss your own case with a qualified clinician. To arrange an assessment at Chongqing West District Hospital, see Contact & Consultation.