What can be done for the folds “parentheses lines” around the mouth? Dr. John Burroughs, Colorado Springs Oculofacial Plastic Surgeon, Answers?

he deep folds that are seen around the mouth can be very bothersome to patients. Dermal fillers have provided a great tool to improve these in an instantaneous manner without any surgery required. Hyaluronic acid fillers (Restylane, Juvederm, Belotero) may be used, but only provide approximately a 6-9 month improvement in most circumstances. Radiesse (hydroxylapatite) is a different type of dermal filler and provides between 12-24 months of improvement. It needs to be placed deeper, and is not suitable for the lips. Some patients have such deep folds that they benefit from a deep placement of Radiesse followed by more superficial placement of a hyaluronic acid filler. These fillers provide a very naturally pleasing improvement. Lower face lifting can further improve the results, but Dr. Burroughs has found the fillers to be very complimentary to lower face lift procedures. The photos show before (top) deep nasolabial folds, and after (bottom) 1 syringe of Radiesse filler. This patient has rosacea skin issues causing her folds to be more red than usual. The patient was thrilled that her folds were less deep and felt she looked more “relaxed” following the single injection.