Extra thin fillers, specifically for fine lines

There are various methods for treating crow’s feet and smoker’s lines. Since everyone’s skin and needs are different, personalized advice is essential. What works for one person might be ineffective for another.

1. Crow’s Feet

Crow’s feet are often caused by the muscles around the eyes. To relax these muscles, Botox is usually needed. If the lines are visible even when you’re not smiling, Botox alone may not be sufficient. In such cases, you can opt for a treatment that involves focusing and heating the skin locally using a CO2 laser, PlexR (with a strong preference for the laser), or Morpheus8. These methods help to thicken and firm the skin. Another option is to apply a very thin hyaluronic acid filler superficially to the skin. More on that later.

2. Smoker’s Lines

Smoker’s lines are sometimes caused by the repeated pursing of lips while smoking, but are more commonly due to the use of the muscles around the mouth during speaking. When we were younger, we had a layer of fat between the skin and the muscles around the mouth. As we age, this fat layer decreases, causing the skin to adhere directly to the muscles, which leads to the formation of lines.

Botox can be used to relax these muscles, but it often affects your ability to articulate certain letters and can make it difficult to eat soup, among other things. For this reason, it may not be the best option. A more effective approach is to thicken and firm the skin and reduce the depth of the lines using a CO2 laser, PlexR (again, with a strong preference for the laser), or Morpheus8.

Another option is to slightly loosen the skin above the mouth from the muscles using a blunt needle. It sounds intimidating but isn’t. I make a small incision next to the corner of the mouth with a sharp needle, then use a blunt needle to gently move it back and forth.

Finally, you might consider using fillers to mimic the fat layer and fill in the fine lines. Pre-treating the skin by loosening it from the muscles as described above can also be an option.

Thin fillers: focused on minimal volume increase

Let’s talk about these extra thin fillers. The last thing you want is a “duck face,” where the area above the mouth becomes overly thickened, giving the appearance of a beak from the side. The goal is to increase skin thickness without creating this beak-like look. Fortunately, there are special fillers on the market that can be injected very superficially, providing minimal volume increase. With a special technique known as the blanching technique, fine lines like crow’s feet and smoker’s lines can be effectively treated.

The treatment is quite similar to regular filler procedures but may be slightly more sensitive due to the superficial injections and the number of needle pricks involved. Cooling with cold packs can help alleviate this discomfort. I don’t prefer using numbing creams as they can cause the skin to swell, making it harder to see what I’m doing.