Anatomy and Aging of the Perioral Region

Abstract

Perioral region, although severely impacted by facial aging, is often overlooked in texts on facial rejuvenation. Sun exposure, bone resorption, dynamic contraction of the sphincteric and nonsphincteric oral musculature, gravitational pull, histological changes of the skin, and unhealthy habits all take their toll in this area. Fine wrinkling on the lips, deep nasolabial and mentolabial folds, elongation and flattening of the upper lip, downturned corners of the mouth, marionette lines, diminished vermillion and upper teeth show and chin irregularities are the main signs of this process, raising great concern amongst patients and making the perioral region the most demanded area for facial rejuvenation treatment. A huge armamentarium of surgical and nonsurgical techniques, with or without complex technology, are available to tailor patient's specific needs, from chemodenervation and mild chemical peels to operations designed to restore the size and shape of the lips. In this article we perform a comprehensive review of the contemporary treatment of the aging perioral area, detailing the most common techniques and their nuances.

Natural Fiber-Reinforced Polycaprolactone Green and Hybrid Biocomposites for Various Advanced Applications

“…Following the recent launch of a PCL-based microsphere dermal filler belonging to the collagen stimulator class (Ellansé), PCL is being employed in the field of human aesthetics [ 162 , 163 ]. PCL-based products have also been utilized to treat facial ageing indications, such as contour laxity and volume loss, by stimulating collagen formation, resulting in an immediate and long-lasting natural impact [ 159 , 163 , 164 , 165 , 166 , 167 ]. In addition, it is being studied as a scaffold for tissue engineering-mediated injury repair using the guided bone regeneration (GBR) membrane, which has been extensively reported by numerous researchers [ 168 , 169 , 170 , 171 , 172 , 173 , 174 ].…”

Lifting the Mouth Corner: A Systematic Review of Techniques, Clinical Outcomes, and Patient Satisfaction

“…During aging, the oral commissures depress over time partly due to increased contractility of the depressor anguli oris (DAO) muscles, sagging of facial fat pads (jowling), and deterioration of skin smoothness. 7 Downturned oral commissures could also have a congenital origin, which seems to result from hyperactive DAO and mentalis muscles or an imbalance of mouth corner elevators and depressors 6 , 8 …”

Prospective Evaluation of the Safety and Efficacy of Thermomechanical Fractional Injury for Perioral Rhytides

“…1,5 For perioral rhytides, neurotoxins and dermal fillers can typically offer modest short-term improvement; however, combination treatments, including with resurfacing, can often provide effective outcomes. [1][2][3] Although traditional resurfacing methods, including ablative and nonablative lasers, can be highly effective, they typically require the application of anesthesia to minimize treatment discomfort and are often associated with significant recovery time, especially with ablative modalities. 6,10,11 Thermomechanical fractional injury can offer clinical improvement of fine lines and wrinkles with minimal downtime and discomfort during treatment, without the need for any anesthesia.…”

“…1 Epidermal and superficial dermal resurfacing and thermal coagulation can improve the appearance of perioral rhytides through the upregulation of collagen and elastin formation, which can improve fine lines and surface texture. [1][2][3] Traditional options for perioral rejuvenation include neurotoxins, soft-tissue fillers, chemical peels, dermabrasion, radiofrequency microneedling, ultrasound, and lasers, and a combination of treatments. 1,4,5 Fully ablative, fractional ablative, and fractional nonablative lasers have been used successfully, with fractional lasers typically offering clinical improvement with less postprocedural downtime and overall risk for adverse events.…”

“…1 Epidermal and superficial dermal resurfacing and thermal coagulation can improve the appearance of perioral rhytides through the upregulation of collagen and elastin formation, which can improve fine lines and surface texture. 1–3…”