The search for a youthful upper lip via laser resurfacing

Generally, the upper lip resembles a bow of harmonious shape, characteristi c of youthfulness. At the lip, noticeable wrinkles develop with aging, and these wrinkles can be successfully treated with laser resurfacing. Ideally, the aim of the treatment should include not only the wrinkles but the reco very of the whole aesthetic configuration of the upper lip. The study includes 236 patients treated for wrinkles of the upper lip eithe r with the Coherent 5000C pulsed CO2 technology (300 mJ, density 6) or with the Flashscanning continuous wave emission, also CO2 technology (Sharplan FeatherTouch 36 W). Once resurfacing was done, passing the laser three time s over the whole surface to recover the upper lip from the aging appearance of wrinkles, three more passes (same laser parameters) were performed at t he area of the philtrum to reshape the Cupid's bow. Biopsies were taken to examine possible particular implications of tissue behavior and the role in the recovery of the anatomy and aesthetics of young lip characteristics af ter resurfacing, using the proposed technique. Laser resurfacing, done with a few more passes at the philtrum area, reshap es the anatomic-aesthetic youthful appearance of the upper lip and fully re covers the appearance of the Cupid's bow Results proved to be about the sam e when using the Coherent or the Sharplan laser. The sum of "very good" (e. g., equal to >80 percent clinical improvement and >60 percent improvement f or "good" results, for both systems) was as follows: (1) Sharplan, rate of success 52 percent "very good" and 35 percent "good," and (2) Coherent, rat e of success 40 percent "very good" and 50 percent "good" against a group o f 118 patients treated with each laser. No bad results were scored. Histologic samples after laser resurfacing showed effects down to the retic ular dermis, which, anatomically, is closely related to muscle layer becaus e of the nonexistence of a subcutaneous fat layer. Two months later, tissue showed signs that typically appear after laser resurfacing, that is to say , there was a rich broad band of compacted collagen present immediately bel ow the epidermis-dermis junction. This band could be very well distinguishe d from collagen before laser treatment, which was lax and presented clear s igns of elastosis. The orbicular, the main muscle surrounding the mouth, is attached to the de rmis with practically no layer of fat in between. Thus, when the technique is used as described, extra laser passes will promote a more compacted rich band of collagen that efficiently stretches the fibers of the mirtiform mu scle which lies in direct connection with the philtrum and its physiognomy. Extra pulling on this particular location, related to the philtrum, will r esult in reshaping che anatomic and aesthetic lip configuration. Laser resu rfacing offers possibilities of enhancing the results of lip rejuvenation b y improving the vermilion appearance and the aesthetic pattern with little risk of complications.