What filler can you recommend for treating smoker's lines? Do you approve lasers and chemical peels for this?

We inject 1-2 units of Botox on two spots on the upper lip.

I like Belotero for perioral lines as well as 4 units of Botox to the upper lip. Ultherapy (Ultrasound) has a transducer for fine lines that works well around the mouth too.

Interested to learn more. I would like to know which is your favorite way to inject smoker lines? Micro drops? Tunneling?

Reduced cross linked HA with microcannulas + dermabrasion (or medium depth peelings in protocol

I find that skin needling with the dermapen most effective. Treatment sessions required will depend on severity. I block the area so that 2.5mm depth can be tolerated. I then follow with a HA to address volume loss. Volbella, Esthelis or juvederm ultra, I find all are suitable.

PRP is amazing! We teach it here in NZ. It does so many things and I have some excellent pre post photos of necks that I have achieved with PRP. I recently finished a series of treatments on a man's face, he shaves his head because he has balding and he comments that his hair is regrowing, which we also know it can be effective for, but this is just from treating his face! I have treated wounds with it also to brilliant effect. It works as a filler or a fine line treatment, shrinks pores, and diminishes pigmentation.

I love PRP with Derma Pen works great and the PRP accelerates the results too!

In my opinion is that Juvederm Volbela is a perfect product for perioral wrinkles.

I agree with RThompson. We have just started using this in Australia and it is excellent for those lines ,used with some Botox, it creates a great result .

Definitely Fraxel Repair helps but I would do the full face, not just peri-oral. I love Belotero for those fine vertical upper lip lines. Some people say to first bolster horizontally underneath the vertical lines but I find that adds too much bulk, even though the product is so thin. They were also touting it for crow's feet but I was very skeptical for good reason; it just pools there. I'm so glad I gave it a second chance for the vertical lip lines. It is best injected just under the surface; a tiny thread injected retrograde with a 30gauge. It doesn't seem to last as long as other HA's but patients love the results. And don't forget the hands when you are injecting aged patients; I absolutely love Radiesse for the hands!! No, I don't work for Merz; I still prefer Juvederm for the lips! But I do have to give Merz praise for good products and excellent training support. We are blessed to have one of the best trainers I've ever had the pleasure of meeting. Her territory is California and Arizona.

Just wondering do you activate the PRP before injection? Does it have a significant difference with the clinical outcome?

Wr don't activate the PRP before injection - stopped doing this several ago. The platelets are activated in vivo and I don't find any significant difference in overall clinical outcome. There are circumstances where you would activate with calcium beforehand such as for AFT, musculoskeletal work, venous ulcer dressings etc. The older THT tubes also required activation.