Update on perioral cosmetic enhancement

PURPOSE OF REVIEW: As our understanding of the perioral region advances and procedures available for its treatment increase, we are more able to successfully treat the aged perioral region with minimal risk. The aged perioral region has traditionally been rejuvenated by direct surgical excision, chemical peels, and laser resurfacing. Many minimally invasive techniques are now employed for this purpose, including chemodenervation, use of soft tissue fillers, and fat grafting. RECENT FINDINGS: Over the last couple of decades, rejuvenation techniques have evolved to include chemodenervation, soft tissue fillers, fat grafting, and dermabrasion. The present article will review the most recent literature regarding the use of these techniques for various perioral age-related changes, including rhytids, labiomental folds, nasolabial folds, lip-cheek grooves, and thinning lips. Often, these modalities are combined to give the most natural aesthetic result. SUMMARY: An increase in our armamentarium of techniques and general understanding of the complex perioral region allows us to treat the area quite effectively with minimal risk. Volume loss, a key component of perioral aging, is best addressed with soft tissue fillers and autologous fat. In addition, botulinum toxin helps rest some of the key muscles responsible for perioral rhytids. Facial resurfacing techniques are still crucial adjuncts in the rejuvenation of this area, and they may be the only treatment that adequately addresses multiple deeper perioral rhytids.