Botox for smokers lines around the mouth

  • Smokers lines or lipstick lines are fine wrinkles and lines on the upper and or lower lip that radiates out from the red lip border.
  • These lines are more prevalent on the upper lips.
  • While they are sometimes called smoker’s lines, most individuals develop the lines for reasons other than smoking.
  • Smokers lines are also known as perioral rhytides or “pucker lines”.
  • The “smokers lines” are worsened when the mouth is puckered by the contraction of the Orbicularis Oris muscle that surrounds the mouth like a purse string.
  • The lines are a result of loss of volume that occurs with age, along with repetitive bunching of the tissue from muscular activity.
  • These lines can contribute to lipstick bleeding, hence the name 'lipstick lines'.
  • The Orbicularis Oris muscle is highlighted in the image below.

Lipstick lines are usually treated with advanced dermal fillers, BtxA, or a combination of both.  The depth of the lines and extent of puckering will influence treatment modalities.  It is very common to use BtxA to treat lipstick lines regardless of the depth of the lines.  BtxA will have a couple of positive effects on the lines over time.  First, it will help relax the lines, which tends to eliminate the more permanent etching that may have occurred.  Secondly, it will help extend the longevity of the advanced dermal fillers.  BtxA is generally placed at certain points in the orbicularis oris muscle which surrounds the mouth, including the area of the vermilion border of the lips. 

If the lines are a little deeper, then Dr. Kelleher will place a soft, smooth dermal filler such as Juvederm® or Restylane® along the lines to help fill them in.  Also Dr. Kelleher may place a dermal filler such as Radiesse® or Juvederm® Ultra Plus underneath and horizontal to the lines to help elongate the area and stimulate collagen growth.  This will help with the puckered look, as well as diminishing the furrowed lines. 

Adding some bulk to the lips with dermal fillers such as Restylane® or Perlane® will also have a positive effect on the lipstick lines by further elongating the lip that has contracted over the years.  Additionally, this treatment will help with lines on the lips themselves.

What to expect in your treatment

  1. The patient sits back on a bed with the backrest up.
  2. The area is cleaned.
  3. The skin overlying the muscles to be injected is marked out with a skin marker.
  4. The injections are placed in the area where the smokers lines are, close to the red border (vermillion border) of the lip.
  5. The injections sometimes also cause a slight eversion of the border of the lip, i.e. the lip can look slightly fuller.
  6. The muscles are injected.
  7. It takes about 30 seconds.
  8. Light pressure is applied to the area to prevent bruising.
  9. The skin marker marks are wiped off.

Botox dosage for Orbicularis Oris muscle  injection (highlighted in the image above) for smokers lines:

  • females: 1-2 units per injection spot
  • males: 1-3 units per injection spot


  • Slight bruising can occur, but can be concealed with make-up.
  • It resolves in a few days.
  • The effect will kick in after 3-10 days and last between 2 and 7 months, depending on the Botox dosage used and the patients physiology.
  • Some patients dissolve Botox faster than other patients.
  • First time patients will sometimes be requested to return after 2-3 weeks for a check-up and top-up if required.
  • Most patients have the injections repeated once or twice a year.
  • See the LK Aesthetics Post Treatment Fact Sheet for Botox