04/28/2026
NEUROMODULATOR OFF LABEL INDICATION- Dr. Hal London
Perioral lines are a problem commonly seen in my practice, like everyday. Mostly effecting woman, these lines add age to the face. Men have whiskers and are thought to add protective support to the skin.
Women hate them, really hate them. Iβm asked what can be done to soften or remove them. First, why do they develop?
Under the skin around the mouth there is a circular muscle( obicularis oris) , like a ring around and under the lips. When this contracts the mouth purses. This action allows you to speak and contain food and drink in your mouth, kind of important yes?
Also kissing, whistling, and other less critical motions are produced when o. oris is working. These motions fold the overlying skin and overtime cause multiple vertical lines resembling a barcode especially above the lip. Horrible.οΏΌ
What can be done to help? The solution is multi factorial. First, stop or limit the motion.
I try to teach my patients how to use their face so as not to produce or worsen existing expression lines. This is a tough sell because
expressions are habits and habits are hard to break. Thatβs where using judicious amounts of neuromodulators like Dysport or Botox come into play.
These medications weaken muscle temporarily, and when used properly, can soften these lines and prevent worsening.
The skill comes in knowing where to inject and how much. Too much medication and you are drooling your soup. Not enough and the effect is insufficient. I have seen many patients who have gone to someone who was not experienced in this treatment and suffered three months of disability. Horrible twice.
In addition to using neuromodulator, I employ my CO2 aggressively to soften these lines. Multiple treatments might be needed depending on the depth of the lines. I will often use blended filler in some of these lines to great effect as well.
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UNFILTERED PHOTOS TODAY
A woman in her 30s was developing vertical lip lines. Gentle use of Dysport inhibits the muscular contraction without totally blocking the motion. The lines are less visible yet she still has full functionality of her mouth.
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LONDON MEDICAL SPA- physician only treatments.
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Dr. Hal London -Artistry and Excellence in every treatment
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LONDON MEDICAL SPA
19 South 6th Street
Fernandina Beach, Florida 32034
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