Anatomical-Based Diagnosis and Filler Injection Techniques: Perioral Wrinkles

Abstract

This study focuses on anatomically based diagnosis and filler injection techniques for managing perioral wrinkles, which present unique challenges due to complex vascular anatomy and diverse wrinkle types. Key perioral wrinkles include vertical lip wrinkles (smoker's lines), oblique lip-chin creases, labiomental creases, central chin creases, and marionette lines. Effective treatment requires understanding the underlying anatomy and careful procedural planning. Superficial injections of low-viscosity hyaluronic acid fillers are typically employed, with techniques such as the fern leaf method or duck walk technique ensuring natural, smooth results. Adjunctive botulinum toxin injections can reduce dynamic wrinkle formation, enhancing filler outcomes. Attention to vascular considerations, such as the horizontal labiomental artery and superficial branches of the facial artery, is critical to minimize complications. While conservative filler use and precise injection techniques improve outcomes, anatomic variations and atypical arterial patterns underscore the importance of individualized approaches. The findings emphasize a multifaceted strategy for safe, effective, and aesthetically pleasing perioral rejuvenation.