What is Perioral Rejuvenation?
The perioral region, covering the lip area and the lips themselves; is a very important anatomical area that reflects youth, liveliness and attractiveness in the facial expression in terms of aesthetics. Over time, the effects of aging in this region; manifest themselves in the form of wrinkles, volume loss, sagging and a decrease in contour clarity. These changes can create a tired, sad and old appearance in the person's facial expression.

Clinical Findings of Perioral Aging
Perioral wrinkles ("cigarette lines")

Volume loss in the lips and lip contour

Flattening of the philtrum and blurring of the vermilion border

Marionette lines (lines extending from the corner of the mouth down)

Orange peel appearance in the mental region (chin)

These symptoms are the result of physiological changes such as collagen and elastin loss, increased muscle activity, and atrophy in bones and soft tissue. Smoking, sun exposure, genetic factors and some professions (such as musicianship) can accelerate this process.

Treatment Methods
1. Botulinum Toxin Applications
Perioral wrinkles are reduced with low dose and superficial injections.

Marionette lines are lightened with application to the DAO (depressor anguli oris) muscle.

The rough appearance of the chin is corrected with injections to the mentalis muscle.

Injection points and doses should be carefully selected to preserve lip function.

Application Notes:

Upper lip: 4–6 U (usually 1.5 U x 4 points)

Lower lip: Low dose to 1–2 points when necessary

DAO muscle: 6–8 U on each side

Mentalis muscle: 2–8 U, intramuscular injection

2. Filling Applications
Fillers are used to correct both static wrinkles and volume loss in the perioral region. The most commonly preferred fillers:

Hyaluronic acid (especially cross-linked forms)

Calcium hydroxyapatite

Areas of Use:

Nasolabial fold

Marionette lines

Lip contour and volume loss

Fine perioral wrinkles

Techniques: Serial point, tunnel, fan, sandwich techniques; can be applied with needle or cannula.

Things to Consider:

Overcorrection should be avoided.

Excessive volume to the lip can cause a “duck lip” appearance.

Upper lip volume should be kept at 75–80% of the lower lip.

Thinner and superficial fillers are preferred for contour.

Basic Regions in Lip Rejuvenation
Vermilion border: For contour definition

Red lip area: For volume gain

Philtrum columns: For midface aesthetics and lip projection

Result
Perioral rejuvenation; It is the entirety of minimally invasive treatment approaches applied to alleviate the signs of aging in the lower 1/3 of the face, improve the aesthetic appearance and provide the person with a younger, more vigorous and balanced facial expression. Botulinum toxin and filler combinations offer highly effective results with careful patient selection and appropriate injection techniques.