Best non surgical treatment for upper lip lines 2022

New Year, new you? Nah. We prefer: New Year, new options—to level up your look, if you so choose. In the coming months, you can expect to see the greenlighting of some long-awaited breakthroughs—from novel skin-boosting injectables to cutting-edge tools unlike any others we’ve seen before. Here, discerning dermatologists and plastic surgeons share the most celebrated arrivals of 2022.

1. Ellacor dermal micro-coring, for lines and laxity

One of the most hotly anticipated launches of the new year, Ellacor was recently cleared by the U.S. Food and Drug Administration (FDA) to treat moderate to severe wrinkles in the mid to lower face on Fitzpatrick skin types I through IV. (Data on dark complexions is said to be forthcoming.) Conceived, researched, and developed at Massachusetts General Hospital, the first-of-its-kind gadget uses hollow needles and a sewing-machine-like action to drill out and suction up thousands of tiny cores of skin, extracting up to 8% of skin in the treatment area in under an hour. Both the precise depth of treatment and the number of microcores removed can be customized to suit each patient, says Dr. Michael Abrouk, a cosmetic dermatology fellow at Harvard University who was involved with the Ellacor clinical trials and now performs the procedure in practice. The tech is heat-free and creates zero scarring, even at a cellular level. 

The device typically targets the cheeks, jowls, chin, and region around the mouth. The channels it creates reportedly cinch closed within 10 minutes of treatment, leaving skin smoother and tighter. Full results rely on collagen remodeling and can take up to six months to show, “but even after three days, you’re able to see an appreciable improvement in skin laxity and wrinkles,” notes Dr. Abrouk. “With a single treatment, we’re seeing some fantastic results.”

Before an Ellacor procedure, patients are injected with anesthesia; after, the skin is red, tender, and swollen for a few days to a week. Bruising is possible. In rare cases, the device’s prongs can imprint the skin with tiny circular marks that are about “the width of three or four human hairs,” says Dr. Abrouk, but these fade over time. The aftercare protocol for Ellacor is similar to that of laser resurfacing—gentle cleanser followed by a light application of petroleum jelly, plus strict avoidance of the sun, hot tubs, saunas, and the like. 

Currently, only a handful of doctors—mainly those involved with the trials—have Ellacor in the office, but from what we hear, select physicians will be receiving devices in January and a more widespread rollout is planned for the first half of 2022. The dermatologists we’ve talked to about the machine are unequivocally excited to get their hands on it—but they harbor no illusions about microcoring’s limitations. “This is not a surgical facelift—and we have to set that expectation,” says Dr. Amelia K. Hausauer, a board-certified dermatologist in Campbell, California. Unlike surgery, Ellacor doesn’t address the deeper tissues of the face, so results will be considerably less dramatic. But for the forty- or fiftysomething who is looking for a minimally invasive way to improve lines and laxity, “Ellacor could be the treatment of choice,” she says. 

2. Daxi: the longer-lasting neurotoxin

While the aesthetics community had been optimistic about a 2021 arrival for Daxi (daxibotulinumtoxinA for injection)—a new neuromodulator shown to last twice as long as Botox—the FDA dashed those hopes this past fall when it refused to approve the drug, after finding certain “manufacturing deficiencies” during a routine plant inspection. The makers of Daxi are working to rectify the situation in hopes of getting the toxin approved by the end of 2022.

The good news: the delay had nothing to do with the inherent safety of the product, which was supported by “really robust clinical data,” Dr. Hausauer tells us. Part of what sets Daxi apart from its competitors is a proprietary peptide that gives the botulinum toxin a positive charge, theoretically allowing it to bind more effectively to our cell receptors and minimize muscle movement for 24 weeks. Daxi will also be the first neuromodulator free of human albumin, a benign stabilizing protein, which may boost its appeal among purists.

What remains to be seen, however, is if the drug can reliably relax muscles for a solid six months when injected in smaller doses than those used in the trials. “My patients tend to want a soft, natural result [from toxins], so we usually use less than on-label doses,” says Dr. Hausauer. Can injectors promise a six-month effect when using the baby doses that allow for normal expressions? Probably not, she says, since neuromodulator studies have consistently shown that higher doses beget a longer-lasting freeze—but only time will tell.

3. RHA Redensity, for lip lines

Rounding out the RHA Collection of hyaluronic acid (HA) fillers is RHA Redensity, which just won approval for the correction of moderate to severe lip lines—“those fine vertical wrinkles above the upper lip and below the lower lip that form as a result of repetitive movements, thinning of the skin around the mouth, and age-related changes in the supporting bone and teeth,” explains Dr. Hema Sundaram, a board-certified dermatologist in Fairfax, Virginia, and Rockville, Maryland. (She was a principal investigator on the pivotal FDA study of the filler.) 

The barcode-like lines around the mouth are often targeted with ultrafine HAs, like Belotero, but injectors find these grooves challenging to treat. “Fillers tend not to last long in mobile areas like this, due to the constant shearing forces when we talk, eat, and make facial expressions,” Dr. Sundaram says. “Facial movements can also shift fillers that don’t distribute evenly in the skin, giving rise to lumps and bumps.” The ideal filler for around the mouth, she adds, “adapts well to movement, resists breakdown, and stays soft and natural-looking, even in motion.” 

Enter RHA Redensity: its biophysical properties make it “soft and flowing and quite moldable,” she says. It integrates evenly into the skin and bounces back after being “compressed, stretched, or bent” by surrounding muscles, she notes. “Patients will find that [it] sits nicely in the skin and doesn’t form lumps or bumps, even in very mobile facial regions”—quite an accomplishment, given that the gel is made to be injected superficially—and that it has a natural look and feel, “both when the face is at rest and when it’s moving.”  

The clinical trial, on 202 subjects of all Fitzpatrick skin types, found the gel to be safe, effective, and highly durable, with 66% of patients maintaining results at 52 weeks. It’s this longevity that will make Redensity a true standout when it launches in 2022. “When I treat perioral lines [with other fillers], I’m lucky if I get six months out of it—some patients metabolize it in three months,” says Dr. Hausauer. “If there’s something that looks natural, moves organically, and [can last] up to 52 weeks—that could be a really important addition to the market.” 

4. Aptos: a new kind of thread lift

By summer 2022, a new type of thread may win FDA clearance for skin lifting. The Aptos PLLA/PCL threads are made from a novel blend of polymers, distinguishing them from the threads currently used by American providers. “They’re barbed, for good tissue gripping strength” and “anecdotally, many physicians find that PLLA-PCL offers longer-lasting results,” says Dr. Sundaram, who is a scientific consultant for Aptos. (To know whether there’s truly a difference in durability, controlled comparative studies of various types of threads would be needed, she points out.)

Dr. Sundaram believes that the Aptos threads work best in the mid- and lower face—to contour the cheeks and tighten the jawline and under-chin region—and, ideally, as a complement to fillers. By using the two in tandem, she says, doctors may be able to skirt a number of common filler pitfalls, thereby “avoiding chipmunk cheeks, pushing up of the cheeks into the eye region, ‘filler moonface,’ and other signs of overvolumization.” Ultimately, she adds, the combination can give “a more natural appearance, both when the face is at rest and when smiling.” 

5. Volite: a glow-boosting injectable

Juvéderm Volite has headlined many future-of-beauty stories—but we now have it on good authority that the HA’s overdue approval is finally imminent. Unlike traditional HA fillers, Volite doesn’t actually fill or volumize or add shape or structure—or do any of the things we’ve come to expect from a filler, really. In fact, its goal is more akin to that of a laser: it strives to enhance the quality of the skin—its tone and texture. Yet it operates in a totally unique way, by “improving hydration and elasticity, for fewer fine lines and better light reflection,” explains Dr. Hausauer.

When teeny amounts are injected just below the skin’s surface, in a one-centimeter grid, across the mid and lower face, the gel pulls in water, hydrating the skin from within for about nine months. “As skin ages, it loses the ability to hold water, so anything that allows it to better retain hydration is going to help achieve that glowy, dewy, supple look that’s often linked with youthful skin,” adds Dr. Hausauer.

Once approved, Volite’s indication will likely be for the face, but elsewhere in the world, where the skin booster has been popular for years, it’s frequently used to plump and smooth the neck, chest, and backs of the hands as well. U.S. doctors forecast similar off-label uses here.

6. Sculptra, for cellulite

The collagen-stimulating injectable, Sculptra, is aiming for a cellulite indication, with the clinical trial expected to wrap in summer 2022. “Sculptra Aesthetic has been used off-label for many years for augmentation of the buttocks and also, more specifically, for the textural improvement of cellulite,” says Dr. Jessica Weiser, a board-certified dermatologist in New York City. “It’s helpful for skin smoothing, in general—not just for textural irregularities of the buttocks and thighs but also the crepey skin texture of the arms, elbows, knees, and more.” 

In Dr. Hausauer’s experience, Sculptra shines at firming up the lax, wavy skin that often accompanies dimples, whereas other cellulite fixes, like the injectable Qwo, tend to address only clearly defined divots.

But if Sculptra is already being used successfully on the body, does an FDA stamp of approval for this purpose really matter? “A new FDA indication is always a win in the cosmetic industry,” Dr. Weiser tells us. “Patients, in general, feel some added reassurance knowing that the treatments they elect to have are done according to FDA guidelines.” The new indication would also allow for Sculptra to be marketed as a cellulite solution specifically, which may lead to a surge in patient inquiries about the drug’s dimple-smoothing powers, our doctors say.

7. A cleavage-enhancing breast implant

Plastic surgeons will soon be offering a newly FDA-approved breast implant from Mentor called the MemoryGel Boost. This smooth, round, silicone device marries two seemingly opposing traits—it holds its shape in the breast while remaining soft to the touch, according to the company. “It’s for the patient who desires enhanced upper pole fullness as a result of breast implant surgery,” says Dr. Sean Doherty, a board-certified plastic surgeon in Boston. 

With age, he explains, as our breasts deflate and sag, we lose certain youthful hallmarks, like perkiness and cleavage. These types of changes are, in fact, what drive most women to seek breast surgery, he notes. But that cups-runneth-over look can be difficult to recapture.

Ordinarily, during a breast augmentation, when a surgeon places a traditional implant underneath the breast tissue and muscle, “it will soften to round out the lower pole [of the breast], highlighting a patient’s native tissue, for a subtle outcome,” he says. To really amplify the cleavage, he adds, patients would generally have to go with a bigger implant, increasing their breast size overall—for better or worse.

The Boost, which Dr. Doherty describes as “taut” and “overfilled,” is said to deliver more focused oomph up top—“and this is a true advantage,” he says. “This implant will enhance the upper pole and create a full, volumized breast that will be long lasting.”