Smoker’s lines are not actually caused by smoking. They represent attachments between the skin and muscle, and loss of fat (from weight loss or age) and decreasing skin thickness (from sun exposure or smoking) make them more visible. Treatment includes a combination of approaches, including filler, neuromuscular toxins, and resurfacing. Fillers, like hyaluronic acids or fat, can replace lost volume, but for deep wrinkles, using a filler alone can lead to “duck lips”. Neuromuscular toxins, like Botox or Dysport, can minimize muscle motion, but they should be used with caution since too much can cause not only an unnatural appearance but also problems with drinking and speaking properly. Finally, resurfacing with procedures like peels and laser can also improve the appearance. More intense treatments (deeper peels, dermabrasion, and ablative lasers) work best, but they also have the longest downtime and highest risk of pigmentation problems, especially for darker skin types. A board certified plastic surgeon or dermatologist can guide to to the best treatment for you since it is very individual.
