29/08/2026
“I can’t see any difference.” 😬
Those words can be disheartening for both the patient and the injector — especially when, objectively, there is an improvement in the before-and-after.
But this is one of those areas of aesthetic medicine that is genuinely tricky to treat: lipstick lines and the perioral area.
It’s an uncomfortable area to treat, so numbing is used. The mouth is constantly moving — eating, drinking, talking, smoking, smiling — so whatever we do is working against a huge amount of movement and wear and tear.
And we have to be careful. Overfilling this area can look far worse than the lines themselves. The aim isn't to erase every line, but to soften them while keeping the mouth looking completely natural.
In this case, the treatment shown was dermal filler alone, and although the photographs do show an improvement, my patient unfortunately wasn't able to see or feel the difference she had hoped for. And honestly, that makes me sad. 😔
So what else can an aesthetic nurse offer when treating this area?
If I'm being completely honest, this is often an area where a combination approach gives the best results, rather than relying on one treatment.
✨ 1. Specialist dermal filler – such as RHA 1, used carefully to support and soften the area without overfilling.
✨ 2. A tiny amount of wrinkle-relaxing treatment – to reduce excessive puckering and pursing around the mouth where appropriate.
✨ 3. Laser treatments – to stimulate collagen and improve skin quality and texture.
✨ 4. Medical microneedling – potentially combined with polynucleotides, alongside polynucleotide treatments where appropriate.
Sometimes, every little bit helps. We aren't necessarily looking for one dramatic transformation; small improvements in skin quality, movement and structure can add up to a meaningful difference — and, most importantly, a boost in someone's confidence.
But here's the other side of aesthetic medicine that isn't always talked about…
You can't win them all.
Sometimes you've done everything you can, the photographs show improvement, but the patient still isn't happy with what they see. And learning to accept that disappointment — for both the patient and the practitioner — is part of the job.
For me, it's a reminder that aesthetic medicine isn't simply about treating a line or changing a feature.
It's about understanding what the patient wants to see when they look in the mirror — and sometimes, despite our best efforts, we don't quite get there. ❤️
