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Ask Dr. Scott

Have a question about plastic surgery, laser treatments or other anti-aging techniques? E-mail Dr. Brenda Scott at This email address is being protected from spambots. You need JavaScript enabled to view it.. Scott is a board certified family physician and practices with her team at her Inspir Medispa in the Portland/Troutdale area.

Dear Dr. Scott,

I had a face-lift done several years ago, which helped with my saggy jaw line, but I still have 'smoker's lines' around my mouth. Are there any new cosmetic procedures that would help smooth out these lines?

Signed, 'Smokin Sue'

Dear 'Smokin Sue,'

Face-lifts are helpful for improving excessive drooping of skin and muscles over the cheek and jowl area, but they do not help much in the center part of the face, i.e. around the mouth, the lines that run between the nose and mouth, and the lines between the eye brows.

For the area around the mouth, the best treatment is a combination of BotoxCosmetic® and a dermal filler (a plumping substance that is similar to the consistency of Jello). The dermal filler instantly fills in the fine lines, and the BotoxCosmetic® relaxes the muscles, so the lines are softened. By relaxing the muscles, the results of the treatment will last significantly longer.

Another option is to use cosmetic laser treatments around the mouth. There are a variety of different lasers that can help treat this problem, but overall, the results are usually not as dramatic as with the Botox/dermal filler combination.

Dear Dr. Scott,

I'm always hiding my hands, because I have numerous 'age spots' on them. I seem to be getting more as time goes by. What is the best way to treat these and to prevent new ones from appearing?

Signed, 'Spotted Hands'

Dear 'Spotted Hands,'

What patients commonly call 'age spots' are usually solar lentigos or seborrheic keratoses. Both of these conditions are benign (not medically concerning) but are cosmetically bothersome. Solar lentigos are usually the result of excessive sun exposure. It is unclear why seborrheic keratoses form.

Before presuming that your 'spots' are benign, I recommend having a doctor examine them to make sure that none of it is cancer.

The best way to treat these spots depends on if they are flat brown spots or if they are slightly raised. Flat brown spots can be treated with topical creams, cosmetic laser or liquid nitrogen freezing. If they are slightly raised, liquid nitrogen freezing works best.

Use caution when undergoing treatment to make sure the provider explains to you which treatment would be best for your situation. The goal is to remove the 'brown spot' without taking out too much color and leaving a white spot behind that is lighter than the surrounding skin. To prevent the return of solar lentigos, sun block is highly recommended.