There are a number of options for management of vertical facial lines. In general, the more superficial lines can be treated with injectables like Collagen or Restylane, or in some cases may respond to skin tightening procedures like chemical peel or laser treatments.

Deeper lines may benefit from Cosmoplast (cross-linked collagen) or Restylane injections, or fat injections. The advantage of Collagen or Restylane injections is the ready availability of the material "off the shelf", without advanced preparation or harvesting, and the procedure involves no more than a quick office visit every few months, in order to maintain the desired result.

The principal disadvantage of fat injections is that they involve a minor surgical procedure to harvest the fat from a separate donor site location where there is surplus fat, along with time for preparation of the fat for re-injection into the desired recipient area. Fat injections may not be suitable for very fine or superficial lines in the face, and the injected fat may not survive completely, possibly requiring additional future injections. The advantage of fat injection is that there is a possibility of survival of a substantial amount of the injected fat, which would eliminate the need for future "maintenance" injections if complete or near-complete correction is achieved, since the lines have now been filled with living tissue.

There are temporary solutions (hylaform and other injections), less intrusive solutions (light spot abrasion with light chemical peel or “light” laser) and more permanent solutions (wide undermining and fat grafts, plus light peels) and skin programs (such as topical vitamin C and enzyme home programs). It is no longer necessary to lose skin color or appearance, or have a prolonged recovery time.

The best possible treatment plan for you is one based on a personal consultation comprised of a detailed history, physical examination and discussion of your goals and desires. In general, I can tell you that there are minimally invasive options or more complex solutions. The former can be performed in an office setting with minimal "downtime" whereas the latter tend to produce more lasting results. The key determinant of which technique is best suited for you is how, as you said, "deep" your lines are. Early lines can be treated with a variety of soft tissue fillers ranging from bovine collagen or human-derived collagen to Restylane, Radiance and other available products. The best filler for your needs can only be determined at the time of your consultation. The next set of options necessitates minor surgical procedures such as autologous fat injections (using fat from your own body), alloplastic implants or suture suspension techniques. More definitive treatment requires more complex surgical correction such as a midface lift, S-lift, or full facelift.

I would have considerable reservation about using collagen for breast augmentation. In its usual clinical application only one or two cc's is injected in the face for augmentation of certain areas and wrinkle lines. In order to have a satisfactory enlargement of a breast it would require many
cc's of collagen. Moreover it is well known that collagen is extremely temporary. Not only does it not last for a lifetime; collagen in the face often lasts no more than three months. I would be reluctant to predict some of the side effects that may occur if such large volumes of collagen were used. I suppose, theoretically, it could trigger some sort of severe immune response. In summary, I wouldn't even consider it.

If the lines are rather deep, then a chemical peel or carbon dioxide laser resurfacing would be very good options. Collagen injection is another alternative, and this would be less invasive. The best treatment for a particular individual can only be recommended after a consultation to evaluate the problem.