The youthful appearance of perioral area has long been appreciated by patients and surgeons. This recognition has prompted the introduction of mynad procedures to restore lost volume or provide augmentation of the aged skin, these options can correct specific soft-tissue deficiencies or provide a means of achieving aesthetic goals. Rejuvenation of such area requires a multifaceted approach. There are many factors that contribute to the aging skin, the most significant being atrophy of the subcutaneous tissue with volume loss, genetic predisposition for rhytides and/or thin lips, actinic changes, degenerative diseases and smoking. There is no one procedure that can correct all of these problems, the aim of this essay is first to recognize the contributing factors, resultant deficits, and then to formulate a plane to maximize improvement.