How to Get Rid of Smile Lines: Filler, Botox, Laser and Skincare Options Compared
Bothered by the lines running from your nose to the corners of your mouth? Dr. Liza Wakim compares filler, Botox, laser and skincare for smile lines, explains what each can realistically do, and why treating the cheek often works better than filling the line.
Smile lines are one of the first things many people notice as their face changes, especially in photos. The good news is that they are a sign of a face that smiles, and almost everyone has them to some degree. The question is whether they bother you, and if so, what will actually soften them.
In this post I will walk you through what causes smile lines and an honest comparison of the treatment options, including the approach I often find works best.
The short version
- Smile lines (nasolabial folds) run from the sides of the nose to the corners of the mouth.
- They deepen mainly because of volume loss in the midface and changes in the skin.
- Hyaluronic acid filler is the most common in-office treatment; restoring cheek support often helps more than filling the fold itself.
- Botox is not a main treatment for smile lines, and creams can improve skin but not fill a deep fold.
What are smile lines (nasolabial folds)?
Smile lines, also called laugh lines or nasolabial folds, are the creases that run from the sides of the nose down to the corners of the mouth. Everyone has them when they smile. They become a cosmetic concern for some people when they stay visible, or deepen, at rest.
What causes smile lines
- Volume loss in the midface: the fat pads of the cheeks shrink and shift down with age, so the cheek hangs a little heavier over the fold
- Skin changes: collagen and elasticity drop, so skin creases more easily
- Sun exposure and smoking, which speed up skin aging
- Weight changes, which can change facial volume
- Lip and tooth support: the teeth support the upper lip, so worn or missing teeth can change how the area around the mouth looks
Treatment options compared
Hyaluronic acid filler
Filler is the most common in-office treatment for moderate to deep smile lines. A hyaluronic acid gel is placed beneath the fold to soften it. The FDA notes that fillers are temporary and that swelling, bruising and redness are common side effects that usually settle within one to two weeks. Hyaluronic acid filler can usually be dissolved if needed.
Cheek support instead of filling the fold
This is the part many people do not expect. Smile lines often deepen because the cheek has lost volume and sits lower over the fold. In those cases, restoring a little support in the midface can lift the area and soften the line more naturally than filling the crease alone. Overfilling the fold itself can make the area look heavy or puffy. My post on cheekbone filler explains realistic results.
Botox for smile lines: when it helps and when it doesn’t
Botox is not a main treatment for the smile line itself, because the fold is mostly a volume issue, not a wrinkle from muscle movement. Very small, careful doses around the mouth are sometimes used for related concerns, but too much can affect your smile and speech. As a dentist who works on these muscles every day, I am cautious here.
Laser resurfacing and SmoothLase
Laser treatments can improve skin texture, firmness and fine etched lines around the mouth. They do not replace volume, so they work best alongside filler for deeper folds. My post on SmoothLase for smoother skin around your smile explains one option we offer, and our SmoothLase page has the details.
Microneedling and skincare
Microneedling, retinoids and daily sunscreen can improve skin quality and help slow further changes. They are great for prevention and fine lines, but will not fill a deep fold.
How to get rid of smile lines naturally: what’s realistic
You can improve skin quality and slow smile lines at home with daily sunscreen, a retinoid, good hydration, not smoking and a stable weight. What you cannot do at home is replace lost volume. Facial exercises and “smile line hacks” on social media have little evidence behind them. If the fold is deep, in-office treatment is what makes a visible difference.
How long results last and what it costs
- Filler: results are immediate once swelling settles and often last many months, depending on the product and the person. My post on how long dermal fillers last explains the factors.
- Botox: about three to four months, when used.
- Laser: results build over a series of treatments.
Cost depends on the treatment, the amount of product and how many sessions you need. You will get a clear quote at your consultation.
When to see a provider
Book a consultation if smile lines bother you at rest, if you are unsure whether filler, laser or a combination fits your face, or if you had filler elsewhere and the area looks heavy or uneven. Learn more about our filler injections. If you also notice lines running down from the corners of the mouth, see my post on marionette lines.
Frequently asked questions
What causes smile lines?
Smile lines form where the cheek meets the upper lip. With age, volume loss in the midface and thinner, less elastic skin make the fold deeper. Sun exposure and smoking speed this up, and genetics play a role.
What is the best treatment for smile lines?
For moderate to deep folds, hyaluronic acid filler is the most common in-office option. Often the most natural result comes from restoring cheek support rather than filling the line itself. Laser can improve the skin around it.
Does Botox work on smile lines?
Botox is not a main treatment for smile lines, because the fold is mostly caused by volume loss rather than muscle movement. Small, careful doses around the mouth are sometimes used, but too much can affect your smile.
Can you get rid of smile lines naturally?
Sunscreen, retinoids and not smoking can improve skin quality and slow smile lines. They will not remove a deep fold, because they cannot replace lost volume.
How long does smile line filler last?
Many hyaluronic acid fillers last many months, and some longer, depending on the product, the amount used and the person. Touch-ups help maintain the result.
Are smile lines normal at 25?
Yes. Most people have some fold when they smile, even in their twenties. It becomes a cosmetic concern only if it stays visible at rest and bothers you.
Find out what will soften your smile lines
If you are in or around Washington, PA, you can request a consultation at Enhanced Wellness or call us at (724) 225-5070. Results vary, and we will recommend the approach that fits your face.
Sources
- U.S. Food and Drug Administration. Dermal fillers (soft tissue fillers).
- U.S. Food and Drug Administration. Dermal filler do’s and don’ts for wrinkles, lips and more.
Want softer smile lines?
Dr. Liza often looks at cheek support before filling the fold itself, for a result that looks natural when you smile and at rest. You will get an honest plan and a clear quote.
Dr. Elizabeth Wakim, DDS, is the founder of Enhanced Wellness. She’s a compassionate and highly-regarded dentist with her own practice in Washington, Pennsylvania, known for providing modern, comprehensive dental care, botox and facial aesthetics with a focus on patient comfort and anxiety reduction, serving general, cosmetic, and pediatric dentistry needs.
