Smile Lines - is there a procedure that can fix these? (Photo)

Question

When I smile I get these weird chipmunk like smile lines. Usually these lines are a stright slant, they have some sort of angularity but mine is completely curved and looks wierd. What sort of preocedute can be sought to fix this, if it can be fixed.

Randy Lindgren, MD · Answer

Smile lines (also called nasolabial folds) are a very common concern and often become more noticeable as volume in the midface decreases with age. When the cheeks lose support, the skin and deeper tissues begin to fold more prominently around the mouth. A nonsurgical facelift with dermal fillers and Sculptra can be an excellent options depending on the cause and severity of the lines.
Traditional hyaluronic acid fillers can be used to soften the fold directly by adding subtle structural support, improving the contour without creating an overfilled look. However, the best results usually come from restoring the underlying volume loss in the midface and cheek area, which lifts the fold upward rather than filling it outward. This creates a more natural, refreshed appearance.
Sculptra is another effective treatment, especially for patients with thinning skin or deeper collagen loss. Instead of providing immediate volume, Sculptra stimulates your own collagen production over time, gradually improving skin thickness and elasticity in the treated area. This can reduce the appearance of smile lines in a very natural way and enhance overall facial support.
Most patients benefit from a combination approach&mdash;strategic cheek support, gentle fold softening, and collagen stimulation&mdash;tailored to their anatomy and desired outcome. A consultation allows us to determine which option will give you the most balanced and long-lasting result.

Ajaya Kashyap, MD · Answer

Thank you for your query. The smile lines that you do not like can be improved with just a couple of units of botulinum toxin applied skilfully.  Please find an experienced board certified Plastic surgeon or Dermatologist who can help you with all your concerns. All the best!

Shahnoos Mahdavi, MD · Answer

thank you to trusting us to give you some guidance. you will be able to minimize these line with correct dermal filler injection and add to your beauty. depending your midface volume, the injection site may be chosen not even direct to these line but on your chick area to push these lines back.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your question and the photo—it really helps to understand the pattern you’re describing. What you’re noticing, the “chipmunk-like” curved lines when you smile, is actually quite common. These lines are usually a combination of muscle movement (the way your smile engages certain facial muscles) and the natural way your skin folds in that area.

Options to soften or improve these lines:

Dermal Fillers:
Carefully placed filler can help smooth the lines and provide subtle lift. The goal is to support the skin without affecting natural expression. Because your lines are more curved and dynamic, precise placement is key.

Botulinum Toxin (Botox, Dysport, etc.):
In some cases, small amounts of neuromodulator can help relax the muscles that create exaggerated folds, softening the lines when you smile. This is usually done very conservatively to maintain a natural expression.

Combination Approaches:
Often, a combination of filler and targeted neuromodulator gives the most natural, lasting improvement—softening the lines while keeping your smile expressive.

Skin Quality Treatments:
Laser resurfacing, microneedling, or radiofrequency can improve skin texture and elasticity over time, making lines less pronounced even without adding volume.

It’s important to remember that fully “erasing” smile lines is usually not realistic, especially when they appear only with movement, but they can be softened significantly to look smoother and more natural. The key is a conservative, tailored approach so your smile still looks like you.

Nelson Lee Novick, MD · Answer

At least from the photos provided, the use of a low viscosity, malleable, cohesive HA filler would be appropriate for addressing these motion-accentuated lines. In the hands of an experienced, board certified cosmetic dermatologist filler injection expert, the filler can be injected in such a way as to provide a supportive buttress under the lines in order to minimize skin accentuated skin folding with facial expressions. Treatment should take no more than about ten minutes to perform, usually engenders little to no significant post-treatment downtime, and the results typically are immediate. Hope this helps and best of luck.

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. For curved, chipmunk-like smile lines, filler or laser treatments are typically used to smooth and soften the area. Filler can add support where the tissue folds, and laser resurfacing can improve skin texture and tighten the lines. I hope this helps and best of luck!

Smile Lines - is there a procedure that can fix these? (Photo)

Answers (6)

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