What can be done to minimize the appearance on indent by nose when smiling? Not interested in filler (photos)

Question

Hi, ive never had filler in my cheeks or undereyes only anti wrrinkle around my brows, crows feet and jaw for clenching. In the last 12 months Ive noticed when i smile I have small thumb print indents next to my nose. I dont want filler, what should i do? Is it a muscle or ageing? I am 30. it is not visable when my face is at rest.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing these details and your photos. What you’re describing—small indentations or “thumbprint” marks next to the nose when you smile—is actually fairly common, especially in your 30s. Since they’re not visible at rest, this is usually related to dynamic movement of the muscles around your nose and mouth rather than volume loss.

Why it happens:

The muscles used for smiling (mainly the levator labii superioris alaeque nasi) can pull the skin in a way that creates these little indentations.

Even in younger adults, repeated muscle movement over time can make these dimples more noticeable.

Aging or minor skin laxity can contribute, but at 30, it’s mostly muscle-related.

Options without filler:

Neuromodulators (Botox/Dysport): Small, precise injections in the nasal elevator muscles can reduce the pull that causes the indent when smiling. This can soften the appearance without affecting your natural smile.

Skin quality improvement: Treatments like microneedling, radiofrequency, or laser resurfacing can improve skin elasticity so the dimples appear less noticeable, though results are subtler than muscle modulation.

Targeted exercises: Sometimes, facial exercises or awareness of muscle movement can slightly reduce the appearance over time, but changes are generally modest.

Since you’re not interested in filler, a small neuromodulator approach is often the most effective and minimally invasive way to reduce these smile indentations while keeping your expressions natural.

What can be done to minimize the appearance on indent by nose when smiling? Not interested in filler (photos)

Answers (1)

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