What Causes a Horizontal Crease Above Upper Lip (Beneath Nose) when I Smile?

Thanks for your question . A horizontal crease above the upper lip when smiling is often caused by the activity of certain facial muscles, particularly the depressor septi nasi muscle. This muscle pulls down the nasal septum and can contribute to the formation of the crease . The strength of the levator labii superioris muscle, which raises the top lip, is one of the other variables that may affect how this crease appears.
Although many individuals consider this wrinkle to be a normal aspect of face expression, others may find it unattractive. Speak with a Board Certified Plastic Surgeon about your choices for treatment if you're worried about how this crease looks. These might consist of:
Botox injections: By momentarily paralyzing the muscles causing the wrinkle, botulinum toxin injections might lessen its visibility.
Dermal fillers: To soften the look of the crease and give the lips more volume, fillers can be injected into the affected region.
Surgical operations: To treat the underlying muscle activity or to elevate the surrounding tissues, surgical techniques may be considered in some situations.
To find the best course of action for your unique requirements and concerns, it's crucial to speak with a certified healthcare practitioner.
Hope this was helpful!
Best wishes,
Dr Ali Sajjadian
TRIPLE Board Certified Plastic Surgeon

This is often from the activity or pulling of a muscle called the depressor septi which basically goes from your nose to your upper lip. Nonsurgically, a little botox in this muscle often lessens or eliminates it. Surgically, a this muscle can be released on its own or during a rhinoplasty procedure.

At 42, it's common to start noticing changes in skin elasticity and volume, especially around the mouth and nose area. The horizontal fold or raised pouch you describe could be caused by a combination of factors, including natural aging, loss of collagen and elastin, sun exposure, and repetitive facial movements. Non-surgical options to help lessen or improve this area include treatments like dermal fillers, which can restore lost volume, botox, which can soften dynamic wrinkles and skin tightening procedures such as radiofrequency or ultrasound therapy. Additionally, a good skincare routine that includes hydration and sun protection can help maintain skin health. Consulting with a skincare professional can provide personalized recommendations tailored to your needs.