What's best for smile lines Botox or filler and will it help in the long run?

Question

What's best for smile lines Botox or filler ? And does filler help in the long run or is it just a temporary fix ? I'm in my early 20s but my smile lines really bother me and I feel they make my nose appear wider in photographs I've also had a photographer point them out and I wanted to know is it just a temporary fix that will look great as long as you're consistent and keep up to date with it or will it also have some long term benefits?

Ron Shelton, MD · Answer

Smile folds, the creases that go from the side of the nostrils to the corners of the mouth, are best treated by fillers. Sometimes fillers are needed first in the upper outer and mid cheek to support sagging structures that contribute to the smile folds. I commonly do this with Voluma.  After that filler is done, the smile fold is observed for any improvement. If it is still desired to fill the smile fold, then it can be done at the same visit. I usually use Juvederm Ultra, or Juvederm UltraPlus or Vollure for these folds. Some smile creases are very thin and narrow and may benefit by more superficial fillers such as Belotero

Christopher J. Davidson, MD, FACS · Answer

Thank you for your question.  Without a photograph it is difficult to comment on what procedure to suggest for your particular circumstances. Botox cosmetic interacts with muscle contracture.  Done regularly, Botox will decrease creasing and therefore prohibit deep lines from forming.  Dermal filler is an excellent option for augmenting depressed areas.  My advice is to seek a consultation with an experienced injector who will guide you through options best suited for your needs.  Good luck.

Harold J. Kaplan, MD · Answer

Hi Beam.  If you are referring to the laugh lines around the mouth, then dermal fillers would be the product you are looking for.  Botox is great for the upper face (frown lines and crow's feet), but dermal fillers are best below the eyes in the cheeks and around the mouth.

Jason Emer, MD · Answer

A combination approach will give the most improvement. I recommend fillers for the lines themselves but also lifting around the mouth and cheeks to build underlying anatomical support. In our practice we combine sculptra with other fillers "layered" on top and lasers, rf treatments, J Plasma and peels to get the most conservative natural look. Please see a facial sculpting expert. Best, Dr. Emer

David W. Kim, MD · Answer

Hi beam195,It sounds like you are talking about the lines that go from the corners of your nose down to your mouth corners. If so, those smile lines are best addressed with filler. Filler is temporary (as is botox), so will not be a permanent fix; it will definitely look best if you are consistent with it. However, there are also longer-term benefits due to the collagen stimulation that occurs as a result of the injections. Hope that helps. Best of luck!

Monika Soni, MD · Answer

Thank you for your question! For your smile lines, Botox would not be helpful and filler is the most appropriate.  Filler is temporary though so you may want to start getting laser, IPL, PRP or other treatments done to help the overall strength of your skin.  If you take a global approach to your face by combining multiple modalities, you may not need as much filler over time.  Either way, make sure you see an experienced provider. Best of luck!

Daniel Kaufman, MD, FACS · Answer

Thank you for your question. Fillers are more suitable for smile lines in most cases - there are a variety of products on the market to choose from. A consultation with a board certified plastic surgeon will be helpful in determining the most suitable product for you. I hope this helps!

Sergey Voskin, MD · Answer

Fillers would be the best injectable when it comes to smile lines. There are many products your doctor can choose from such as hyaluronic acid fillers, suchas Restylane, Juvéderm, These injectables fill and add volume to the creases or wrinkles in your smile lines.

Daniel Chang, MSc, MBBS, MRCS · Answer

Smile lines are lines that run from your corners of the nose to your mouth corners. Otherwise known as laugh lines, they deepen with ageing as a result of volume loss. 
Fillers are gold standard in this area, with Level 1 evidence for safety and efficacy in numerous Randomised Controlled Trials over the years.
In my practice, I notice patients who routinely get touch-ups in the area start requiring less volume and greater longevity of treatment. This is likely because your body begins to generate collagen in the area. So a major plus point.
I hope this is helpful.
Dr Daniel Chang

Shaun Patel, MD · Answer

Laugh lines which include nasolabial folds and marionette lines are best treated with fillers. The results typically last 9-12 months. My preferred fillers for treating the laugh lines are newer generation flexible gel hyaluronic acid based fillers, Restylane Refyne and Restylane Defyne. Both of these fillers integrate nicely into the skin preserving normal facial expression and giving a really nice and natural looking correction.

What's best for smile lines Botox or filler and will it help in the long run?

Answers (16)

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