What else Can I Do for my Smile Lines? (photo)

I have small parentheses lines around my mouth. I have tried two different fillers to get rid of this, but neither seem to completely get rid of them. The first doctor I went to used juvederm, but really only injected it into my cheeks. He stated that the filler would lift the skin, reducing the lines. The second doctor I went to used radiesse, and targeted the mouth more, but still injected more in my cheeks. Neither of these seem to completely eliminate these lines. Any advice?

Doctor Answers 10

Smile Lines.

The area of concern appears to be near the center of the photo. It may be that the underlining facial muscles have subtle insertions into that skin and are excreting a pull. If this is the case, then there will always be some depression in that region. I would be interested in seeing younger facial photos to see the longterm anatomy of this region. Another volumizing option is fat transfer. This will last much longer. 

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 91 reviews

Fillers for Smile Lines

Thank you for the great question and your picture. There are many types of fillers, and each has specific characteristics and uses. For lines around the mouth, a hyaluronic acid (HA) type filler (such as Juvederm or Perlane) is great.  Some doctors will use Radiesse, which is a calcium hydroxyapatite filler and is placed deeper in the tissue. For superficial lines that persist after deeper fillers, a great option is Belotero Balance. This product is an HA but is formulated differently, allowing it to be placed much more superficially.

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 110 reviews

Best approach for facial lines

When you first see a facial specialist for there complaints, you need to find a good doctor to listen to you during a consultation.  Before I make any recommendations, I first want get a very firm handle one what concerns that patient has.  THere should be no discussion on an particular product.  Only after your doctor understands your face how you would like to improve it, does the possibility of a certain procedure or product come up.

By the limited photo which is available, it's not crystal clear which lines you may want to be improved. 


Often times I have seen patients and clients that get too hung up on minor details of their face or body which do nor really detract from their appearance.  My job is tho help them understand my plan for their face so what they can look their best.  GOod luck


Michael Bowman, MD
Roanoke Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Skin Care is important

While fillers can help soften smile lines, it is difficult to complete erase them. That being said, optimizing your current skin care regimen will help to improve the quality of your skin and further improve your results. Retinoids (either prescription or over the counter), a good moisturizer, and antioxidants can help with fine lines. Lasers (Fraxel re:store, fractionated CO2) can also help. Sunscreen is a must. 

Ramona Behshad, MD
Saint Louis Dermatologic Surgeon
5.0 out of 5 stars 6 reviews

Smile Lines Around the Mouth

The lines you are referring to seem more dynamic than static in nature. Filler is not likely going to soften these lines as much as you would like. Sometimes Botox done carefully and conservatively can help reduce these smile lines as they are dynamic in nature. However, to be quite honest, I think they are very natural looking and you may want to consider keeping them.

Channing R. Barnett, MD
New York Dermatologist
4.1 out of 5 stars 8 reviews

Dimpling around the mouth

Fillers are way overused by every medical doctor and injectors with little understanding of the facial anatomy. It is an easy way to make money by those wannabe plastic surgeons.

Fillers are way overused, that is how some clinics, day spas, dentists, OBGYN, internists Emergency room doctors, nurses, PAs make some cash money in this economy. The demand is high , so why not jump on the band wagen and get some cash not dealing with insurance headaches.

You case needs a good examination after all these fillers and decide what is dimple and what is scar and what is the cause and treat accordingly. Before you accept the treatment ask what is the anatomical pathology and what is the best way to treat, and how and where the filler, if need filler, is going to be injected and why

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Smile lines-dermal fillers and botox/dysport

Smile lines are a common problem. You are definitely not alone.  I tell my patients it is difficult to completely erase all the lines. But you definitely can get some improvement.

With proper placement of dermal fillers(there are many choices) and neuromodulators (Botox and Dysport) you could get a great result.   You should find someone who is very experienced with these techniques.   Good luck with everything.    Dr.  Daniel A. Radin

Daniel Radin, MD
Windsor Dermatologist
5.0 out of 5 stars 2 reviews

Lip line persisting after filler

If filler was placed primarily in the cheeks, there is a possibility that the area will lessen with the added cheek volume. However, if you were to fill with Restylane or Juvederm specifically to the crease, you may find better results. Because this appears to be the natural crease of your smile, it will likely soften the line but not fully eliminate it. Best of luck.

George T. Boris, MD, FRCS, FACS
Los Angeles Facial Plastic Surgeon
3.7 out of 5 stars 18 reviews

What else Can I Do for my Smile Lines?

       Belotero or Restylane injected more superficially will achieve the desired result.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Superficial injection of Belotero

You may consider a more superficial injection of Belotero underneath the skin.  The benefits of Belotero are that the injection can be used more superficially.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.