What can I do to help reduce my smile / simple lines? (Photo)

Question

I’m 32 years old and my smile and dimple lines are very deep. I had juvaderm filler to correct this from a beauty spa and did not see a difference at all.

Anna Chacon, MD, FAAD · Answer

At 32, it’s very common for smile lines and dimples to become more noticeable, and it doesn’t necessarily mean your face is “aging” prematurely. These lines are influenced by facial movement, genetics, cheek volume, skin elasticity, and the way your skin folds when you smile.
The fact that Juvederm didn't make much of a difference doesn't necessarily mean that filler was the wrong treatment—it may mean that the lines weren't primarily caused by a lack of volume. If the crease is created mainly by facial movement or the way the cheek folds, simply placing more filler directly into the line may not give a meaningful improvement.
I would also be cautious about repeatedly adding filler to the smile lines. Overfilling the nasolabial or smile-line area can sometimes make the lower face look heavier or puffy rather than smoother.
Depending on your anatomy, a better approach may be to address the supporting cheek area rather than filling the crease itself. In some patients, subtle cheek support can soften the transition without directly filling the line. For dynamic lines, a carefully selected neuromodulator may sometimes help, although this requires precision because these muscles are important for smiling.
For skin quality, treatments such as microneedling, fractional resurfacing, or other collagen-stimulating treatments can gradually improve the texture and fine creasing of the skin, but they won't completely erase a deep anatomical fold.
Most importantly, I wouldn't chase the lines until they're completely gone. Some of what you're seeing when you smile is normal facial anatomy. The goal is usually to soften the crease while preserving your natural expressions, rather than trying to make the face completely smooth.

Nelson Lee Novick, MD · Answer

At least from the one photo provided, the issue here are pronounced parallel laugh lines when smiling (and very likely still present to some extent as skin creases at rest, as well). Success with fillers requires three major components: an experienced filler injector, the choice of an appropriate filler, and proper injection technique for the problem area. For parallel laugh lines this translates to: an experienced board certified cosmetic dermatologist filler expert, the use of a low viscosity, cohesive malleable HA filler (not ordinary Juvederm), and a proper fanning technique below and perpendicular to the folds in order to buttress the area. Going forward, you would be wise to see out an experienced, board certified cosmetic dermatologist filler expert. Hope this helps and best of luck.

Camille Cash, MD · Answer

Fillers when placed correctly can help minimize the smile lines that concern you.  Another option is Morpheus8.  This treatment combines RF technology with microneedling to improve overall skin tone and texture.  Generally three treatment sessions are recommended for optimal results.  I've included a video that I hope you find helpful.

Raffy Karamanoukian, MD, FACS - Account Suspended · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

What can I do to help reduce my smile / simple lines? (Photo)

Answers (4)

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