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Smile Lines: treatment options
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What gets rid of smile lines around the mouth?

Smile lines are a family of three: the folds from nose to mouth, the lines from mouth to chin, and the fine lines that fan into the lip. They come from lost volume, lost skin quality, and years of movement, and each cause has a different fix. Filler for the folds, resurfacing for the fine lines, and a light touch everywhere.

Dr. Victoria Taraska Medically reviewed by Dr. Victoria Taraska, MD, FRCPC

Smile lines are the lines a face earns, and most people are happy to keep the version that appears when they laugh. What they want to lose is the version that stays: the deepening folds from nose to mouth, the lines that pull the corners down toward the chin, and the fine creases that fan into the upper lip and catch lipstick. Those three are different problems wearing one name, and treating them well means treating them separately.

The folds

The nasolabial folds from nose to mouth and the marionette lines from mouth to chin deepen because the tissue above them has lost volume and dropped. They are support problems. Dermal filler restores that support, placed along the fold and, often more effectively, in the cheek so the whole area lifts from above. Immediate result, twelve to eighteen months. Sculptra does the same job gradually and broadly by rebuilding your own collagen, for people who want a slower, longer-lasting, very natural change. Our separate guides on nasolabial folds and marionette lines go deeper on each.

The fine lines

The vertical lines above the upper lip, sometimes called smoker’s lines whether or not you smoked, and the crepey skin at the corners of the mouth are not support problems. They are etched into the skin by decades of pursing, sun, and thinning. Filler here is a blunt tool; packed into fine lines it makes the lip area look heavy. Fractional laser resurfacing rebuilds the skin itself and is the treatment that actually smooths them, with a few days of recovery. Microneedling does a gentler version over a series. Micro-doses of Botox above the lip can reduce the pursing that re-forms the lines.

The corners

A mouth that turns down at rest reads as sad regardless of the lines around it. A small amount of Botox in the muscle that pulls the corners down (an off-label use), combined with a little filler to support them, lifts the corners subtly. It is a precise treatment and a place where injector experience shows immediately.

The sequence that works

Support first, surface second. Restore the cheek and the folds so the architecture is right, then resurface the fine lines so the skin matches. Doing it the other way round means resurfacing skin that is about to be lifted and moved. A good consultation lays this out as a plan over a few visits, with a total price, rather than as one product sold today.

How to choose a provider

Ask the injector to separate your lines into folds, fine lines, and corners, and to name a different approach for each. Ask how they avoid the overfilled mouth. Ask to see results smiling, since the mouth is where overtreatment shows most. And if resurfacing is part of the plan, ask what device they use around the lips and how they handle skin tone.

Browse the clinics below. Bring a photo of yourself at rest and one laughing; the difference between them is the consultation.

Your options

Treatments for smile lines, compared

Best-first, with honest notes on when each is the right call.

Treatment Typical cost Downtime When it's the right call
Dermal Fillers $600–$1,500 per syringe 1–3 days of mild swelling or bruising For the folds: nasolabial lines from the nose and marionette lines to the chin. Filler restores the support beneath them. The core treatment for most smile lines, immediate, lasting a year or more.
Cheek Filler $650–$1,400 per syringe 1–3 days of possible swelling or light bruising Lifting the cheek softens the fold below it from above. Often the more natural approach than filling the lines directly.
Sculptra $800–$1,200 per vial 24 hours of mild swelling; possible bruising For overall thinning and softening around the mouth. Gradual collagen restoration that improves every line at once over months, lasting two years or more.
Laser Skin Resurfacing $500–$3,500 per session 1–2 days (non-ablative) up to 1–2 weeks (ablative) For the fine vertical lines above the lip and the crepey texture at the mouth corners that filler cannot fix without looking heavy.
Botox $200–$600 per treatment area None. Return to normal activity right away Small doses at the corners of the mouth lift a downturned corner, and micro-doses above the lip soften fine lip lines. A supporting role, not the main treatment.
FAQ

Smile Lines: common questions

Is it filler or Botox for smile lines?

Mostly filler, with Botox in a supporting role. The folds around the mouth are volume and support problems, and filler restores both. Botox relaxes muscle, which helps a downturned mouth corner or fine lip lines, but it cannot lift a fold and placing it around the mouth carelessly affects speech and drinking. An injector who suggests Botox as the main fix for nasolabial or marionette lines is using the wrong tool.

Will filler around my mouth look obvious?

Not when it is placed to restore rather than to fill. Overdone results come from packing filler into the line itself; natural results come from supporting the cheek and the corner of the mouth so the lines soften on their own. Ask to see the injector's results at rest and smiling, and ask how they keep the mouth area from looking heavy.

How much does it cost?

Filler is priced per syringe, several hundred to over a thousand dollars depending on product and city, and treating the smile lines and their causes typically uses one to three syringes. Resurfacing for lip lines is a separate session at a few hundred dollars and up. Sculptra runs per vial over a short series. Ask for a total plan price, not per-area quotes.

Sources

Where this information comes from

Clinical facts on this page are checked against these primary sources.

  1. 1.Dermal Fillers, American Society of Plastic SurgeonsThat aging causes loss of subcutaneous facial fat, which is what makes smile lines more apparent, and that dermal fillers work by restoring volume and fullness, backing this page's description of the nasolabial folds and marionette lines as support problems that filler corrects.
  2. 2.SCULPTRA Aesthetic (Injectable Poly-L-Lactic Acid): Physician and Patient Labeling, PMA P030050/S002, U.S. Food and Drug Administration (CDRH device labeling)That Sculptra Aesthetic is FDA-approved for correction of nasolabial fold contour deficiencies and other facial wrinkles, that its effect builds gradually over several weeks rather than immediately, and that effectiveness was followed through 25 months in the pivotal study, backing this page's description of Sculptra as a gradual collagen treatment lasting two years or more.
  3. 3.Microneedling can fade scars, uneven skin tone, and more, American Academy of DermatologyThat microneedling can treat fine lines on the skin above the upper lip and is performed across a series of sessions, backing this page's description of microneedling as a gentler, series-based option for the fine vertical lip lines.
  4. 4.Laser Resurfacing, American Society for Dermatologic SurgeryThat Erbium lasers cause fewer side effects than CO2 lasers and that healing after resurfacing takes about three to ten days, backing this page's description of laser resurfacing for the fine lines above the lip as a treatment with a short recovery.
  5. 5.Botulinum toxin therapy: FAQs, American Academy of DermatologyHow botulinum toxin works (relaxing the injected muscle to diminish the fine lines it causes) and that results last about 3 to 4 months, sometimes longer, backing this page's description of small Botox doses softening a downturned mouth corner or fine lines above the lip.
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This page is for education, not medical advice or diagnosis. The right treatment depends on an in-person assessment by a qualified provider.