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Softening Smile Lines

Dr. Matthew Karpman

Softening Smile Lines

By: Dr. Matthew Karpman

Smile lines, sometimes called laugh lines, are the grooves in the skin that develop around our mouth as we age.  These lines vertically curve downward from around the nose and end at the corners of the mouth.  Smile lines are a natural part of our facial expression as we smile, but the issue is their permanent presence on a face that is at rest with a neutral or no expression.

These unwanted lines occur from loss of volume in the face as we get older.  Research has shown that our facial appearance is made up of a collection of several discrete fat compartments in the face and specific ligaments that hold everything in place.  These are present in all human beings.  As we age, the ligaments relax, and the fat compartments sag downward, creating noticeable smile lines, even when we are not smiling.

There are several ways to address smile lines.  The most extreme example is a full facelift.  Many patients shy away from this strategy because of the risks of surgery and the costs associated with the procedure.  A second, less invasive option is through the use of fillers.  Hyaluronic acid is a natural water-binding molecule that already exists in the skin.
It forms a hydrated gel and is available in different viscosities to replenish the lost scaffold that gives our skin its structure.  

There are two techniques that I use to minimize and soften smile lines.  The first classic technique uses a soft and malleable version of filler to inject right into the nasolabial fold (between the nose and the corner of the mouth) where the smile lines appear.  This instantly decreases the visibility of the etched in grooves.  The second more recently described technique that I use is to inject a higher viscosity filler into strategic locations in the cheek.
This provides structural support to the cheek and midface, which, if done correctly, minimizes the smile lines as well.  As usual, my focus is to create a rested and rejuvenated natural appearance.

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