Smile Lines: Why They Deepen and What Actually Changes Them

Smile lines (nasolabial folds) are the creases that run from the sides of your nose to the corners of your mouth. Everyone has them. They're part of normal facial anatomy, and they show up whenever you smile or laugh. The concern most people have isn't that they exist, but that they're getting deeper and staying visible even when the face is completely at rest.

Understanding why they deepen helps you understand what's actually going to change them, and what won't.

Why Smile Lines Get Deeper Over Time

The deepening of nasolabial folds is driven by several things working together, and it's rarely just one factor.

Midface volume loss is the biggest driver in most people. The fat pads in the cheeks shrink and descend with age, removing the structural support that once held the tissue up. As the cheek drops, the fold between the cheek and the upper lip deepens. This is a three-dimensional structural change, not just a surface crease.

Collagen and elastin decline makes the skin less able to resist folding. The crease forms more easily with each expression and takes longer to smooth out afterward, until eventually it stays.

Bone resorption in the midface reduces the scaffolding that supports the soft tissue above, accelerating the descent.

Repeated facial expressions contribute over decades. Every smile creates the fold, and over time, the skin creases permanently along the same path.

What Actually Changes Them

Because the main driver is usually volume loss and structural descent, the treatments that make the most difference are the ones that address that.

Restoring volume to the midface (cheeks) can lift the tissue that has descended and reduce the depth of the fold from above. This addresses the root cause rather than just masking the symptom.

Product placed directly into or alongside the fold itself can smooth the crease and reduce its depth. This is a more targeted approach for moderate to deep lines.

Combining both approaches often gives the most balanced, natural result.

For dynamic smile lines (those that only appear during expressions), relaxing the relevant muscles can reduce the depth of the fold during movement, but this approach is less common for nasolabial folds than for other expression lines.

What These Treatments Will Not Do

Nasolabial folds cannot be eliminated completely. They're a normal part of facial anatomy, and even the best treatment will reduce rather than remove them. Pursuing the total erasure of smile lines almost always leads to an overfilled, unnatural result.

No treatment can stop the ageing process that causes them. Ongoing maintenance is needed to sustain improvement, and the lines will gradually return as the treatment wears off.

Topical creams will not change nasolabial folds. These are structural folds driven by tissue descent and volume loss, not surface lines that a cream can plump.

Risks and Side Effects

Volume-based treatments in the nasolabial area carry risks including swelling, bruising, asymmetry, lumps, product migration, and overcorrection. Less commonly, vascular compromise can occur if product is inadvertently placed near or into a blood vessel, which requires urgent dissolving.

The nasolabial region is vascular and complex. Practitioner experience and careful technique are essential for safe treatment in this area.

Who Should Be Cautious

People with active skin infections, autoimmune conditions, bleeding disorders, known allergies to cosmetic injectables, or who are pregnant or breastfeeding should discuss suitability with their practitioner before treatment.

Alternatives

Good skincare (SPF, retinoids, hydration) can slow the rate at which lines deepen, though it won't reverse established folds. Skin tightening treatments (radiofrequency, ultrasound) can offer mild improvement in skin laxity. Surgical options (facelift) offer more dramatic and longer-lasting correction for significant midface descent. Doing nothing is a valid choice. Smile lines are a cosmetic concern, not a medical one.

Individual results vary. Outcomes depend on your anatomy, the depth of your folds, the cause of the deepening, and how your body responds to treatment.

A consultation with a qualified practitioner is the best starting point. They can assess your individual situation, explain the risks and benefits, and help you decide whether treatment is appropriate for you.

TT Aesthetics in Docklands, Melbourne offers consultations for smile lines and midface concerns. Our practitioners assess whether volume loss, skin laxity, or both are driving the change before recommending any treatment.

This content is intended for educational purposes and does not constitute medical advice or a recommendation for treatment. Only licensed healthcare providers should perform injectable procedures.