Nose to mouth lines: How to correct smile lines both surgically and non-surgically

Nose to mouth lines (also known as the nasolabial fold) run from the outside of the nostril to the corners of the mouth. They appear as we get older, as our cheek fat descends and we lose volume in our faces. These lines naturally look deeper when we smile, but if they stick around when our expression is serious, they can appear to drag our features down. That's why many people look for a solution to restore a smoother, happier look.

Consultant Plastic Surgeon Mr Marc Pacifico, who works at Nuffield Health Tunbridge Wells Hospital, says the first, safest and simplest option is to plump out fine lines by injecting them with a temporary hyaluronic dermal filler. "If done carefully this fills in the crack and gives a fantastic effect," he says. "Less is more here, so look for a doctor who offers you a complimentary follow up appointment as part of your treatment," says Mr Pacifico, "It's much better to have to have a little more filler injected rather than over-filling in the first place." The procedure is quick and straightforward. "I might use a little numbing cream beforehand, but modern hyaluronic fillers contain anaesthetic and the needle is very fine, so any discomfort should be minimal."

Deeper folds are caused when the fat in the cheeks sags down to the nasolabial lines and the skin becomes less elastic with age. The result is that the skin and fat appear to droop around the mouth.

Mr Pacifico says, "If the folds are more pronounced an alternative approach to injecting directly into the lines, is to use a thicker filler to restore volume to the cheeks. This pulls up the skin over the cheeks, so smile lines soften or disappear. Again, this needs a subtle approach. Do not be tempted by permanent fillers as they are much more likely to cause complications. Results from fillers can last from six months to a year.

"For folds with overhanging sagging that fillers can't fix, or if you want a more permanent solution, a facelift or mid-facelift is a good approach.  This replaces the cheek tissue into its youthful position and tightens loose skin. It will leave scars in the crease where the ear meets the face, behind the ear and into the hairline. But in the hands of a skilled and experienced surgeon can create a beautiful result."

Last updated Wednesday 7 December 2016

First published on Monday 24 August 2015