Smile lines (nasolabial folds) deepen when two things happen at once: the tissue above them sags with gravity, and the area just inside the fold hollows out as collagen is lost. Here’s how a combined approach works—lifting for the sagging, and filler or a skin booster for the hollowing.
Hi, this is DAYONE Clinic. Have you ever caught your reflection and felt your heart sink—“Wow, I really am getting older”? Here’s the thing: the biggest reason a face looks older often isn’t crow’s feet or gray hair. In many cases, it’s the smile lines that run from the sides of the nose down to the corners of the mouth.
Because smile lines have such a big effect on your overall look, today we’ll start by explaining exactly why they form.
What really causes smile lines
Smile lines don’t have just one cause. Two main factors are at work at the same time.
Sagging—With age, gravity gradually pulls the skin and tissue that once sat higher on the face downward.
Volume loss—At the same time, certain areas lose collagen and begin to hollow out.
The area just inside the smile line, from beside the nose down to the mouth, is one of the spots most prone to hollowing. As the tissue above sags under gravity and the fold area below sinks, the gap between the two widens—and that gap is what makes the crease look deeper and deeper.
It would be nice if the tissue that sags could simply move into the spots that hollow out. Unfortunately, aging doesn’t work that way—some areas keep hollowing while others keep sagging.
Sagging and volume loss need different fixes
Once you understand these two causes, the way to treat them becomes clear.
Sagging → needs lifting
Sagging tissue needs to be lifted structurally, and the go-to options are lifting treatments like a thread lift or Ultherapy. But there’s one important caveat. If you don’t have much facial fat and it’s mainly the skin itself that has sagged, a thread lift alone may be enough. If you have more facial fat, it’s a different story.
Think of a clothesline: dry laundry barely makes it dip, but wet laundry drags it down with its weight. Faces work the same way. If you have more facial fat, lightening that load first and then doing a thread lift leads to a more effective result. In these cases, we first reduce volume with Ultherapy or fat-dissolving injections, then add a thread lift.
Volume loss → needs filling
Hollowed areas must also be treated with something that restores volume. The main options are filler in the smile lines and collagen-stimulating skin boosters such as Sculptra.
Pairing a thread lift with filler has another advantage. Once the thread lift has done some of the correcting, the area that looked deep no longer looks as deep, so even a small amount of filler can be enough.
The bottom line
Smile lines aren’t just a sagging problem, and they aren’t just a volume-loss problem. Because the two work together, each cause needs to be treated with the right procedure, in combination, to get a natural, satisfying result.
In our next post, we’ll look at how to deal with the fine lines that can linger even after a thread lift and filler. If you have questions, feel free to reach out to DAYONE Clinic near Gangnam Station anytime.
This post is based on an interview from DAYONE Clinic’s YouTube channel, Face Design Lab.
This article is general information about the treatment and does not replace an individual diagnosis or treatment plan. Results and their duration vary from person to person.
Wondering what would suit you?
Whether a treatment suits you, and how to plan it, is best decided with a doctor.