Facial Ageing
Creases around the mouth, from the nose to the mouth corners and from the mouth toward the chin, that deepen with movement, volume change, and tissue descent.
Physician-led assessment · individualized care · Vancouver clinic
Understanding Smile Lines and Marionette Lines
The folds around the mouth are among the most misunderstood targets in facial ageing, because the instinct, to fill the line, is usually the wrong one. Nasolabial and marionette folds form where mobile tissue meets fixed tissue, and they deepen not mainly because the line itself has changed but because the cheek above has deflated and descended, leaving the fold with less behind it. That is why the most natural results often come from restoring fullness higher up rather than injecting the crease directly, and why over-filling a fold reads as heaviness rather than youth. Reading the whole midface, not the line in isolation, is the difference between refreshed and overdone.
Related Presentations
These focused pages explain different patterns within this concern.
Causes and Contributing Factors
These folds form where mobile tissue around the mouth meets more fixed tissue, so they naturally deepen with years of normal expression. Age-related loss of collagen and skin elasticity, reduction and downward shift of cheek fat, loosening of facial ligaments, and loss of bone around the midface and jaw all contribute. Sun exposure, smoking, sleeping position, and significant weight change can add to the effect. Genetics and facial shape strongly influence how prominent the lines become and when.
Signs and Symptoms
Assessment
A clinician usually looks beyond the line itself, considering cheek volume and position, skin quality, tissue descent, the balance of the midface and jawline, and how the folds change with expression. This helps clarify whether the fold is driven mainly by lost fullness above it, by tissue settling, or by the skin crease itself, which influences which approaches are sensible.
Treatment Options
These are some of the options connected to this concern. The appropriate plan depends on assessment, suitability, and your goals.
Because these folds are shaped by the surrounding structure, management often begins with restoring midface and jawline structure rather than filling the crease directly, which tends to look more natural. Clinics commonly discuss options such as injectable volume restoration to the cheek or fold, treatments aimed at skin quality, and, for some, thread-based reinforcement; muscle-relaxing injections may play a limited role for certain contributors. Results vary between individuals, are generally temporary, and depend on the underlying anatomy. A physician-led consultation helps pin down the main driver and set realistic expectations.
There is rarely one right answer here; the natural result usually comes from treating the underlying structure rather than the visible line, and often from combining approaches. That is what a consultation is for: an unhurried assessment, a candid account of what each option can and cannot do, and a reasoned plan with realistic expectations and no obligation.
Uses botulinum toxin type A to temporarily relax selected muscles, softening dynamic lines and helping certain muscle- or sweat-related concerns.
Uses injectable fillers to restore or reshape facial volume and contour, selected for the structure and balance each area needs.
Places small amounts of injectable hydrating or regenerative product within the skin to help quality, hydration and smoothness rather than to add volume.
Uses absorbable barbed threads to reposition and lift facial tissue, with a gradual collagen build as the threads absorb.
For the fuller picture, explore the treatment pages above or discuss the options during a consultation.
Medical Assessment
These folds are not usually a medical concern, but assessment is important if you notice new one-sided drooping or weakness of the face, an inability to move part of the face, sudden asymmetry, or a lump or skin change near the fold. Such features suggest something other than ordinary aging and should be assessed promptly.
Frequently Asked Questions
Smile lines, or nasolabial folds, run from the sides of the nose to the corners of the mouth, while marionette lines run from the mouth corners down toward the chin. They are related and often occur together, and a clinical assessment can clarify which is more prominent and what is contributing.
These folds are often deepened by loss of support in the cheek and midface above them. Restoring that fullness can soften the fold more naturally than filling the crease directly, which risks an over-filled look. What is most appropriate depends on your anatomy and should be discussed during a consultation.
Because these folds reflect normal facial movement and structure, they usually can be softened rather than erased entirely. Treatment results vary between individuals and are generally temporary. A clinician can help you gauge what degree of change is realistic for you.
Not necessarily. Some degree of these folds is normal at any adult age and is strongly influenced by genetics and facial shape, not only by how you have aged. If you are concerned about the pace of change, a clinician can review the contributing factors with you.
Physician Assessment
An assessment can help clarify what may be contributing, which options may be appropriate, and what a reasonable next step could look like for you.
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Anti-Aging Medical & Laser Clinic combines medical assessment, individualized planning, physician oversight, and a broad range of treatment options in its Vancouver clinic.
Bring your questions, treatment history, and goals. Your provider can help you understand appropriate options, expected recovery, and realistic outcomes.
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