POSTED: 5 Jul 2023

The Pros and Cons of Dermal Fillers for Smile Lines & Other Non Surgical Alternatives

Smile lines, also known as nasolabial folds, are the creases that run from the sides of the nose to the corners of the mouth. These lines become more visible as we age due to a decrease in collagen and elastin production, facial volume loss and repetitive facial expressions over time. While these lines are a natural part of skin ageing, a lot of people seek treatments to minimise their appearance for a more youthful look. As always, there are surgical options to treat the smile lines but in this blog post, we will explore the pros and cons of dermal fillers for treating smile lines and discuss some other non surgical alternatives including skincare.

Dermal Fillers for Smile Lines

Dermal fillers are gel-like substances that are injected beneath the skin. They restore volume, smooth out wrinkles, and enhance facial contours. The most common type of dermal fillers used for treating smile lines are hyaluronic acid fillers. This is because they have a long-standing record for safety (they’re dissolvable and temporary) and effectiveness. An experienced medical practitioner such as a doctor can carefully place dermal filler directly in to the smile lines. This softens the folds by smoothing the crevice. Sometimes it can be useful to also place dermal filler in the cheeks. This supports the mid-face region and indirectly lifts and softens the smile lines.

Pros of Dermal Fillers for Smile Lines

When done properly, dermal fillers for smile lines can give a lifted and tighter appearance to the nose to mouth line area. Here are some of the main benefits for using dermal fillers to treat smile lines:

  • Immediate results: one of the biggest advantages of dermal fillers is that they provide instant results. Once the filler is injected, you will usually see an immediate improvement in the appearance of your smile lines. There might however be some bruising or swelling and so you may need to wait for a few weeks to see the final result.
  • Non-surgical: dermal fillers are an excellent non-surgical and minimally invasive option for treating smile lines. This means there is no need for general anaesthesia, cuts or a lengthy recovery period.
  • Customisable treatment: your practitioner can adjust the amount and placement of the filler to address your concerns and achieve your desired results. They can also be done over stages rather than one sitting to fine-tune the outcome. This makes dermal fillers a highly versatile treatment option for smile lines.
  • Temporary and reversible: hyaluronic acid fillers are temporary and can be immediately dissolved if necessary. This offers a level of flexibility and reassurance for anyone worried about committing to a permanent change. Additionally, it makes them much safer as they can be dissolved in the event of an emergency or any side effects.

Cons of Dermal Fillers for Smile Lines

Like any cosmetic treatment, one has to balance the pros with the cons when deciding whether a procedure is best for you. When done by an experienced medical practitioner, dermal fillers enjoy a great safety profile as well as high satisfaction level. That being said, there are still a number of potential negatives you should consider:

  • Cost: while dermal fillers offer impressive results, they can be expensive to maintain if you need a large volume of fillers to achieve your desired solution. This can add up when using standard fillers that usually need to be repeated every 6-8 months to maintain the results. You can reduce the cost and frequency of treatment by opting for longer lasting hyaluronic acid dermal fillers like Juvederm Voluma, Volift or Volux can last up to 12-24 months depending on the filler type and your metabolism.
  • Potential side effects: although dermal fillers are generally safe, they can cause side effects such as redness, swelling, bruising, and in rare cases, infection or filler migration. There are also rare but serious risks like vascular occlusion. This occurs when filler is injected into a blood vessel or compresses the vessels. This can cause tissue death, scarring and even blindness. Its worth noting that these risks are far less in the hands of an experienced and qualified medical practitioner.
  • Results may vary: like any treatment, longevity and effectiveness of dermal fillers can vary depending on your facial structure and metabolism, the type and amount of filler used as well as your practitioner’s skill level.

Non Surgical Alternatives for Treating Smile Lines

Although surgery and non surgical injectables like dermal fillers produce the most dramatic results, there are a number of alternatives that can improve the appearance of nasolabial folds. These treatments improve the quality of the skin and treat signs of skin ageing.

Anti-Ageing Skincare

Over-the-counter retinol and prescription-strength retinoids like Tretinoin can help stimulate collagen production and increase cell-turnover. This can improve the appearance of fine lines and wrinkles, including smile lines. Additionally, regular use of sunscreen, moisturisers and antioxidants like Vitamin C can help prevent further damage to the skin. Whilst these topical treatments won’t eliminate smile lines, they can make them less visible by improving your skin’s hydration, smoothness and elasticity. They will also augment the effect of any other treatment for smile lines enhancing your skin’s quality and appearance.

Skin Boosters

Profhilo and other injectable skin boosters like Volite can help address smile lines by improving overall skin quality. These treatments deliver hyaluronic acid other nutrients through microinjections. Skin boosters revitalise the skin by enhancing hydration and increasing elastin and collagen production. Although they can improve the appearance of mild smile lines, they are most effective when used to complement other treatments. They work especially well with dermal fillers, to smooth smile lines and provide a more youthful, glowing complexion.  

Botox Anti-Wrinkle Injections

Botox, or botulinum toxin, works by temporarily relaxing the muscles responsible for facial expressions. This helps soften the appearance of dynamic wrinkles and lines, such as those around the mouth. While Botox may not directly target the nasolabial folds, they can help reduce the prominence of smile lines by relaxing the muscles that contribute to their formation.

Chemical peels

Generally speaking, chemical peels involve the application of a chemical solution to the skin. This causes the superficial layers of dead skin cells to exfoliate and eventually slough or peel off. This process can help improve the texture and appearance of the skin, including reducing the appearance of smile lines. There is a wide variety of different types of chemical peels and strengths. You will need to see an experienced medical practitioner to determine the best one of your skin and also to reduce the risk of side-effects like scarring, burns or post inflammatory hyperpigmentation. Whilst chemical peels can be effective at targeting mild to moderate lines and wrinkles, they will not work on deep folds. Additionally, you will normally need multiple sessions to get optimal results.


Collagen induction therapy with microneedling is a minimally invasive procedure that involves creating micro-injuries in the skin using tiny needles. This process stimulates collagen production and vascularisation. The end result improves the thickness, elasticity and quality of the skin. This can help reduce the appearance of smile lines over time. Like chemical peels, you will need a course of treatment to achieve optimal results. Like all professional skin treatments, you should only see a qualified and experienced medical practitioner to avoid injuring or damaging your skin.


Radiofrequency devices deliver heat energy to the deeper layers of the skin. This promotes collagen production which results in skin tightening and thickening. Radiofrequency can also be combined with microneedling (known as RF microneedling) which furthers enhance its effects. This non surgical treatment can help reduce the appearance of smile lines over time. However, you will need multiple sessions for optimal results. Like with the previous treatments, you will need to see a medical practitioner to reduce the risk of side-effects.


Non-ablative fractional lasers can target the deeper layers of your skin to stimulate collagen production. They however leave the surface of the skin intact which reduces down-time. This is a non-invasive treatment that can help improve the appearance of smile lines over time. Like with all professional treatments, results are nit instant and require multiple sessions for best results. Again, you should see a qualified and experienced practitioner to ensure that they perform the treatment properly and reduce risk of skin damage.

As you can see, dermal fillers offer an effective, non surgical solution for treating smile lines. They can provide immediate results. They’re also customisable to tailor the treatment to your individual needs. However, the cost, potential side effects and temporary nature of the results may be off-putting for a lot of people.

Alternative professional treatments like skin boosters, Botox, chemical peels, microneedling, radiofrequency and laser can also help improve the appearance of smile lines. However, they are also not cheap and may require multiple sessions to achieve optimal results. Topical treatments like retinoids will not get rid of these lines but can significantly reduce their appearance by improving the overall quality of your skin. Ultimately, the best treatment depends on your needs, skin goals and personal preferences. When considering which treatment option is right for you, it’s vital to consult with a qualified practitioner. They can evaluate your individual needs and recommend the most appropriate course of action.

Are you interested in anti-ageing skincare? Check-out our doctor-led prescription skincare service. Our doctors will create a personalised treatment plan for you using prescription-strength products like Tretinoin delivered straight to your home. Your doctor will monitor your progress and give on-going support. We do this to ensure that you get the most out of your treatment. Book your online consultation to take your first step towards better skin.


Authored by:

Dr Amel Ibrahim
Aesthetic Doctor & Medical Director
Founder City Skin Clinic
Member of the Royal College of Surgeons of England
Associate Member of British Association of Body Sculpting GMC Registered - 7049611

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