Smiling is the greatest gift you can give to another human.

But we know that there are many of you out there that are incredibly conscious about showing those pearly whites!

My lips disappear when I smile. My gums show when I smile

I hate those fold at the side of my mouth when I smile. I don’t like my wonky smile. I look like I’m sad but I’m not.

A lot of clients visit us with the above concerns and we can happily provide them with a simple solution using fillers and/or muscle relaxants.

We asked Jean Charles, Clinical Manager & Jasmine, Cosmetic Nurse Injector to discuss possible solutions for the above listed concerns:

My lips disappear when I smile
The disappearance of the upper lip whilst smiling is not necessarily due to the lack of volume in the upper lip.
A thin upper lip may not help with the fact that the lip disappears, but it is quite often due to the muscles around the mouth.

Some muscles might be too strong, which would cause curling of the upper lip inwards or/and lift the upper lip showing too much gum.

The (lazy) short cut option would be to address this issue with adding ever more filler in the upper lip, instead of relaxing the strong muscles causing the curling of the upper lip inwards. But too much filler might not give the desired cosmetic outcome and the patient may risk to have too much projection of the upper forwards and/or upwards, with the risk of ending up looking like Marge Simpson.

On the other hand, choosing to relax the over active muscles causing the lip to disappear, might be a simpler and cheaper option by just having a muscle relaxant injection. Although, this treatment has its limits.

We cannot relax the muscles completely as the muscles around the mouth have a cosmetic function along with a functional purpose (action of pursing the lips). Therefore a low dosage might mean a shorter duration of the desired outcome.

The best option is to discuss this with your physician, who will assess your muscles strength, smile pattern and lip volume.

A holistic approach would be to relax the appropriate muscle (if required) and add some lip volume (if required) as a combined treatment to ensure a natural look.

My gums show when I smile
Everyone has a different smile pattern, showing more or less of their upper teeth and/or lower teeth.
“Hollywood smile”: showing upper and lower teeth when smiling. Barack Obama
“Mona Lisa” smile: not showing much teeth at all.
“Gummy smile” showing upper teeth and gum

These different patterns are caused by all of the different muscles attached around the mouth, pulling both upper and lower lips in different directions and with more or less strength.

Some Hyper active muscles (running along the nose and often causing bunny lines) would cause having a gummy smile. These muscles are pulling the upper lip too high when smiling.
Sometimes, we may have a crooked smile naturally, because one of our muscle is pulling more on one side.

Crooked smiles may be also caused after having a muscle relaxant treatment (side effects) if injected into the incorrect muscle. Or a crooked smile may result subsequent to muscle relaxant treatment. This is a side effect if injection into the incorrect muscle.

I hate those fold at the side of my mouth when I smile
Accordion lines are caused from the smiling muscles. These could be non-existent or very subtle when we are young however, can become more noticeable and severe as your skin ages and loses its natural collagen support.  

Treatment with dermal fillers could be a “quick fix” / “band-aid” solution, to hydrate the skin and add extra support. But dermal filler treatment outcomes are limited to treat accordion lines, before we go too far by placing too much filler. The risk is to increase the skin volume in that treated area giving too much heaviness.

It is better to “turn back the clock” and rejuvenate the tissues/skin by producing more collagen production in the weak area. Treatments such as DermaPen and Laser treatments (even better when combining them) would repair the skin. The skin will become stronger, avoiding the skin to collapse when smiling.

I don’t like my wonky smile
One muscle around the mouth might be stronger on one side. We could relax the mirrored muscle across on the other side of the mouth to match the other. However, the overall look might not be aesthetically pleasing.

Best not to try to relax and leave it as it is. Although it is possible to play with it still. Quite an art! The use of some filler in the lip could be an option to adjust the symmetry.

Again, it would depend of the smile pattern and what the physician would decide as the best treatment option or if it is better not to treat.

I look like I’m sad but I’m not
Two factors could give the impression of a “downturn” mouth. even more pulling down of the corner of the mouth in an addition of the DAO.

At around the age of 40, we start to show early shadowing in the corner of the mouth (called modiolus) due to soft tissue laxity in the mid face, and/or volume loss in the mid face causing the skin to roll over the mandibular cutaneous ligament (causing marionette folds in older patients). We also may lose volume in the corner of the mouth.

In an addition, we have a combined muscle groups pulling the modiolus of the mouth (corner of the mouth) down. DAO (Depressor Anguli Oris) is pulling the mouth down. Some people may use this facial expression as a habit, which needs to be stopped by having repeat treatments of muscle relaxants.

A second muscle would also increase even more the pulling down of the corner of the mouth in an addition of the DAO. The platysma neck bands can add an extra pulling of the corner of the mouth.

For optimal treatment outcomes, it is best to combine the DAO & Platysma band (if strong) to ensure a good result and a good treatment longevity.

For a cosmetic consultation with one of our experienced cosmetic injectors:
Call: 02 8897 0000
Email: [email protected]

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