The lines around the mouth are among the most age-revealing features on the face — and among the most underappreciated treatment targets. They’re also frequently misunderstood. Smile lines, marionette lines, and lip lines are three distinct types of perioral wrinkling, each with a different anatomical origin and a different optimal treatment.
At Modern Aesthetic Institute in Bakersfield, treating the mouth area well requires matching the right tool to the right problem. Here’s how we think about it.
How to Get Rid of Lines and Wrinkles Around the Mouth
The most effective way to get rid of lines around the mouth depends on whether they appear only when you move your face or stay visible at rest. Most people get the best result from a combination, and a short consultation determines the right mix for you. The main options are:
- Botox or a lip flip to soften dynamic lip lines and perioral wrinkles caused by muscle movement.
- Dermal fillers to restore volume and smooth deeper folds such as nasolabial (smile) lines and marionette lines.
- Sculptra to rebuild your own collagen for gradual, longer-lasting support around the mouth.
- Daily sunscreen and a retinoid to slow new lines from forming between treatments.
Below we break down the three types of lines around the mouth and which treatment fits each, so you know what to expect before your visit.
The Three Types of Lines Around the Mouth
Nasolabial Folds (Smile Lines)
Nasolabial folds run from the outer edges of the nostrils down to the corners of the mouth. Nearly everyone has them — they’re a natural anatomical feature. The question is whether they’re a soft, subtle fold that reads as normal facial structure, or a deep, sharp crease that creates the appearance of heaviness and age.
These folds deepen primarily because of volume loss in the mid-face. As the fat compartments in the cheeks thin and the bone structure shifts over time, the overlying tissue droops, and the fold becomes more pronounced. This is a structural problem — treating it with the wrong tool won’t work.
Best treatment: Dermal filler placed in the mid-cheek to restore volume and lift the tissue, reducing the fold indirectly. Direct injection into the fold itself is sometimes appropriate for fine-tuning, but restoring mid-face structure gives more natural, lasting results.
Marionette Lines
Marionette lines extend downward from the corners of the mouth toward the chin, creating the appearance of a puppet mouth or a downturned expression — even when the face is at rest. They’re caused by a combination of volume loss, skin laxity, and the pull of the depressor anguli oris muscle, which draws the mouth corners down.
This area communicates mood powerfully. Deep marionette lines can make a person appear sad, stern, or exhausted regardless of how they actually feel — which is one of the most common frustrations we hear from patients.
Best treatment: A combination approach. Filler placed along the marionette line restores structure and softens the fold. A small amount of Botox in the depressor anguli oris (the muscle pulling the corners down) can subtly lift the corners. In some cases, filler in the pre-jowl area also helps by supporting the soft tissue above.
Perioral Lines (Lip Lines / “Smoker’s Lines”)
These are the fine vertical lines that radiate outward from the lips — sometimes called smoker’s lines, though they affect non-smokers too. They’re created by the orbicularis oris (the circular muscle surrounding the mouth) contracting repeatedly over decades, combined with the loss of collagen that keeps skin plump between contractions.
Best treatment: Botox in very small doses along the upper lip border relaxes the pursing motion and prevents the skin from folding repeatedly. This is often combined with filler to restore volume and smooth existing lines, and sometimes with topical or energy-based treatments to improve skin texture.
Why Getting This Area Right Matters More Than Most
The mouth area is expressive. We use it constantly — for speaking, eating, laughing, kissing. Overtreat it and the effects are immediately visible: difficulty forming certain sounds, an unnatural upper lip posture, a loss of natural movement. The goal is always to maintain full function and expression while softening what ages the face.
This means the mouth area demands the most conservative, precise approach of any region we treat. At Modern Aesthetic Institute, we use smaller amounts of product in more targeted locations — and we follow up to make sure the result is exactly right before adding more.
What a Consultation for Mouth Lines Looks Like
We start by having you speak and smile naturally, so we can see which muscles are active and how deeply the lines set. We look at the face at rest and in motion. We assess your lip shape, the depth and character of each line type, and your skin quality.
Then we build a treatment plan that addresses the cause of the lines, not just the surface symptom. Most patients need a combination of treatments for the best result — Botox for active muscle components, filler for volume and structure, and potentially skin care or resurfacing for texture.
We walk you through the plan before we do anything, so you understand exactly what we’re recommending and why.
Frequently Asked Questions
Can Botox alone fix my nasolabial folds?
No — and this is an important distinction. Nasolabial folds are primarily caused by volume loss and tissue descent, not by muscle movement. Botox doesn’t address these causes. Filler, placed strategically in the mid-cheek and sometimes along the fold, is the appropriate treatment.
How much filler does it take to treat marionette lines?
It varies significantly by patient and the depth of the lines. A conservative treatment might use 0.5–1 mL per side; more advanced marionette lines may require more, sometimes spread across multiple appointments. We always recommend starting conservatively and building from there rather than treating aggressively in a single session.
Will lip lines ever come back after Botox?
Yes — Botox for lip lines lasts 6–8 weeks, after which the muscle gradually regains movement and lines can return. Many patients find that with regular treatment, the lines become progressively less prominent as the muscle softens over time. Consistent maintenance gives the best long-term result.
Can I combine Botox and filler in the same appointment?
Yes, and we often recommend it for the perioral area. Botox is typically done first, filler second. The two treatments work synergistically — Botox prevents the muscle from undoing what the filler has corrected, and filler addresses the volume component that Botox can’t touch.
I’ve noticed the corners of my mouth turning down. Is that treatable?
This is one of the most impactful and underutilized Botox treatments we offer. A very small amount of Botox in the depressor anguli oris — the muscle that pulls the corners of the mouth downward — can visibly lift the corners and restore a more neutral or slightly upturned mouth posture. Results are subtle but genuinely striking. Most patients say people stop asking if they’re upset or tired.
Is the mouth area painful to inject?
The perioral area is moderately sensitive. We use topical numbing cream before any filler injections in this zone, and fine needles for Botox minimize discomfort. Most patients find the treatment very tolerable.
Book a Consultation
If lines around your mouth have been bothering you — whether they’re smile lines, marionette lines, lip lines, or drooping corners — we want to hear about it. The right treatment plan starts with understanding exactly what’s happening anatomically and matching the solution to the cause.
Modern Aesthetic Institute serves Bakersfield, Kern County, and the surrounding region. Schedule your consultation today and let’s talk about what we can do for you.