Botox for Smile Lines: Where It Helps and Where It Doesn’t

Smile lines tell a story. They mark laughter, conversation, and time spent outdoors. They also show up in different ways, and not every line responds to the same treatment. That is why people get mixed results when they try cosmetic botox for the folds running from the sides of the nose to the corners of the mouth. Some lines soften beautifully with neuromodulator injections. Others barely budge because the cause is not muscle overactivity at all.

After years of evaluating faces in a mirror and under bright clinic lights, I have learned to separate what botox does best from what it cannot do. If you are weighing a botox appointment to treat smile lines, understanding this divide saves money, prevents odd results, and points you toward the right plan.
What we call “smile lines” is not one problem
Three patterns commonly get bundled under the phrase smile lines, and they behave differently with botulinum toxin injections.

First, dynamic wrinkles etched by a specific muscle. These are the fine crinkles at the outer corners of the eyes, known as crow’s feet, and the “bunny lines” across the upper nose. They deepen when you grin or squint and fade when your face is at rest. These are classic targets for botox cosmetic because they come from muscles pulling the skin.

Second, marionette lines and nasolabial folds. These are the grooves that run from the nose to the mouth and from the mouth down toward the chin. They have a structural component. Over time, bone resorption, fat pad descent, and skin laxity create folds, while repeated expression exaggerates them. They do not respond strongly to botox because they are not primarily muscle driven.

Third, perioral fine lines and a gummy smile. Vertical lip lines, sometimes called smoker’s lines, and the lift of the upper lip that exposes gums both have muscular influence. They can be refined using precise, low dose facial botox but require caution to keep speech and smile natural.

Sorting these patterns during a botox consultation is the first step. I ask patients to exaggerate expressions and then fully relax. If a line melts away at rest, botox is in the conversation. If a fold remains fixed, we plan around volume, skin quality, and support.
Where botox excels around the smile
Crow’s feet are the poster child for wrinkle relaxing injections. The orbicularis oculi muscle contracts with smiling and squinting. Botox face treatment here softens radiating lines while preserving cheek movement and brightness. Done well, your eyes look fresher without that frozen crescent. Doses range widely based on gender, muscle strength, and prior treatments. Many women do well in the 8 to 12 unit range per side, while some men require more. Expect results in 3 to 7 days, with peak smoothing at two weeks and a three to four month duration.

Bunny lines respond to a couple of micro injections on either side of the nasal bridge. The upper nasalis muscle drives those diagonal creases that appear when you laugh. Two to six units total often do the trick. It is quick, and when combined with crow’s feet, it creates a balanced upper face botox result.

A gummy smile can be quietly corrected by relaxing the levator labii superioris alaeque nasi and neighboring elevators that pull the upper lip high. We use botox micro injections near the alar base and, in select faces, near the philtral columns. The goal is small - usually 2 to 4 units per side. Too much product risks a heavy lip or altered diction. When calibrated correctly, the tooth-to-gum ratio looks natural and the smile remains lively.

Chin dimpling and an orange peel look around the chin come from an overactive mentalis muscle. Facial muscle relaxing injections here smooth the texture and, when needed, can also help with a mild upward curl of the chin that shortens the lower face. Many patients pair this with subtle filler along the labiomental crease to improve the contour.

DAO relaxation for downturned mouth corners is subtle but meaningful. A careful, low dose botulinum toxin treatment to the depressor anguli oris can lift the oral commissures a millimeter or two. On the right face, that small lift changes a tired look into something more neutral. This is a technique for experienced injectors, because misplacing product can affect the smile.

Together, these focused moves deliver a gentle refresh. They are not a face overhaul, and that is the point. Natural looking botox keeps expression, tempers the most distracting lines, and carries minimal downtime.
Where botox does very little
Nasolabial folds are the number one area where people hope for botox results but need something else. These folds develop largely because of midface volume loss and ligamentous tethering. Smile and speech do deepen them, but the fold lives there even when you are expressionless. Softening comes from structural work: hyaluronic acid filler strategically placed in the midface, lateral cheek, and occasionally in the fold itself, plus skin quality improvements such as biostimulatory treatments or energy devices. I rarely use botulinum toxin cosmetic here, and when I do, it is to help with nearby muscles that exaggerate movement, not to fill the fold.

Marionette lines and prejowl grooves behave similarly. If you add botox in the lower face indiscriminately, you can weaken smile function before you ever alter a stubborn sag at the jawline. For these areas, I rely on a mix of filler for support, skin tightening where appropriate, and lifestyle measures that protect collagen.

Static etched lines on the upper lip also resist neuromodulator injections alone. Botox for lip lines helps when the lips pucker sharply and lines are dynamic, but if sun damage and collagen loss have carved in fine creases, better results come from fractional laser, microneedling with radiofrequency, resurfacing peels, or microdroplet filler under strict control.
The balance between movement and structure
Botox works by relaxing targeted muscles that create expression lines. Think of it as an off switch for repetitive creasing. Filler and lifting procedures, by contrast, rebuild contour and support. A pleasing lower face often needs both: relax overactive pullers, then add scaffolding where time has taken it away.

When a patient points at a deep nasolabial fold and asks for botox results, I test cause and effect in the mirror. I have them smile widely, then relax. If the fold collapses by half at rest, volume and skin work lead. If the fold is faint at rest but streaks appear with grin, a small amount of botox around the nose may be justified, knowing it will not erase the fold but can soften the crinkle above it. That kind of distinction prevents disappointment.
Dosing, placement, and why experience matters
The lower face speaks, eats, and emotes all day. It tolerates far less botulinum toxin than the forehead or crow’s feet. A certified botox provider will underdose first, reassess at two weeks, and adjust with precision botox treatment rather than chase quick changes. We measure in units, but the art lies in drop placement and depth.

A few examples from typical treatment plans help illustrate the nuance. For crow’s feet, we fan injections along the orbital rim, staying superficial to avoid eye heaviness and spacing out points to reduce spread. For bunny lines, we place small aliquots into the upper nasalis, keeping away from the levator labii to avoid a flat upper lip. For a gummy smile, we find the midline smile elevator junctions and use tiny doses to restrain, not erase. For DAO relaxation, we palpate the muscle while the patient smiles, then inject laterally to avoid diffusion into the depressor labii inferioris which would distort lower lip movement. Every face is different, and even small anatomical variations change the plan.

Re-treatment windows vary. Most patients return every 3 to 4 months for maintenance. Some metabolize faster and come in closer to 10 or 12 weeks. Others stretch to five months. Baby botox, with intentionally low dosing, can be repeated more frequently or maintained as part of a preventative botox approach for those in their 20s and 30s who crease but have not etched lines yet.
Safety and the limits of subtlety
Botox remains one of the safest aesthetic injections when performed by a licensed botox injector using medical grade botox in a proper clinic setting. Risks still exist. The most common issues are pinpoint bruising and temporary tenderness. Less common problems include brow or eyelid heaviness if the forehead or crow’s feet are mismanaged, asymmetry in the smile if lower face injections migrate, and a feeling of weakness that lasts until the product wears off. Rare reactions, such as headache or flu-like symptoms, resolve in a few days.

The bigger risk from overzealous lower face botox is social. We read micro movements around the mouth. If those motions are dulled, the face can look flat. I would rather leave a trace of a line than erase too much warmth. Subtle botox results win in real life.
What a thoughtful plan can look like
A patient in her late thirties visits the botox clinic asking for help with smile lines. She points to crow’s feet and nasolabial folds. On exam, the crow’s feet are active and fan into the cheek. The nasolabial folds persist at rest, especially near the alar base. Her skin has mild sun damage and early collagen thinning. We design a customized botox treatment: 8 units per side for crow’s feet, 2 units per side for bunny lines, and a conservative 2 units per side for a gummy smile component. No botox to the folds. Two weeks later, she returns brighter around the eyes and without the nasal scrunch. The folds still show, so we add a small amount of hyaluronic acid filler to the midface, not the fold itself, to lift the cheek and ease the fold naturally. A month later, she looks rested, and the smile reads as fully hers.

Another case, a man in his mid forties with deep crow’s feet and chin dimpling. We treat crow’s feet with 12 units per side and the mentalis with 6 to 8 units total. He keeps masculine movement but loses the pebbled chin that made him look tense. He does not need nasolabial fold work yet, only sunscreen and a plan for skin rejuvenation botox paired with a resurfacing treatment later in the year.
Botox is not a one-size-fits-all tool
Patients often ask about full face botox or upper face botox packages. Bundles can make scheduling easier, but good care remains personal. Expression maps vary. One person overuses the frontalis and needs forehead wrinkle injections and a tiny botox brow lift to keep lids open. Another hardly moves the brow but crinkles fiercely around the nose. A blanket number of units does not serve either face.

The same applies to preventative botox. If you barely crease at rest, one or two targeted sessions per year may be enough. If you have strong frown lines or a tendency to squint outdoors, more regular wrinkle prevention injections make sense. A skilled injector will calibrate based on your goals, anatomy, and how long lasting botox results matter to your lifestyle and budget.
What to expect on treatment day
A typical botox session for smile related concerns takes 10 to 20 minutes. We clean the skin, mark points if needed, and use a small-gauge needle for micro injections. Most patients describe quick pinches rather than pain. Makeup can usually go back on after a gentle wipe. I advise avoiding heavy workouts, face-down massage, or tight goggles for the rest of the day to reduce unwanted product spread.

Bruising risk sits around a few percent, higher if you take fish oil, aspirin, or other blood thinners. Ice helps. Plan your botox appointment at least two weeks ahead of photography or events to allow for fine tuning.
Cost and value, with realistic ranges
Botox pricing varies by region, injector experience, and whether you pay per unit or per area. In many metropolitan areas, the per-unit fee ranges from 10 to 20 dollars. Crow’s feet often require 16 to 24 units total. Bunny lines may take 2 to 6 units. A gummy smile adjustment may take 4 to 8 units. That puts typical treatment costs between a few hundred and several hundred dollars, compared to filler which tends to cost more per session but can last longer in structural areas.

The most cost-effective strategy is not to chase lines that botox cannot fix. If your main concern is a deep nasolabial fold at rest, direct your budget to filler or skin tightening and use botox for crow’s feet or perioral balance. When the right tool meets the right problem, value shows in the mirror.
When to combine treatments
Blending modalities often gives the best outcome for smile-adjacent aging. Aesthetic injections pair well with energy devices and skincare. If you use botox for crow’s feet, consider adding a fractional laser or microneedling series once or twice per year to thicken the dermis in the cheek extension of that area. If vertical lip lines persist after light botox for lip lines, a microdroplet filler technique or a light resurfacing peel can finish the job. If the lower face sags despite DAO relaxation, evaluate for filler along the jawline or, in certain cases, masseter botox for jaw slimming that softens bulk in a square jaw. Masseter treatment does not fix folds, but it refines face shape in someone with hypertrophic chewing muscles. Each addition should have a clear purpose, not just pad a package.
Maintenance without overdoing it
The temptation with smooth results is to return early. Resist that urge. Your skin St Johns FL botox https://newbeautycompany.com/services/botox/ benefits from cycles of movement and rest. After a stable baseline is reached, I recommend spacing visits to maintain function. Most patients thrive on three or four visits per year. If you prefer ultra subtle changes, baby botox every three months can preserve expression while keeping lines at bay. If you are new to neuromodulators, start conservative and build. Photos help track botox before and after differences that your eye misses day to day.

Support your investment with sunscreen, topical retinol or retinaldehyde, and habits that protect collagen. No injectable outperforms daily SPF. Hydration, sleep, and a balanced diet matter too, not for a miracle, but for skin that holds results longer.
Red flags and how to choose an injector
Credentials and communication matter more than a trendy offer. Seek an injector who performs a full facial assessment, not a quick “how many units” exchange. They should explain why botox helps your crow’s feet yet will not erase a nasolabial fold. They should review risks, set expectations, and schedule a two week follow-up. If every line is met with botox alone, or if lower face dosing sounds aggressive, consider another opinion.

Here is a short checklist many of my patients now use:
Ask whether your smile lines are dynamic, static, or structural. Your plan should change based on the answer. Confirm that only medical grade botox or an FDA-cleared neuromodulator will be used, and that it is freshly reconstituted. Review a map of injection points and expected unit ranges before the needle touches skin. Schedule a two week review to address asymmetry or fine tuning. Discuss alternatives for folds at rest, such as filler, energy devices, or resurfacing, rather than adding more botox. The truth about natural results
People worry about looking frozen. That fear is valid if the wrong product is used in the wrong place. Natural looking botox does not silence the face. It quiets the loudest creases at the right moments. If you still smile fully, squint a bit in bright sun, and recognize yourself from all angles, the balance is right.

Patients who get the most compliments often choose targeted botox results and leave some lines untouched. A hint of crow’s feet when you laugh reads as warmth. Zero movement across the lower face can look uncanny. The art lives in restraint and in the conversation between injector and patient about what feels like you.
Bottom line, line by line Crow’s feet and bunny lines are excellent candidates for wrinkle relaxing therapy. Expect reliable softening with quick recovery. A gummy smile and chin dimpling improve with small, precise doses. Preservation of function is the priority. Nasolabial folds and marionette lines are not botox problems. Treat structure with filler and skin therapies. Lower face botox demands expertise. Start low, reassess, and avoid heavy dosing that flattens expression. Maintenance beats makeover. Personalize intervals and combine treatments only when each has a clear role.
Botox is a precise instrument in the right hands. Use it to ease dynamic wrinkles that shout when you smile, not to fight folds that need support. With that mindset, you will spend wisely, protect your natural expression, and see steady, believable changes from one botox session to the next.